Editor At Large/As I See It
A Column by Marvin Spieler
My Friend Nancy, As I Remember Her
One night Nancy arrived at my support group in Sunnyside, Queens, New York City and she became a regular participant. Usually, when the group ended, I walked her to the bus stop as the neighborhood was in transition, but not for the better. As a woman, she didn’t feel comfortable standing at the bus stop on a deserted street waiting for the bus. We had time to talk about the night’s group. I realized Nancy was easy to talk to as she didn’t pretend to be a hotsy-totsy. Also, as I got to know her, I learned that she wasn’t a Jewish American Princess either. Nancy was down to earth, not a gold digger, honest, and a good person.
Nancy, unfortunately, had schizophrenia. In a sense it was self-induced. Sounds like a weird statement, yes? Well “acid” was in vogue in the nineteen-sixties. Nancy took, I guess, her fair share of it. Many years later, she had a major side-effect from it. Up until I met Nancy, I never met anyone who had become schizophrenic from taking acid, but I heard of this side effect. Thank God acid is not as popular a drug now as it was then. It is a mind-altering drug. Different people had different experiences with acid, some good and some bad.
I never asked Nancy what her experiences were like. I was curious. Whether her experiences were good or bad, I had no way of knowing. She’s dead now, unfortunately. In my eyes, she died because of one major side effect of acid—schizophrenia. I had read about this potential problem, but never knew anyone who had it until I met Nancy.
We cared for one another and helped each other when we could because we were friends. Our relationship grew. We saw each other frequently as we both had a lot of spare time. She was unable to work as was I. We got to know one another. Basically, she was a kind individual. She never said a bad word about anyone. She was bright, had attended college and graduated. She had a good mind. She was no dummy. She especially cared about her friends and helped them when she could. She showered us with gifts of needed items we couldn’t afford or didn’t want to spend money on ourselves. In a word, Nancy was generous. She was there for her friends when needed. Nancy had a good soul.
Why she actually died couldn’t be determined. An autopsy was inconclusive. But I felt it was a suicide. Nancy was depressed a great deal of the time. This went on for weeks. The last book she was reading was on the afterlife. The book seemed to calm her. Unfortunately, none of her friends picked up on this signal, which lead to her eventual death. This is what I feel she did to herself. She’s missed greatly.
Her symptoms of schizophrenia were primarily of being paranoid. She also had low self-esteem and she may have heard voices. I really don’t remember for sure. She kept a journal, which was full of her weird thoughts and feelings.
But the cure that she did experience eventually, in a way, made her worse. Her sanity after being put on Clozaril really didn’t help. She felt miserable knowing how sick she was previously. She couldn’t accept who she had become—a sane individual. Is this a crazy statement? It sounds that way, but she was very uncomfortable with her new found sanity.
Another major problem developed that I felt actually did her in was Tardive Dyskinesia. She had a severe case. Her hands shook and her mouth movements were also very severe. It embarrassed her. Nancy kept a towel over her hands so they wouldn’t be seen. Her mouth movements she couldn’t hide. This in effect did her in. She couldn’t live with these involuntary movements. Eventually, this problem became constant. She was severely depressed as a result and spent a lot of time at home. Nancy was seen infrequently. She didn’t answer her phone regularly. At some point she must have taken an overdose and was finally at peace with herself.
Wednesday, June 17, 2015
NYAPRS' Annual Legislative Day in Albany
NYAPRS' Annual Legislative Day in Albany
By Sharon Spieler
Outlined Are Their Priorities
The Annual Albany Legislative Day sponsored by the New York Association of Psychiatric Rehabilitation Services (NYAPRS) took place on February 25, 2015.
Consumers from all counties throughout New York City and New York State attended. There was a full schedule of events for the day. The morning began with a welcome from NYAPRS Co-Presidents Carla Rabinowitz and Alison Carroll and Public Policy Co-Chairs Carla Rabinowitz and Ray Schwartz.
After this, NYAPRS laid out the 2015-16 State Public Policy Priorities. Various speakers made their case:
1. There is a housing crisis. Funds are needed for supported housing as the cost of these houses has risen over 50% and are now underfunded. Add $82 million to the Executive Budget’s $17 million allocation;
2. Expand housing for the homeless by creating 30,000 New York City and 5,000 statewide units of supportive housing;
3. Adult home residents with psychiatric disabilities have been promised a transition to community-based residences and in order to achieve this, an approved $30 million allocation must remain;
4. Much was said about criminal justice reforms such as expanding crisis intervention teams, raising the age of youthful offender status to 21, prohibiting solitary confinement for any person with a psychiatric or physical disability, establishing Medicaid eligibility for all individuals discharged from forensic settings to enable immediate access to needed services and supports, and expanding the New York State's Office of Mental health (OMH) criminal justice services for persons leaving state prisons through discharge planning, wrap-around community supports and supported housing. Use the $22 million executive budget allocation for this;
5. Those persons with disabilities should have access to a home health aide for personalized assistance and a smooth community transition from institutional settings;
6. There should be no interference in what kinds of medication can be prescribed to patients to ensure the safety and choice of public benefit consumers regarding their medications and restore $4.1 million;
7. Preserve $115 million in Medicaid funding to support a recovery-focused transition to Medicaid managed care; and finally
8. Approve $15 million in new community-funded services such as urgent care, crisis respite, housing and recovery supports.
