NYAPRS Note: A group of NYS mental health advocates pushed back yesterday against outrageous media depictions they say inaccurately and unjustly vilify Americans with mental health needs. They also supported an acceleration of state health/behavioral healthcare reforms that are making services much more active, accountable, coordinated and outcome focused and are already showing very promising results in expanding preventive measures that are reducing avoidable relapses and readmissions.
Key elements to these reforms include expanded outreach and engagement, widespread use of peer counselors and improved access to housing. They also urged the adoption of several new initiatives, including the creation of state/local Incident Review Panels to investigate and make recommendations upon review of tragic incidents involving people with psychiatric conditions.
NY Advocates Say Mentally Ill Are Maligned
Associated Press January 4, 2013
ALBANY, N.Y. - Advocates say the mentally ill are far more likely to be victims of violence than to be attackers, faulting media reports and gun rights interests for perpetuating inaccurate stigmas following recent crimes, including the Connecticut school shootings by a reportedly troubled 20-year-old.
Harvey Rosenthal, executive director of the New York Association of Rehabilitation Services, says referring to the mentally ill with phrases like "violent psychotics" and "monsters" vilifies one-fifth of Americans who have various psychiatric disabilities.
He says defamatory media will shame and deter many from seeking help, though most can substantially recover from disabling conditions with personalized services.
He and other advocates said Thursday recent emphasis on 24-hour emergency phone lines, peer support, housing, family services, managed care and outreach are showing results.
Better Care Sought For Mentally Ill
After Shootings, Advocates Push Back For Reforms
By Jessica Bakeman Gannett News Service January 3, 2013
ALBANY - Psychiatric health advocates called for better care and more public education about mental illness Thursday in the wake of recent fatal shootings.
Treatment of mentally ill people, as well as gun control, has come to the forefront of national attention after a gunman last month killed 27 people, mostly children, and himself in Newtown, Conn. Also in December, a man killed two firefighters in Webster, N.Y., as they responded to a blaze.
Statewide groups at the news conference near the Capitol referenced news coverage of the murders that has labeled mentally ill people as “crazies,” “monsters” and “lunatics.” They cited research that shows most mentally ill people are not violent and are more likely to be victims of crime.
“We’re not only horrified about these deaths and tragedies, but we’re horrified at recent statements and media coverage that has rushed to judgment, viciously attacked people with mental illnesses here in New York and around the country,” said Harvey Rosenthal, executive director of the state Association of Psychiatric Rehabilitation Services. “This is scapegoat-ism - the worst kind. It amounts to a virtual public lynching.”
The groups lauded steps Gov. Andrew Cuomo and the Legislature have taken to move institutionalized patients to more integrated or community settings, as required by federal law. But there is more work to do, Rosenthal said.
Glenn Liebman, CEO of the state’s Mental Health Association, said New York should allocate funds for further treatment and support of mentally ill people in their communities rather than in state hospitals.
Cuomo’s Medicaid Redesign Team, which he formed last January to identify savings in the expensive program, recommended state support for housing and health homes, which are affordable-living environments where people can get physical and mental health care, substance-abuse treatment and employment counseling. The aim is to to improve health outcomes and save money spent on expensive emergency care.
The state has asked the federal government to reinvest some of the money the group saved to improve Medicaid in New York. Also, Cuomo issued an executive order early last month creating a cabinet to enforce a federal law that aims to prevent disabled people from being segregated from the general population.
Cuomo is expected to propose tougher gun-control measures in response to the shootings. He said mental health needs to be a component of any change.
“We think this is a multifaceted problem. And it’s not just guns. This is also about mental health. This is also about a culture of violence that has been permeated and perpetuating,” Cuomo said Wednesday.
Rosenthal said Cuomo is making progress in improving care for New York’s mentally ill population. “We are really hoping he will accelerate his own reforms,” Rosenthal said.
Liebman also called for increased support for families of those with mental illness, publicizing of local 24-hour help lines and more aggressive preventive efforts, including suicide-prevention and mental health education in schools.
The groups also urged New York lawmakers to reject expanding Kendra’s Law. Named for Kendra Webdale, who was killed when a man with schizophrenia pushed her onto subway tracks in New York City, the 1999 law lets courts order mentally ill people with histories of violence into outpatient treatment. An amendment some groups pushed for last year would require jails to notify mental health officials when an inmate set to be released had been taking psychiatric medication. This would increase the number of people covered under the law.
