Who’s Watching the Mental Health Providers?

Who’s Watching the Mental Health Providers?
By Warren Berke, Chair, NYC Department of Health and Mental Hygiene Community Advisory Board

Proper Customer Service Can Prevent a Mental Health Crisis
A functioning client with bipolar and anxiety disorders, of a well known mental health service provider in NYC, has to have his regulated drug prescription renewed every thirty days. Being responsible and knowing his need for the medication, he visits his provider and requests the renewal prescription one week prior to finishing up the current doses. The doctor informs him that he will send it electronically to his pharmacy.

Two days go by and the client does not get notification that the prescription is ready. The client calls his pharmacy to check and they inform him that they have not received the prescription. The client calls the provider. They inform him that the prescription will go out “right away.” The client checks with the pharmacy the next day; still no prescription. The client now has two doses of medication left, calls the provider, and is assured the prescription will be sent out. Client checks with the pharmacy the next day; no prescription has been received. With one dose left, the client begins to feel the symptoms of anxiety.

Another day goes by and the client is out of medication due to the non-performance of the provider. Client is getting very anxious, and, for the second time, goes to his provider on Saturday morning. He sees his doctor and is told by the doctor that the prescription will go out that day before the doctor leaves. Client checks with pharmacy early Saturday afternoon, and is told that the prescription has not been received. Client calls provider and is informed the doctor has left and will not be back until Tuesday. Client asks if another doctor can submit the electronic prescription. He is told it is not the provider's policy and to go to the emergency room to get the medication. Client is having an anxiety attack and physical discomfort, goes to the emergency room, waits two hours to request four doses to hold him over until his doctor returns on Tuesday. The doctor at the emergency room checks records and agrees, giving client one dose (Saturday night) and a paper prescription for three more doses.

It is Tuesday, eight days after the client requested the refill of the prescription. The client is informed that the doctor is not in until 5 pm. On the ninth day, the pharmacy receives the prescription.
The provider has failed to deliver the proper services to its client. By shirking their responsibility to provide good customer service, both the doctor and provider created both a human and financial toll.

The Human Toll: a client goes from wellness to crisis, not due to his mental illness, but due to poor customer service delivered by the provider and its doctor. The client had to invest 10 direct hours and three days of discomfort from anxiety, trying to receive the simple, basic service of a prescription refill.

The Financial Toll: the provider will be paid for two visits and the hospital will be paid for an emergency room visit and other services provided. One could speculate that the above services will be invoiced for a couple thousand dollars versus the much lower cost of one office visit, all due to the provider's poor customer service.
Is this an isolated patient experience or does this happen more often than we know? Mistakes happen, but for a provider to not correct the mistake and cause a series of events that result in a mental health crisis that wastes scarce mental health treatment dollars is grossly negligent. The State and City have sophisticated methods to evaluate the level and effectiveness of care being delivered to persons with mental illness. Providing good customer service should be a major part of that equation.  

Editor's Note: This article does not necessarily represent the views of City Voices, our readers, or the New York City Department of Health and Mental Hygiene. If you live in NYC and something similar has happened to you with your provider, you can call the Office of Consumer Affairs at (347) 396-7194.

On Getting the Most Out of Life: An Interview with Jane Grandi

On Getting the Most Out of Life: An Interview with Jane Grandi
By Carl Blumenthal

Jane Grandi, 65, has coped with mental illness since adolescence. She has found satisfaction in family life, employment, and advocacy. On the day I interviewed her, she wore a Museum of Modern Art T-shirt with pictures of famous artists on it. Monet is her favorite because his paintings of water lilies represent tranquility.

City Voices: Can you describe some of your jobs?

Jane: I worked in retail, in sales, at Abraham & Strauss, Sachs Fifth Avenue, and Franklin Simon. Did some modeling of clothes for customers. My first husband was a police officer. I was a traffic enforcement agent (“meter maid”) for 17 years. 

Voices: And education?

Jane: I graduated Midwood High School. Got 18 credits from St. Francis College. [Both in Brooklyn].

Voices: What are examples of your advocacy?

Jane: One time I convinced a jury I was on that a young guy accused of robbery shouldn’t be convicted because he was in the wrong place at the wrong time. Twenty-five years later I saw him again. He had become a police officer. It was the best day of my life. 

My involvement with law enforcement. I know how to talk to officers at meetings on how to treat people with mental illness. I’m against solitary confinement. It makes you mentally worse. There’s no justice for many people.

I went to [Senator] Schumer for help [when he was a congressman]. He told me I had Medicaid rights and helped me get food stamps. It’s good talking to politicians about what’s on your mind. 

Voices: What are your other activities?

Jane: I take care of my husband who’s older than me. The usual things a wife does.

Voices: Anything else?

Jane: I’m beginning to write about my experiences. A doctor once told me writing about myself wasn’t good. But now I feel better when I do. Writing relieves anxiety.

I go to support meetings here. I’ve been to ones at Baltic Street [Advocacy, Employment and Housing, Inc.].

Voices: What are your plans for the future?

Jane: I’ve taken some of the peer courses [at Academy of Peer Services]. I’ve applied to Howie the Harp [for peer specialist training] a couple of times. Withdrew my application cause I’m not sure anyone would hire me at my age.  

Voices: It sounds like you would have a lot to offer with all of your experience. Why not give it another try?

Jane: They told me if I want to I’ve got to fill out the application again. I’ll need to go to 125th Street [Howie the Harp’s Harlem office] and do it there.

Voices: Anything else you’d like to do?

