October 26

Mental Health System called "Snake Pit"

Subject: Mental Health System called “Snake Pit”_Editorial WJN

Date: Mon, 23 Sep 2002 10:06:57 -0400

A Sept 15 report by the National Council on Disability found that mental health services are in crisis nationally: “many public mental-health systems are stuck in neutral gear, content that people with psychiatric disabilities will be ‘maintained’ in the community, rather than supported in their recovery and helped on the road to economic self-sufficiency. In other words, the aspirations of the public mental-health system . . . has not, for most people with psychiatric disabilities, changed much in 30 years.” http://www.ncd.gov/newsroom/publications/mentalhealth.html

The report also found that: “children and youth from low-income families are disproportionately represented among young people diagnosed with emotional disturbance. While this labeling theoretically entitles children to a wide range of services and supports, these are often not delivered. In addition, the labeling itself may serve to reinforce a view of these children as dysfunctional, and relegate them to segregated settings.”

The unacknowledged fact is: people diagnosed with mental illness have been subjected for the last 30 years to an inhumane, costly human experiment of deprivation. Thousands of vulnerable people have been denied the support they need to recover and even to survive. They have been dumped into modern day “Snake Pits”– homeless shelters, jails and adult homes where they are abused, drugged, and subjected to clinical drug trials and unnecessary medical / surgical procedures. The New York Times reported that adult home owners received kick backs from surgeons who performed eye surgery on residents simply to qualify for Medicaid reimbursement.

This cruel and dehumanizing experiment has resulted in a higher mortality rate, and lower recovery rate for mentally disabled people today. But the mental health bureaucracy that oversees the system and a retinue of unscrupulous providers have thrived. On Sept. 15, The Times reported that a year after its (2001) investigative series, nothing had changed and the Adult home owners continued to bilk the public of a quarter of a billion dollars annually. [See: Despite Inspections by State, Violations at Home Continued. By CLIFFORD J. LEVY METROPOLITAN DESK Final, Section 1, Page 35, Column 1 ]

The Times failed to report that those adult home owners have kept their licenses throughout the years by contributing to the campaigns of state politicians, including the Governor. An investigation by the Office of the Inspector General of DHHS is long overdue.



Westchester Journal News Today’s ‘snake pit’ Editorial Sept. 21, 2002

Not only are many, if not most, of the mentally ill people who live in adult homes in New York state in crisis. So is the United States’ entire system of mental-health services.

Two independent panels, one state and one national, each recently released reports with alarming conclusions about inadequate, ineffective, costly programs that show what a disgrace, and tragedy, the alleged “system” is.

In fact, the federal report baldly states, mentally ill people today are not as removed from the “snake pits” of decades ago that warehoused people with psychiatric disabilities as Americans might like to think.

It is not as if there are no “innovative models” for supporting the mentally ill, the report released Monday by the National Council on Disability concluded. It is that a “lack of visionary leadership and inadequate funding have prevented these models from ‘going to scale’ in order to serve more people.

“Instead, many public mental-health systems are stuck in neutral gear, content that people with psychiatric disabilities will be ‘maintained’ in the community, rather than supported in their recovery and helped on the road to economic self-sufficiency. In other words, the aspirations of the public mental-health system . . . has not, for most people with psychiatric disabilities, changed much in 30 years. Instead of being warehoused on back wards of hospitals, many people with psychiatric disabilities today are warehoused in homeless shelters, jails and prisons, and other isolated and segregated settings throughout our communities.”

That is tragically evident in just one of those settings, adult homes, according to a second study just released by the state Commission on the Quality of Care for the Mentally Disabled. The scrutiny was triggered by a New York Times investigation earlier this year into the often horrific conditions at several New York City “homes.”

The panel found “that many residents received multiple layers of services from different providers that were costly, fragmented, sometimes unnecessary, and often appeared to be revenue-driven, rather than based on medical necessity.”

By factoring in Medicaid and room and board costs, the study found that the average annual total cost was about $37,000 per adult-home resident more than a quarter of a billion dollars each year for the 7,000 residents with mental illness living in New York City-area homes alone.

That is a staggering amount for taxpayers to bear, particularly when, as the commission concluded, “residents are often poorly served, and resources are not utilized cost-effectively.” There also is well-documented fraud, with residents undergoing questionable medical procedures, or the Medicaid and Medicare system being billed millions of dollars for treatment never given.

Worse, months later, Albany has only begun to address the widespread neglect, uncoordinated services and often filthy conditions that many adult-home residents live in, as documented by the Times series. The issue is rising in the gubernatorial campaign as Gov. George Pataki faces Comptroller H. Carl McCall this November. And senior administration officials, including Health Commissioner Dr. Antonia Novello, clearly are in a defensive mode as they try to revamp the system and tout “inspection sweeps” of the most serious offending homes.

Meanwhile, the federal report â€" “The Well Being of Our Nation: An Inter-Generational Vision of Effective Mental Health Services and Supports” warns of a system for both children and adults that forces them to “hit bottom” before receiving appropriate supports and services. Even then, response is sketchy, with young people forced to depend on inadequate programs that obviously can’t even serve adults.

“In this fashion,” the report warned ominously, “hundreds of thousands of children, youth, adults and seniors experience poor services and poor life outcomes, literally from cradle to grave.”

That report now goes to President Bush’s New Freedom Commission on Mental Health, which held its first public hearings in July.

“The mental-health system in this country is in crisis,” it bluntly concludes. However, it insists that there are solutions and incentives for states that, astonishingly, won’t necessarily cost more.

For the “snake pits” that have joined to become one long coil of bureaucracy for mentally ill people, that irony is untenable.

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