The featured Speakers included Assistant Deputy Secretary for Health Tracie Gardner, OMH Commissioner Ann Marie Sullivan, Assembly Mental Health Committee Chair Aileen Gunther, Senate Mental Health Committee Chair Robert Ortt and Assembly Criminal Justice Committee Chair Daniel O’Donnell.
NYAPRS Awards were presented to Jennifer Parish, Karen Wera, Dottie Harie and Michael Virtanen. A rally took place in front of the Capital Building and groups of Consumers met with their own state legislators to discuss these mental health issues.
By Sharon Spieler
Outlined Are Their Priorities
The Annual Albany Legislative Day sponsored by the New York Association of Psychiatric Rehabilitation Services (NYAPRS) took place on February 25, 2015.
Consumers from all counties throughout New York City and New York State attended. There was a full schedule of events for the day. The morning began with a welcome from NYAPRS Co-Presidents Carla Rabinowitz and Alison Carroll and Public Policy Co-Chairs Carla Rabinowitz and Ray Schwartz.
After this, NYAPRS laid out the 2015-16 State Public Policy Priorities. Various speakers made their case:
1. There is a housing crisis. Funds are needed for supported housing as the cost of these houses has risen over 50% and are now underfunded. Add $82 million to the Executive Budget’s $17 million allocation;
2. Expand housing for the homeless by creating 30,000 New York City and 5,000 statewide units of supportive housing;
3. Adult home residents with psychiatric disabilities have been promised a transition to community-based residences and in order to achieve this, an approved $30 million allocation must remain;
4. Much was said about criminal justice reforms such as expanding crisis intervention teams, raising the age of youthful offender status to 21, prohibiting solitary confinement for any person with a psychiatric or physical disability, establishing Medicaid eligibility for all individuals discharged from forensic settings to enable immediate access to needed services and supports, and expanding the New York State's Office of Mental health (OMH) criminal justice services for persons leaving state prisons through discharge planning, wrap-around community supports and supported housing. Use the $22 million executive budget allocation for this;
5. Those persons with disabilities should have access to a home health aide for personalized assistance and a smooth community transition from institutional settings;
6. There should be no interference in what kinds of medication can be prescribed to patients to ensure the safety and choice of public benefit consumers regarding their medications and restore $4.1 million;
7. Preserve $115 million in Medicaid funding to support a recovery-focused transition to Medicaid managed care; and finally
8. Approve $15 million in new community-funded services such as urgent care, crisis respite, housing and recovery supports.
The featured Speakers included Assistant Deputy Secretary for Health Tracie Gardner, OMH Commissioner Ann Marie Sullivan, Assembly Mental Health Committee Chair Aileen Gunther, Senate Mental Health Committee Chair Robert Ortt and Assembly Criminal Justice Committee Chair Daniel O’Donnell.
NYAPRS Awards were presented to Jennifer Parish, Karen Wera, Dottie Harie and Michael Virtanen. A rally took place in front of the Capital Building and groups of Consumers met with their own state legislators to discuss these mental health issues.
More Sensitivity Needed Toward Trauma Survivors
More Sensitivity Needed Toward Trauma Survivors
By Angela Cerio, Psychiatric Survivor and Certified Psychiatric Rehabilitation Practitioner
Insights Gained from Trauma Informed Peer Support Training
How much do you know about trauma? What comes to mind? The Veteran, returning from combat with “Post Traumatic Stress?” The disaster survivor? The battered spouse? The abused child? Abandonment?
Trauma goes much further than that, as I recently learned in a Mental Health Empowerment Project (MHEP) sponsored training on “Trauma Informed Peer Support.” Studies show that over 90% of people with psychiatric diagnoses, and nearly 100% of incarcerated women are trauma survivors. Trauma can be defined as “extreme stress brought on by shocking or unexpected circumstances or events that overwhelm a person’s ability to cope.”