Jane: I don’t think ahead the way I used to. One day at a time. I like dancing. I learned as a kid. We do ballroom dancing at the senior program where I go.

Voices: Thank you for sharing your life with us!  

Determined to Help Others Along the Path Through Life

Determined to Help Others Along the Path Through Life
By Steven Alvarez, Intern, Urban Justice Center's Mental Health Project

Finding Purpose During the Good and the Bad Times

I truly believe that everything happens for a reason. If it weren’t for my own struggles, and meeting many peers with the same issues, I would never have gotten into this work. One friend that I met, Faigy Mayer, would ultimately set me forth on a new path in life, to work in mental health. I met Faigy during this transitional phase of my life. When she died, it only fueled me deeper along my path.

Growing up, I remember being terribly shy and not having many friends. I grew up in a hostile environment in which my dad (although I love him to this day) was physically and verbally abusive to my mother. I ended up inheriting his anger.

One day I stopped doing my homework. I couldn’t find the motivation, and worried that the kids at school would make fun of me. So rather than face the embarrassment I stayed at home. Eventually my mother took me to see the guidance counselor at school. The guidance counselor asked me if I wanted to go to class. Since I feared my classmates, I got angry and knocked everything off of her desk. She called the police, and when they came, I wouldn’t talk to them. They took me to a hospital, in which I was later admitted. I would live with the label of “crazy” from that point forward. I was only ten years old.

I began to act out and live by my own rules. I wasn’t the class clown; I was the class terror. Cursing out the professors, getting into fights, cutting class, smoking weed, and the like. I even remember getting picked on by the special-ed students and fighting back in the craziest ways possible to make them leave me alone. I was getting bullied, and unfortunately, to fit in, I was also a bully.

During this point, I was put on one of the most powerful drugs on the market called Clozaril, an atypical antipsychotic, usually used as a last ditch effort to treat the most severe cases of psychosis. Its list of side-effects are horrendous, but the worst required me to take a blood test to check my white blood cell count. Besides killing off my white blood cells, my weight ballooned to 300 pounds.

When I was taken off Clozaril my life changed. I suddenly became a new person, mentally and physically. My therapist describes me as waking up, as if a whole new person arrived, as if I had been living in a bubble all these years. My life started to transform. I became more socially active, lost 100 pounds, gained friends, and a girlfriend. Amazing things started to happen.

I relapsed in 2011 and was hospitalized three times that year. I emerged with a new vision, but unfortunately I was heavily medicated, and regained all of the weight I had lost. Still set on my mission, I eventually got off of another antipsychotic, Zyprexa, and lost the hundred pounds once again.

During this time, I ran support groups, threw the craziest parties, hiked, bowled, played pool, anything and everything, with a group of friends I will love for life. I credit two “Meetup” groups for my recovery: NYCDSG (New York City Depression Support Group) and, first and foremost, the New York Shyness and Social Anxiety Meetup Group. Through these social interactions I have lived several lifetimes in a matter of years. 

In January of 2016, I enrolled in the Howie the Harp Peer Advocacy Program. The training was like no other. Every day was a struggle, but also a gift. I began to realize that all of the things I went through had a meaning and purpose. I needed to suffer so that I could help decrease the suffering of others. The training was awesome and the people I met even more so. 

One day a friend messaged me about an Open Mic Night hosted by the Urban Justice Center, the law office I’m currently writing from. If I learned anything, it is that experiences, both good and bad, will prepare you for the future. Sometimes in life, our future works out based upon our plans and sometimes it doesn't. I often reminisce about my friend Faigy, and the times I went to visit her in the hospital. I know she would want me to continue to help others as I helped her and to never let go.

Ward Stories A column organized by Dan Frey, Interim Poetry Editor

Ward Stories
A column organized by Dan Frey, Interim Poetry Editor
For this winter 2015 edition, we feature three poets, each with their own style and message. R. Martinez Jr. makes addiction real for his readers in Love is a Drug. Paul Chipkin grows into a peaceful man through his poem I Am That I Am. Beryl Khabeer explains that our soul is beyond the material world in her poem Brooching SOUL. I hope that you enjoy as much as I have.

Love is a Drug
By R. Martinez Jr.
I need a quick fix
I'm addicted to you
feeling high feeling low
what am I to do?
an aphrodesiac
affection in a sack
I can feel you in my veins
but Im stuck without a track
I'm drowning in a bottle
of absolute sorrow
if I cant have you now
there will be no tomorrow
Pure euphoria
when I'm with you its ecstasy
I take so much of you in
that I can't even see
I might have to quit cold turkey
I might have to ween
Love is a drug
you already proved it to me.

I Am That I Am
By Paul Chipkin
I am the very one
Who did those things
That I can be the one
Who is growing into
Who I am today
Because I am who I was
And have seen complexity
As I strengthened
Growing
And making peace better.

Love appears here,
Sprouts anew there…
Goodness greets me
In response to faith.

Divinely-inspired liberties
And holy trust
Bring me to pray
That those
Who I hurt along the way
Are exercising forgiveness,
(Believing in that eases my burden
as I stand in this present moment
loving my fellows with developing confidence).

Having fought off hoplessness,
I hold an optimistic vision
For the salvation of individuals.

Now, as it always was,
I am grateful for all that I have!

Brooching SOUL
By Beryl Khabeer, M.A.
The body is just the shell I live in.
I am no sensation; I am no senses.
I am a living  S O U L.
The beat of my environ touch my true self,
Touch my  S O  U  L
And echo through the senses.

Knowing and using the senses
For only the senses’ sake
Is to abridge Creation and Creator.