On Oct. 24, with great fanfare, NYC First Lady Chirlane McCray announced a new HelpLine for Mentally Ill (Call
1-888-NYC-WELL or text, "WELL" to 65173). When pressed by a reporter, Ms. McCray admitted that it was little more than 1 800 LIFENET with the addition of text capability.
Ms. McCray is widely hailed by the mental health industry for introducing THRIVE/NYC an $800 million mental health plan. But it largely ignores the seriously mentally ill.
WHY THRIVE/NYC
IS FAILING
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THAT SHOULD BE USED HERE
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Evidence
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Mental Health First Aid (MHFA)
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 Peer Support
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Assisted Outpatient Treatment
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Hospitals
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Housing
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Cuts Homelessness
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No
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No
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Yes
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Yes
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Yes
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Cuts Arrest
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No
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No
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Yes
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Yes
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Yes
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Cuts Incarceration
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No
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No
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Yes
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Yes
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Yes
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Cuts Suicide
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No
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No
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Yes
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Yes
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Yes
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Cuts hospitalization
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No
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No
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Yes
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Yes
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Yes
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THRIVE/NYC shuns
the seriously ill and focuses on “improving mental wellness” in all others.
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Thrive/NYC funds “prevention” but serious mental
illness can’t be prevented because we don’t know what causes it.
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Thrive/NYC funds “early intervention” but we
can’t predict who will become seriously ill until after the symptoms first
appear.
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Thrive/NYC funds “trauma,” but trauma is not a
mental illness. Everyone loses a loved one, loses a job, experiences accidents,
etc. PTSD is mental illness and even that runs from mild to severe.
- ·
Thrive/NYC diverts mental health funds to programs
that do not help seriously mentally ill.
NYC needs an “all hands on deck”
approach to reducing homelessness, arrest, incarceration, suicide, and
hospitalization of seriously mentally ill. Mental Illness Policy Org promotes
ideas to accomplish that. Join us on Facebook and Twitter and subscribe to our
email list at http://bit.ly/2eKarUd
Here is an article that appeared in City Journal that got it right. Also read this one
in Daily News.
De Blasio’s Mental-Health Blindspot
By
Seth Barron (City Journal Online 10/20/16)
On Tuesday, an NYPD sergeant shot and killed 66-year-old Deborah
Danner, an emotionally disturbed woman who attacked officers, first with a pair
of scissors and then with a baseball bat. Mayor Bill de Blasio and police
commissioner James O’Neill wasted no time blaming the sergeant for not
following correct police protocol for responding to mentally distressed
individuals. It may well be the case that the responding officers made serious
errors. It may be that the sergeant’s actions were criminal. But the real mistake was the city’s
Department of Health and Mental Hygiene’s neglect of Danner’s serious mental
illness.
Danner’s case
was known to the city. Her sister, with whom she lived, was Danner’s legal
guardian, and the NYPD had been called to their house many times. Like many
seriously mentally ill individuals, Danner had cycled through the city’s
police-medical complex, and was apparently non-compliant with her medical
regimen—that is, she didn’t take her anti-psychotic medicine as prescribed.
“It’s the classic situation: someone is supposed to take meds and they go off
their meds,” de Blasio said at a press conference. “Because of their illness
they choose not to take their meds. Once they don’t take their meds it is very
hard to get them to engage another kind of treatment.”
Listening to the
mayor, one would think that the paradox he outlined has never been addressed
before. But New York, like almost every state, has a robust set of laws known
generally as assisted outpatient therapy (AOT). Locally, the statute is known
as “Kendra’s Law.” It has proven
effective at keeping the mentally ill out of hospitals and shelters and
promoting compliance with doctor’s orders. Kendra’s Law covers cases where a
non-compliant and seriously mentally ill individual has previously been
hospitalized, and is judicially and medically judged to pose a danger to
himself or others. The law provides for a six-month period of supervision,
during which the subject must comply with treatment or face possible commitment
to a hospital. This rarely happens.
Kendra’s Law is
remarkably successful at helping the seriously mentally ill live relatively stable
lives. The statistics are stunning: violent or harmful behaviors decrease by 44
percent; hospitalizations decrease by 77 percent; drug and alcohol abuse
decrease by half. Patients report high levels of satisfaction with their
participation in AOT, and the costs of care decline substantially, because
outpatient treatment is so much cheaper—in financial and human terms—than
incarceration or hospitalization.
Despite AOT’s
track record of success, New York State rarely chooses to apply Kendra’s Law,
even in seemingly obvious cases like Deborah Danner’s. Liberal critics of
involuntary psychiatric commitment, still shuddering from the 1972 Willowbrook
exposé, argue that any hint of coercive intervention is a violation of the
civil liberties of the mentally ill. Meanwhile, the mental-health industry
prefers to focus on mental illness as a public-health problem, like venereal
disease or typhus. Publicity campaigns advise people on how to identify the
signs of depression in themselves or their associates, or warn about the
problem of stigmatizing mental illness. This epidemiological approach to mental
illness fails because untreated schizophrenia is not contagious, nor is it hard
to identify.
Thousands of
homeless or incarcerated mentally ill New Yorkers aren’t living on the streets
or in Rikers Island jail because they fear the stigma of mental illness.
Rather, the city’s mental-health establishment has chosen not to deal seriously
with their care.
De Blasio speaks
magnanimously about his grand approach to treating mental illness through his
ThriveNYC plan, but that plan includes virtually nothing for the seriously
mentally ill. Instead, the mayor is spending millions of dollars on feel-good
advertising campaigns promoting peer counseling and awareness. His wife,
Chirlane McCray, announced a collaboration this week between ThriveNYC and
Tumblr, where people will be encouraged to submit quilt patches representing “a
creative expression around changing the conversation around mental health and
an individual’s relationship with mental illness.”
Awareness isn’t
the most pressing issue regarding the mentally ill in New York City. New
Yorkers are already aware of the many suffering people in their midst. By
making the police take up the slack for the city’s failed mental-health policy,
de Blasio is being cynical and careless. Kendra’s Law is a working solution to
the problems of people like Deborah Danner, but the mayor refuses to use it.
Seth
Barron is project director of the Manhattan Institute’s NYC Initiative. He
blogs about New York City politics at City Council Watch.
MHFA Research at http://mentalillnesspolicy.org/samhsa/mental-health-first-aid-fails.html. Peer support studies showing no
benefit beyond ordinary care: Cochrane Collaborative, “Consumer-Providers of Care for Adult
Clients of Statutory Mental Health Services." American Psychiatric
Association “Guideline Watch: Practice Guideline for the Treatment of Patients
with Schizophrenia.” "BMC Psychiatry, A Systematic Review and
Meta-Analysis of Randomised Controlled Trials of Peer Support for People with
Severe Mental Illness.”