According to SAMHSA, there are three E's to a traumatic experience: 1. Events and circumstances which cause trauma; 2. The person’s Experience of these events determine if the event is traumatizing; 3. The Effects of the traumatic event on the individual, which includes adverse physical, social, emotional or spiritual consequences.
We use language every day which reinforces the violence in our society. These words in themselves can remind the survivor of the original trauma—perhaps without conscious awareness of the connection.
A list of dotted points in a presentation are referred to as “bullets.” Those things which evoke powerful negative emotions in us are called “triggers.” The professionals we deal with every day in behavioral health programs are frequently referred to as “front-line staff.”
As a peer support specialist, I learned early on to see “coping mechanisms” where clinicians see “symptoms.” One of the key elements needed to avoid “triggering” those behaviors we have developed to cope with trauma is feeling safe in the present.
When confronted with a threat whether real or perceived, the brain signals the body to respond with “Fight, Flight or Freeze.” When the threat is gone, the switch turns “off” and the body returns to “baseline.” If the switch is stuck in the “on” position, and the body remains prepared for threat—this is a “trauma response,” evoking whatever mechanisms the individual has developed to cope with the traumatic event. Instead of “think, process, act,” the individual goes immediately to “act.”
I cringe when I hear a mental health professional talk about a client “acting out.” “Fight” becomes “non-compliant” or “combative.” “Flight” becomes “treatment resistant” or “uncooperative”. “Freeze” becomes “passive” or “unmotivated.”
In the language of trauma-informed peer support, we see “Fight” as a struggle to hold onto or regain personal power. We see “Flight” as disengaging or withdrawing to feel safe. “Freeze” becomes giving in or giving up to those in power to avoid further harm.
The consequences of trauma include mistrust, loss of power and control, manipulation, silencing of one’s voice, invalidation of personal rights, helplessness and hopelessness, violation of personal boundaries and sense of safety. It leaves people feeling powerless and has a lasting effect on a person’s ability to trust others and form lasting relationships.
People are frequently unaware that their emotional challenges are related to past trauma. They may be responding to the present through the lenses of the past. Their coping mechanisms could lead to punitive reactions from others who may label their reaction as “non-compliance.” Trauma survivors have good reason to be sensitive to misuse of power and authority.
Healing from trauma requires first a sense of safety. Then the survivor may be able to develop the ability to trust themselves and reconnect with (or connect for the first time) and trust others. Healing begins when the trauma survivor regains a sense of control over their life and environment.
Trauma-informed services could change the way we receive help for our emotional challenges by creating safe, welcoming environments, by avoiding reoccurring trauma and victimization, by using our listening skills toward collaboration and mutuality, by giving people voice and choice, by focusing on “what happened to you?” rather than “what’s wrong with you?” Safety for us as people with emotional challenges means controlling our own lives. For providers, safety means maximizing control over the service environment and minimizing risks for both the client and the agency.
One last thing to remember is that people with emotional challenges are not limited to those of us who have been labeled by psychiatry. Clinicians are not immune to trauma responses and may not be aware when they are reacting to our challenges through the lens of their own past.
Note: Thanks to the Mental Health Empowerment Project, Cathy Cave, Bill Gamble and the NYC Department of Health and Mental Hygiene's Office of Consumer Affairs for making the training on trauma-informed peer support possible.
By Angela Cerio, Psychiatric Survivor and Certified Psychiatric Rehabilitation Practitioner
Insights Gained from Trauma Informed Peer Support Training
How much do you know about trauma? What comes to mind? The Veteran, returning from combat with “Post Traumatic Stress?” The disaster survivor? The battered spouse? The abused child? Abandonment?
Trauma goes much further than that, as I recently learned in a Mental Health Empowerment Project (MHEP) sponsored training on “Trauma Informed Peer Support.” Studies show that over 90% of people with psychiatric diagnoses, and nearly 100% of incarcerated women are trauma survivors. Trauma can be defined as “extreme stress brought on by shocking or unexpected circumstances or events that overwhelm a person’s ability to cope.”
According to SAMHSA, there are three E's to a traumatic experience: 1. Events and circumstances which cause trauma; 2. The person’s Experience of these events determine if the event is traumatizing; 3. The Effects of the traumatic event on the individual, which includes adverse physical, social, emotional or spiritual consequences.
We use language every day which reinforces the violence in our society. These words in themselves can remind the survivor of the original trauma—perhaps without conscious awareness of the connection.
A list of dotted points in a presentation are referred to as “bullets.” Those things which evoke powerful negative emotions in us are called “triggers.” The professionals we deal with every day in behavioral health programs are frequently referred to as “front-line staff.”