Similar subway murders recently have re-energized the push to strengthen the law. “By strengthening the law, we can improve care, save money and increase safety,” Sen. Catharine Young, R-Olean, said this month. “We need to be more proactive in getting people the help that they so desperately need.”
Rosenthal said forcing treatment on ill individuals is not as effective as deploying peer counselors to work one-on-one with them in their own communities.
“You hear a lot about - let’s have Kendra’s Law at the point of release from hospital to community,” he said. “Why not have a peer wellness coach out there working with people? That’s a relationship that’s going to last.”
Mental Health Community Fears Stigma
by Rick Karlin Albany Times Union January 3, 2013
Those in New York’s mental health community, ranging from peer counselors to advocates, said they knew as soon as news of last month’s Newtown Conn., killings erupted that a new round of stigmatization would start.
References to “ticking time bombs,” or images of lunatics on the loose, even tabloid headlines, including one which referenced a housing plan - “Here come the crazies.”
“Whenever there is a tragedy we shudder,” said Harvey Rosenthal, of the state Association of Psychiatric Rehabilitation Services. Of course, those with mental illnesses share the same grief and horror that strikes other Americans, but they can feel singled out, due to the mental illness tags that are pinned on killers like Adam Lanza of Newtown or William Spengler, of Webster N.Y. who ambushed firefighters before shooting himself.
Rosenthal and others stressed that there is lots of evidence showing those with mental illnesses aren’t any more dangerous than the general population and in fact they are 11 times more likely to be victims of violence themselves.
Yet he feared that post-Newtown, they might see a rash of efforts that could have the effect of taking freedoms away from the mentally ill, and reversing the decades-long trend in which those with mental illnesses have been de-institutionalized and allowed, with support, to live independent lives.
There have been some calls for this, most notably with western New York Sen. Cathy Young to expand Kendra’s Law, the 1999 measure that mandates people get court ordered treatment if they are deemed a safety threat.
Mostly though, Rosenthal and others decried the casual references in the media and in other venues to mentally ill people are dangerous or threats.
Instead of focusing on such negatives, Rosenthal said they wanted to highlight and promote policies that are helping the mentally ill, including moves by the Cuomo Administration and managed care programs to provide more peer counseling and other forms of assistance to people who can live safely outside of institutions but may need a bit of help.
“We do and can recover (from mental illness),” said Coleen Mimnagh, a downstate peer counselor for those with mental illnesses.
Worries Of Fallout For Mentally Ill
At Forum, Advocates Fear School Massacre In Newtown Will Lead To Stigmatization In New York
By Rick Karlin Albany Times Union January 3, 2013
ALBANY - When Katheryn Cascio first heard about last month's tragic massacre in Newtown, Conn., she, like the rest of the nation, was horrified and shocked.
She also worried about fallout for the thousands of mentally ill New Yorkers who pose no danger but would likely be stigmatized by the tragedy.
"My heart sank," said Cascio, who describes herself as a survivor of the mental health system who now helps others with psychiatric illnesses.
"I could see the headlines already," she said.
Indeed, headlines and media reports included a barrage of descriptions of Newtown killer Adam Lanza as a "lunatic'' or a "crazy" madman killer.
With that in mind, Cascio and a group of mental health advocates gathered Thursday to stress that the vast majority of people with mental illnesses are not violent or dangerous.
And the advocates are imploring lawmakers not to embrace measures that would curtail freedoms but instead to support efforts at helping people get better and stay better.
"This is really resonating very painfully in the mental health community," said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services.
While stressing that they don't want to discount the extent of the Newtown tragedy, they said the massacre has triggered a wave of headlines about the mentally ill.
"Whenever there is a tragedy we shudder," said Rosenthal. "They are crazy, they are dangerous. We never should have let them out of the hospitals," he said, referring to some of the statements that came out in the wake of the tragedy in which 20 children and six adults were slain at the school.
Participants at Thursday's meeting pointed to a recent tabloid editorial about a Cuomo administration plan to move more mentally ill New Yorkers from supervised settings to their own housing.
"Here come the crazies," was the headline.
