Thursday, November 1, 2012

NYS Office of Mental Health: The wrong response to Hurricane Sandy

Whenever a tragedy like Hurricane Sandy strikes, the New York State Office of Mental Health (OMH) calls up mental health workers en masse and assigns them to do counseling for those affected by the tragedy. The problem is, they’re not needed, rarely do any good, are expensive, and take resources away from where they are truly needed: helping the most seriously mentally ill.

 New York State has a long history of this.

On February 26, 1993, a largely unsuccessful attempt to bomb the World Trade Center resulted in some individuals having to walk down the stairs. Some received smoke-inhalation, sprained ankles and other injuries for which they were treated and recovered. But NYS mental health authorities pulled all the psychiatric outreach workers who were supposed to be helping psychotic, homeless mentally ill individuals get treatment and instead assigned them to do counseling for people who had to walk down stairs or felt bad from watching people walk down stairs on TV. 

On July 17, 1996, when TWA flight 800 crashed off Long Island and killed 230, again, NYS Office of Mental Health made outreach workers stop helping the psychotic and homeless and start counseling those who lost loved ones. The relatives of the 410 other New Yorkers who died that day did not receive government counseling.  

On September 11, 2011, when the World Trade Center was again attacked, the pattern was repeated. All outreach workers who were supposed to help people who were already psychotic and homeless get into treatment were instead pulled off the job. Their new assignment became comforting people who escaped the attack, lost loved ones, or watched on TV.  

Dr.  Lloyd Sederer, medical director of New York State Office of Mental Health explained the effort cost $137 million over three years. Why? He said:
In response to the attacks on the World Trade Center in 2001, New York City and 10 surrounding counties mounted the largest and most effective (sic) mental health disaster response in history. Approximately 1.5 million people were served, receiving crisis counseling and education in their community settings....
One and a half million people? On September 11, 2001, a maximum of fifty thousand people were at work in the Trade Center. If every one of them died (only 3,000 did) and each had four close surviving family members, that means there were 200,000 people OMH could counsel. 

Who were the other 1,300,000 people OMH was serving? What were their illnesses? What was the cure rate? 

The counseling was not needed. In fact, so few came in for counseling that officials spent more money running TV commercials trying to convince people they suffered and should call. What were the results? Dr. James Coyne wrote about this in, "After 9/11, the crisis that never came." He examined the biggest post 9/11 study and concluded
"(T)his study should lay to rest the idea that there was substantial mental health effects of 9/11 and of watching the events on TV. But the myth of a virtual trauma is well entrenched in lay and public policy circles..."
People with serious mental illness will undoubtedly be adversely impacted by Hurricane Sandy in unavoidable ways. Transportation problems, electric problems, the closing of Bellevue and NYU Medical Center will all make treatment harder to get. But those unavoidable problems should not be compounded by actions of the New York State Office of Mental Health. 

Outreach workers for the homeless, psychotic mentally ill should stay right where they are.