As a peer support specialist, I learned early on to see “coping mechanisms” where clinicians see “symptoms.” One of the key elements needed to avoid “triggering” those behaviors we have developed to cope with trauma is feeling safe in the present.
When confronted with a threat whether real or perceived, the brain signals the body to respond with “Fight, Flight or Freeze.” When the threat is gone, the switch turns “off” and the body returns to “baseline.” If the switch is stuck in the “on” position, and the body remains prepared for threat—this is a “trauma response,” evoking whatever mechanisms the individual has developed to cope with the traumatic event. Instead of “think, process, act,” the individual goes immediately to “act.”
I cringe when I hear a mental health professional talk about a client “acting out.” “Fight” becomes “non-compliant” or “combative.” “Flight” becomes “treatment resistant” or “uncooperative”. “Freeze” becomes “passive” or “unmotivated.”
In the language of trauma-informed peer support, we see “Fight” as a struggle to hold onto or regain personal power. We see “Flight” as disengaging or withdrawing to feel safe. “Freeze” becomes giving in or giving up to those in power to avoid further harm.
The consequences of trauma include mistrust, loss of power and control, manipulation, silencing of one’s voice, invalidation of personal rights, helplessness and hopelessness, violation of personal boundaries and sense of safety. It leaves people feeling powerless and has a lasting effect on a person’s ability to trust others and form lasting relationships.
People are frequently unaware that their emotional challenges are related to past trauma. They may be responding to the present through the lenses of the past. Their coping mechanisms could lead to punitive reactions from others who may label their reaction as “non-compliance.” Trauma survivors have good reason to be sensitive to misuse of power and authority.
Healing from trauma requires first a sense of safety. Then the survivor may be able to develop the ability to trust themselves and reconnect with (or connect for the first time) and trust others. Healing begins when the trauma survivor regains a sense of control over their life and environment.
Trauma-informed services could change the way we receive help for our emotional challenges by creating safe, welcoming environments, by avoiding reoccurring trauma and victimization, by using our listening skills toward collaboration and mutuality, by giving people voice and choice, by focusing on “what happened to you?” rather than “what’s wrong with you?” Safety for us as people with emotional challenges means controlling our own lives. For providers, safety means maximizing control over the service environment and minimizing risks for both the client and the agency.
One last thing to remember is that people with emotional challenges are not limited to those of us who have been labeled by psychiatry. Clinicians are not immune to trauma responses and may not be aware when they are reacting to our challenges through the lens of their own past.
Note: Thanks to the Mental Health Empowerment Project, Cathy Cave, Bill Gamble and the NYC Department of Health and Mental Hygiene's Office of Consumer Affairs for making the training on trauma-informed peer support possible.
Ward Stories
Ward
Stories
Organized
by Dan Frey
Two
poets are featured in the summer 2015 edition of ward stories: Craig
R. Bayer and Sheryl.
Craig describes his hot and cold relationship toward the King of the
Universe and Sheryl's song encourages her (and all women) to be
strong. Enjoy.
Untitled
Poem
By
Craig R. Bayer
God
You’ve blessed me with so much
A loving family
A privileged background
Charismatic rabbis
Great teachers and professors
A joyful and carefree youth
Yet you’ve seemingly cursed me, too
My family was ultimately cynical about religion and it stifled my early attempt at zealotry
You crippled my mother with mental illness
Took away my kindergarten playmate Teri (whom I thought I was destined to marry yet she declined to attend my bar mitzvah)
Deprived me of sex until I was in my twenties
Made a joke out of my attempts to find a career
Yet you saved me that postgraduate summer in Boston
When this bold artist and revolutionary couldn’t find a decent job or pay the rent
The stress was so intense that my ears heard the slightest of sounds
I was depressed and virtually psychotic
I thought I was under surveillance
My anger turned me from a peaceful democratic socialist into a potentially violent Marxist-Leninist
But then I read the biography of Martin Luther King: “Bearing the Cross”
And it described how his faith in You gave him comfort, direction and strength
And I gave my mind and soul back to You
And my inner turmoil subsided…
From that point on, it’s been a journey about how to properly serve You and the people
Should I remain a Jew
Or go Christian or Buddhist?
What if I don’t want to accept that Jesus is your son or that the world is what it is?
Should I give up Marxism, embrace capitalism?
Should I be a professor or rabbi or journalist or hack?
I always fall back on being Marxist Jew and poet
But I think that my journey will never ever be complete
All I know is that I need You for my sanity
Because secular life turned out to be bankrupt and traumatic.
