Friday, June 22, 2012

Mental Health Industry, 2. Mentally Ill, 0.

In New York State the battle to improve care for people with serious mental illness has become increasingly polarized. On the one side, favoring improved care for people with serious mental illness are families of the mentally ill, people with serious mental illness, law enforcement, and the general public. On the other side, is the New York State community-based mental health industry, funded by the New York State Office of Mental Health.

The community-based mental health system won two victories. Earlier this year, they won the battle to close state psychiatric hospitals which only serve the seriously ill. Last week, they had their second success: They preserved cracks in Kendra’s Law that allow them to deny services to people with serious mental illness.

The Kendra’s Law Improvement Act had been proposed by Assembly member Aileen Gunther and State Senator Young. It would have improved the information flow so local mental hygiene directors were made aware of involuntarily committed psychiatric patients and mentally ill prisoners who were being discharged to their jurisdictions. That would have allowed mental health directors to triage the individuals to see they get the right voluntary or Kendra’s Law care to enable them to function in the community.

The mental health directors vigorously opposed Kendra's Law and they were joined by mental health trade associations who feared that if new people with serious mental illness were identified, they would have to treat them rather than being allowed to offload to jails, prisons shelters and morgues. (There are more mentally ill in a single NY jail, Riker’s Island, than all state psychiatric hospitals combined. The opposition to treatment was led by NYAPRS a trade association that has now moved on to lobbying for less medical care for people with serious mental illness (NYAPRS only provides non-medical care).

 As a result of this ‘victory’
  •  Involuntarily committed patients will continue to be released into the community without treatment 
  • Mentally Ill prisoners will continue to be released into the community without treatment 
  • Officials will be allowed to continue to ignore reports of mentally ill persons when those reports come from families 
  • Individuals who do well in Kendra’s Law, will continue to be able to get out from under the court order merely by moving to a different county 
  • Individuals who do well in Kendra’s Law will continue to have their orders expire without a review of whether that is safe or not. 
  • We will have more incidents of violence by and to individuals with serious mental illness like the 90 Preventable Tragedies that might have been prevented had the cracks been closed.
Perhaps Vanessa Bellucci said it best. Her mentally ill brother killed both their parents and that gave her the unique ability to see the issue from both perspectives: the perpetrator's and victim's. In an op-ed she wrote:
As a result of the cracks in Kendra’s Law, my parents are dead and my brother remains in prison, adjudged as being incompetent to stand trial. Perhaps with the proper support from the mental-health system, this all could have been avoided and I could have had parents to give me away at my wedding next year, and my nephew could have had his uncle and grandparents around to watch him grow up. It’s too late for my family, but not too late for others.
The law sunsets in two years. Advocates for improved care will be back to improve Kendra's Law and the community mental health system will come back and defend the status quo.

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