The Newtown tragedy has sparked calls for an expansion of Kendra's Law, a 1999 state statute that allows judges to order people to get psychiatric treatment if they meet certain conditions.
State Sen. Catharine Young, R-Olean, one of the law's original sponsors, called for a strengthening of the measure by extending the time period for which it would stay in effect and requiring more follow up.
Rosenthal, however, said he hoped the state would instead continue to boost support for programs that help people with mental illnesses live on their own. "Our hope is that he'll accelerate his existing reforms," said Rosenthal.
Not everyone in the mental health community agrees.
Kendra's Law "has giant cracks in it," said DJ Jaffe, executive director of Mental Illness Policy Org.
He believes the law has helped keep those with the most serious mental illnesses from harming themselves or others and has kept people from having to be hospitalized.
But there are gaps. A person who is ordered to seek treatment, for example, can simply move to another county to escape the mandate.
Jaffe said he knows the majority of people with mental illness are not dangerous, but there is a small number with severe symptoms who need help and some oversight.
"The most seriously ill," he said. "That is who we are trying to reach."
Mental Health Advocates Decry Defamatory Media Coverage,
Call For Advances In State’s Community Service System
January 3, 2013
A group representing New Yorkers with psychiatric disabilities and mental health advocacy groups came to Albany today to express their outrage at defamatory media depictions of people with mental illnesses.
“We join all Americans in sharing our profound grief and horror at the fatal shootings in Newtown and the subway pusher deaths in New York City,” said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services.
“At the same time, we are horrified and outraged at recent statements and media coverage that rushes to judgement and viciously attacks people with mental illnesses here in New York and across the country,” Rosenthal said.
The recent statements include calling people with mental illnesses “monsters”, “lunatics” and “violent psychotics”. In recent weeks, newspapers like the New York Post have run headlines like “Here Come the Crazies” and “11,000 Psychotics on the Street.”
“These statements amount to virtual public lynchings that unjustifiably terrifies the public, vilifies 1/5 of all Americans and will only serve to shame and deter millions from seeking the help they need,” said Rosenthal.
“Other racial, ethnic and religious groups have had to vigorously fight widespread stigma and discrimination to gain the respect and dignity they deserve. We’re here today to demand that for people with psychiatric diagnoses, “ said Kathryn Cascio of the Mental Health Empowerment Project.
The group called for a focus on “facts not fear” and offered a number of recent research findings that proved that:
- People with mental illnesses are no more violent than the general public but are actually 11 times more likely to be victims.
- People with the most disabling conditions can substantially recover when offered the right mix of engaging and effective services.
- A variety of innovative, persistent and personalized treatment approaches are showing marked success in engaging ‘at risk’ previously unengaged individuals.
“If we really want to address what keeps people from seeking mental health services, we should look at why so much of our current care system fails to offer hope and empathy, isn’t personalized and persistent and generally offers a dehumanizing vision of idle, isolated, impoverished lives,” said Cascio.
“We need to change the conversation and focus on what will best work to help distressed individuals, families and communities,” said Glenn Liebman, executive director of the Mental Health Association of New York State.
“Real solutions can be found in the complete system overhaul we are currently undergoing here in New York, moving to a system that will only reward persistent, personalized engagement, prevention and crisis management,” Liebman said.
“We are implementing sweeping Medicaid reforms that make providers explicitly responsible for moving from an office based to a ‘feet on the street’ 24-7 response and that expects immediate and ongoing follow up after relapses and hospital admissions,” said Rosenthal who is a member of the Governor’s Medicaid Redesign Team.
The state is already seeing immediate results from new ‘health home’ and managed care initiatives that will expect and pay for good performance, he said.
Liebman urged the state to establish state/local Incident Review Panels to investigate and make recommendations upon review of violent incidents involving people with mental illnesses. He also lauded efforts by local mental health officials to more widely publicize 24 hour emergency mental health contact lines that exist in every county.
“The current wholesale overhaul of our behavioral health system will extend the promise of recovery to millions of New Yorkers while reducing avoidable tragedies,” said Rosenthal. These approaches are far superior and more affordable than spending $100 million to expand the controversial Kendra’s Law court mandated treatment program for a few thousand. Let’s expect high quality accountable effective care, follow up and support for everyone,” he said.