You’ve blessed me with so much
A loving family
A privileged background
Charismatic rabbis
Great teachers and professors
A joyful and carefree youth
Yet you’ve seemingly cursed me, too
My family was ultimately cynical about religion and it stifled my early attempt at zealotry
You crippled my mother with mental illness
Took away my kindergarten playmate Teri (whom I thought I was destined to marry yet she declined to attend my bar mitzvah)
Deprived me of sex until I was in my twenties
Made a joke out of my attempts to find a career
Yet you saved me that postgraduate summer in Boston
When this bold artist and revolutionary couldn’t find a decent job or pay the rent
The stress was so intense that my ears heard the slightest of sounds
I was depressed and virtually psychotic
I thought I was under surveillance
My anger turned me from a peaceful democratic socialist into a potentially violent Marxist-Leninist
But then I read the biography of Martin Luther King: “Bearing the Cross”
And it described how his faith in You gave him comfort, direction and strength
And I gave my mind and soul back to You
And my inner turmoil subsided…
From that point on, it’s been a journey about how to properly serve You and the people
Should I remain a Jew
Or go Christian or Buddhist?
What if I don’t want to accept that Jesus is your son or that the world is what it is?
Should I give up Marxism, embrace capitalism?
Should I be a professor or rabbi or journalist or hack?
I always fall back on being Marxist Jew and poet
But I think that my journey will never ever be complete
All I know is that I need You for my sanity
Because secular life turned out to be bankrupt and traumatic.
Who
You Are
By
Sheryl
It's
hard to be optimistic
Looking though an aged mirror
Not seeing the girl
I used to know
The smile hiding inside
Somewhere like a rose
Its leaves die
Looking though an aged mirror
Not seeing the girl
I used to know
The smile hiding inside
Somewhere like a rose
Its leaves die
People say your pessimistic
Why can't you see the glass half full?
You would rather tip it over
Cry out yesterday a river
Distress eustress
Negative and positive
Where is the empowerment of
the
woman you use to be?
Has generativity after the break up
Confused you on commitment
Are you quality?
Chorus:
Procrastination will not bring you anything
What you're waiting for
It's time to open the door to today
Perfectionism is hard to attain in the past
The clock on the wall
Stop forgetting who you are
Who you are?
Has generativity after the break up
Confused you on commitment
Are you quality?
Chorus:
Procrastination will not bring you anything
What you're waiting for
It's time to open the door to today
Perfectionism is hard to attain in the past
The clock on the wall
Stop forgetting who you are
Who you are?
|
Stop
meditation on the past You should be glad that it past Hypnosis on one guy Why wait and listen To the stranger's feedback They all are lies Why treat them like cognitive self talk Can you see the lack of self-esteem Keep your mind on who you are Rather than what people think you do Only you know the truth. Distress eustress Negative and positive Where is the empowerment of the woman you used to be? Has generativity after the break-up confused you on commitment Are you quality? Chorus: Procrastination will not bring you anything What are you waiting for It's time to open the door to today Perfectionism is hard to attain in the past The clock on the wall, stop forgetting who you are Who you are? |
Meet the New Deputy Executive Commissioner
Meet the New Deputy
Executive Commissioner
By Dan Frey, Editor in Chief
Crucial Issues to the Mental Health
Community Discussed
On January 20th at Fountain
House clubhouse in Hell's Kitchen, members of New York City's mental
health community met the new Executive Deputy Commissioner for the
New York City Department of Health and Mental Hygiene (DOHMH),
Division of Mental Hygiene: Gary Belkin, MD, PhD, MPH. The event was
organized by the DOHMH Office of Consumer Affairs whose mission is to
ensure that the consumer perspective is heard and integrated at all
levels of government. Carlton Whitmore is the director of this office
and Teena Brooks, LMSW, assistant director.
Dr. Belkin responded to questions from
a planning committee whose members were: Wendy Brennan, Lynnae Brown,
Angela Hebner, Carla Rabinowitz, Samene Reid, Rachel Saloman and
Moneer Zarou. Topics ranged from housing and criminal justice to
employment and managed care. Some topics listed in the evening's
program such as cultural competence and the assisted outpatient
treatment program were barely touched upon.
Housing
On housing, Dr. Belkin said that
governor Cuomo might approve funding for around 5,000 units of
housing for New York State's homeless, mental health, HIV/AIDS,
substance abuse, and domestic violence populations, including
families and youth. The campaign for supportive housing, known as
NY/NY 4, requested 30,000 units for these disadvantaged groups in New
York City over ten years.
Criminal Justice
On criminal justice, Dr. Belkin said
that, in response to the unnecessary death of a mentally ill Rikers'
inmate, mayor de Blasio's criminal justice taskforce will address
issues of mental illness and substance abuse at every stage of the
criminal justice system, including proper discharge planning from
jail to the community. He said “drop-off centers” will be created
as alternatives to incarceration for people with mental illness, with
the first one to roll out in the fall of 2015 in upper Manhattan.
These drop-off centers should offer an array of services to help keep
our peers out of the justice system. As part of a comprehensive plan,
corrections officers and police officers will receive training on
“deescalation” and understanding behavioral health issues similar
to what other states have been doing with good results.
Employment
The unemployment rate among people with
serious mental illness is a staggering 90%. Dr. Belkin said his
department funds 15 different employment programs and continues to
advocate for more peer hiring. He said that in the future managed
care environment, providers will be held accountable for improved
employment outcomes and that peer services will be Medicaid
reimbursable. He said an “RPC” or regional planning consortium
will be created that brings advocates and stakeholder groups together
to discuss issues of standardization, performance, service planning,
and resource allocation.
Medicaid Managed Care
On the future of service delivery in a
Medicaid, managed care environment (see “Medicaid Managed Care:
Rising to the Challenge” by Briana Gilmore, Winter 2015 edition),
Dr. Belkin said “HCBS” (home and community-based services) will
be offered through the “HARP” (health and recovery plans) for
individuals with significant health and behavioral health needs.
Fully integrated dual advantage plans (FIDA)will be available for
people with both Medicaid and Medicare who use community-based
long-term care services.
Peer Jobs
There was a concern among those in
attendance that peer workers who lacked a GED or high school diploma,
which is currently required to become a certified peer specialist,
would lose their jobs in this new billing environment, but Dr. Belkin
assured us that not all services will be billable to Medicaid and
some will continue to receive funding from the city. The smaller
provider organizations will receive technical support to help them
make the transition to Medicaid billing. He said he was unsure how
many city contracts, if any, will be displaced by the shift to
Medicaid billing.
Conclusion
Although Dr. Belkin and his senior
staff were weary from a long day at the office, we were glad that
they made it to the forum that evening. His liberal use of acronyms
was a bit off-putting, but he did his best to explain some difficult
concepts. The crowd seemed pleased with the event, but I was left
wondering how much influence we would have on future policies that
will affect our lives. Most of us don't even know how to speak the
language that large bureaucracies use, let alone how to affect change
within them. For those of us who do, I hope you step up to the plate
and get involved. We desperately need representation with
sensitivity, intelligence and strength.
Mayor De Blasio Pledges to Implement Crisis Intervention-Team Model
Mayor De Blasio Pledges to Implement Crisis Intervention-Team Model
By Carla Rabinowitz, Community Organizer, Community Access, Inc.
Police Can and Should Handle People in Crisis with More Care
Three years ago Community Access and a few organizations formed the Communities for Crisis Intervention Teams in NYC (CCITNYC) to improve relations between the New York Police Department (NYPD) and New Yorkers with mental illness.
Our goal is to encourage the police to implement a new model of police training where police can identify someone in crisis and respond in a way that de-escalates the crisis, and recognizes that the person in crisis is mentally ill and not a criminal. We now have more than 75 organizations supporting us.
Fortunately, the mayor shares our vision and will create two centers where police can drop off people in crisis and will train 5,500 of the city’s 35,000 officers on identifying mental health symptoms and de-escalating crisis situations.
This is part of the mayor’s new Task Force on Criminal Justice and Behavioral Health. Other areas of change include post-booking diversion, CIT-like training for correction officers, and more help when people leave prison and re-enter the community. In all, the mayor has pledged $130 million for this effort.
A CIT (Crisis Intervention Team) is a method of policing that provides officers with the tools they need to respond to incidents involving people in emotional distress. CITs ensure safe and respectful interactions between mental health recipients and law enforcement.
CITs require coordination between the public health system, police departments and the mental health community. Police need a place to quickly drop off people in crisis and return to other police calls. This is why the mayor’s centers are so important. Without them, police could sit for hours in emergency rooms with each person in crisis.
CITs are needed because the NYPD responds to 150,000 calls of those in mental health crisis a year. They call these calls EDPs (Emotionally Disturbed Person calls). And today NYPD officers receive little training on how to handle these calls.
So what happens? A family member or a housing agency calls for an ambulance if a person is in crisis. Police show up and go into their routine training model of “Command and Control,” proving police are in control. Police may start shouting commands or say to the mental health recipient “do you want to do this the easy way or the hard way?”
Right away the encounter escalates, and the mental health recipient who is in crisis becomes more upset. Sometimes all that happens is a long wait at a hospital or city jail. Sometimes, these encounters take a turn for the worse. In the last two years there have been several fatalities and beatings of mental health recipients by the NYPD. There are also the financial costs.
New York City has set aside $674 million to cover claimants' cases against it and expect to pay $782 million in 2016. Police misconduct, injury and civil rights allegations against the NYPD make up more than 1/3 of claims against the city. Just one of those shootings could cost a city millions of dollars.
The benefits of a CIT program are:
1. Less time for officers in between crisis calls. Chicago reduced this down time from eight hours to 30 minutes;
2. Fewer injuries to police and mental health recipients. San Antonio, which has trained 92% of officers, has not seen one use-of-force case since 2008. Houston, which trained 50% of its 5,200 officers, also reported a drop in cases of force;
3. Improved perception of police by mental health recipients and staff at mental health agencies. Many times families or mental health providers are the ones who call the police. They need to know they can trust how police will treat the people they are helping to care for;
4. Law enforcement’s better view of mental health recipients and better confidence working with mental health recipients;
5. More positive media relations for the NYPD and the mayor. In response to one recent police shooting of a person in crisis, the mayor said that he was going to put new training into place to better help address these incidents; and
6. Lends prestige to NYC. Before the mayor’s plan was released, NYC was the only one of the seven largest cities in the USA without CIT training of police.
Some cities like Houston and Los Angeles have social workers riding along with police. Houston has the social worker co-responder model, but does more. Houston trains all of its officers in the traditional CIT 40-hour training and has a telephone line for officers who are not trained in CIT to call in and get advice when the officer is handling an EDP call.
CITS are a win-win for police, the mental health community and the general public. I am excited that the mayor has embraced better training of police and more interactions with mental health community leaders.
By Carla Rabinowitz, Community Organizer, Community Access, Inc.
Police Can and Should Handle People in Crisis with More Care
Three years ago Community Access and a few organizations formed the Communities for Crisis Intervention Teams in NYC (CCITNYC) to improve relations between the New York Police Department (NYPD) and New Yorkers with mental illness.
Our goal is to encourage the police to implement a new model of police training where police can identify someone in crisis and respond in a way that de-escalates the crisis, and recognizes that the person in crisis is mentally ill and not a criminal. We now have more than 75 organizations supporting us.
Fortunately, the mayor shares our vision and will create two centers where police can drop off people in crisis and will train 5,500 of the city’s 35,000 officers on identifying mental health symptoms and de-escalating crisis situations.
This is part of the mayor’s new Task Force on Criminal Justice and Behavioral Health. Other areas of change include post-booking diversion, CIT-like training for correction officers, and more help when people leave prison and re-enter the community. In all, the mayor has pledged $130 million for this effort.
A CIT (Crisis Intervention Team) is a method of policing that provides officers with the tools they need to respond to incidents involving people in emotional distress. CITs ensure safe and respectful interactions between mental health recipients and law enforcement.
CITs require coordination between the public health system, police departments and the mental health community. Police need a place to quickly drop off people in crisis and return to other police calls. This is why the mayor’s centers are so important. Without them, police could sit for hours in emergency rooms with each person in crisis.
CITs are needed because the NYPD responds to 150,000 calls of those in mental health crisis a year. They call these calls EDPs (Emotionally Disturbed Person calls). And today NYPD officers receive little training on how to handle these calls.
So what happens? A family member or a housing agency calls for an ambulance if a person is in crisis. Police show up and go into their routine training model of “Command and Control,” proving police are in control. Police may start shouting commands or say to the mental health recipient “do you want to do this the easy way or the hard way?”
Right away the encounter escalates, and the mental health recipient who is in crisis becomes more upset. Sometimes all that happens is a long wait at a hospital or city jail. Sometimes, these encounters take a turn for the worse. In the last two years there have been several fatalities and beatings of mental health recipients by the NYPD. There are also the financial costs.
New York City has set aside $674 million to cover claimants' cases against it and expect to pay $782 million in 2016. Police misconduct, injury and civil rights allegations against the NYPD make up more than 1/3 of claims against the city. Just one of those shootings could cost a city millions of dollars.
The benefits of a CIT program are:
1. Less time for officers in between crisis calls. Chicago reduced this down time from eight hours to 30 minutes;
2. Fewer injuries to police and mental health recipients. San Antonio, which has trained 92% of officers, has not seen one use-of-force case since 2008. Houston, which trained 50% of its 5,200 officers, also reported a drop in cases of force;
3. Improved perception of police by mental health recipients and staff at mental health agencies. Many times families or mental health providers are the ones who call the police. They need to know they can trust how police will treat the people they are helping to care for;
4. Law enforcement’s better view of mental health recipients and better confidence working with mental health recipients;
5. More positive media relations for the NYPD and the mayor. In response to one recent police shooting of a person in crisis, the mayor said that he was going to put new training into place to better help address these incidents; and
6. Lends prestige to NYC. Before the mayor’s plan was released, NYC was the only one of the seven largest cities in the USA without CIT training of police.
Some cities like Houston and Los Angeles have social workers riding along with police. Houston has the social worker co-responder model, but does more. Houston trains all of its officers in the traditional CIT 40-hour training and has a telephone line for officers who are not trained in CIT to call in and get advice when the officer is handling an EDP call.
CITS are a win-win for police, the mental health community and the general public. I am excited that the mayor has embraced better training of police and more interactions with mental health community leaders.
Wednesday, February 11, 2015
Emotional Support Dogs and Service Dogs for People with Mental Illness
Emotional Support Dogs and Service Dogs
for People with Mental Illness
By Cissy Stamm,
Co-Founder,
New York Area Assistance Dogs
You Too Can Benefit from Animal
Companionship
The Basics
Something happens when humans and
animals interact. For millennium we’ve been aware of it. Now the
science is developing. Much of the effect of human/animal interaction
appears to be the result of the release of the hormone oxytocin,
often called the bonding hormone between mother and nursing child. It
now appears that the release of oxytocin may be mutual, meaning both
the animal and the human experience it.
For the research on the reasons behind
the beneficial effects of human/animal interaction and what those
benefits are, a summary of the research can be found at: Psychosocial
and Psychophysiological Effects of Human-Animal Interactions: The
Possible Role of Oxytocin
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408111/
This is good information to give to any
healthcare provider if you are considering getting an emotional
support animal (or service dog), especially if you live in “No
Pets” housing.
One of the first things that need to be
clarified is proper and legal terminology.
Therapy Animals
A Therapy Animal is an animal that
provides comfort to a person other than its owner. The animal can in
addition act as an emotional support animal for its owner. Therapy
dogs usually have to go through special training for this kind of
work, be certified and have insurance, normally provided through the
organization that trains therapy animals and arranges pet visitation
in various venues.
Emotional Support Animals
An Emotional Support Animal is an
animal that provides comfort and support to a person with a
psychological disability. They need not have any specialized
training, and are not considered pets for the purposes of most
housing pet limitations. They are legally covered under the Federal
Housing and Urban Development (HUD) regulations and are considered
“reasonable accommodations” so that people with disabilities can
have enjoyment of their homes equal to that of people without these
conditions. A request for reasonable accommodation must be given to
one’s landlord in “no pets” housing or housing that has pet
weight limits (which your animal may exceed) if your animal is for
emotional support. A letter from a healthcare provider stating the
need for the animal is required. It need not state the nature of
one’s disability. It is important to note that Emotional Support
Animals do not have public access with their handlers, except under
certain conditions, on airlines. Emotional support dogs must not
create a nuisance in housing. A sample request for accommodation
letter for a landlord can be found at Fair Housing Information Sheet
# 6, Bazelon Center Right to Emotional Support Animals in "No
Pet" Housing:
http://www.bazelon.org/LinkClick.aspx?fileticket=mHq8GV0FI4c%3D&tabid
Service Animals
A Service Animal is a dog who has been
trained to do tasks to mitigate an ADA-covered disability. A
description of a service dog and the laws covering its use can be
found at: Revised Service Animal Brief
http://www.ada.gov/service_animals_2010.htm
It is very important to note that most
individuals are not qualified to train a service dog and will need
professional help. People using service dogs have access with their
dogs to places the public can normally go. Service dogs are expected
to behave appropriately in public and not bark, bite, to be
house-broken, and not interact with other people or dogs without the
handler’s permission.
Another thing that must be considered
when thinking about a service dog is one’s ability to deal calmly
with situations in which one is denied access because s/he is
accompanied by their service dog. This can happen at any time
whenever you encounter an employee or owner who isn’t familiar with
or doesn’t care about the law. If you are not prepared for the
possible stresses of public access, you might be better served not
considering a service dog.
In either case, one needs to be able to
afford to feed a service dog (food allowance under SNAP still being
tested), and veterinary care and training if necessary.
Reasonable accommodation as described
for emotional support animals should also be requested for service
dogs in no-pets housing.
Persons with questions on emotional
support animals or service dogs in housing can contact their local
HUD office. Questions on service dogs in employment and places of
public accommodation can be answered by the ADA hotline: 800-514-0301
(Voice) and 800-514-0383 (TTY) or you can contact Cissy Stamm at New
York Area Assistance Dogs for free information and advocacy at
212-677-4383.
Pullout: “An Emotional Support
Animal...provides comfort and support to a person with a
psychological disability...need not have any specialized training,
and are not considered pets for the purposes of most housing pet
limitations.”
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