Mobilization for Justice Helps Nursing Home Residents Live More Independently
By Daniel A. Ross, Senior Staff Attorney, Mobilization for Justice, Inc. (Formerly MFY Legal Services)
Mobilization for Justice (MFJ) offers nursing home residents advice and representation on a wide range of legal matters. MFJ’s Nursing Home Residents Project continues the work of Friends and Relatives of the Institutionalized and Aged (FRIA), which provided information and advice to nursing home residents and their families for 35 years.
Callers to the Nursing Home Residents Project’s intake line receive advice about residents’ rights, decision-making, Medicaid and Medicare, and discharge planning. We also represent individuals in administrative hearings and litigation to preserve their apartments in the community, obtain home care, and protect residents’ rights.
For example, one of our clients, Ms. L, is a nursing home resident in Far Rockaway. She wanted to attend her granddaughter’s graduation ceremony in the Bronx. She contacted us when the nursing home refused to approve a day pass. MFJ filed a lawsuit that forced the nursing home to allow her to attend the graduation. Ms. L explained that a day pass “is important because it helps me relax, gives me something to look forward to, allows me to visit my family and reconnect with friends.” We published a report about this widespread problem called Imprisoned in Their Homes.
In another case, Medicaid denied rehabilitation services for Ms. H, a nursing home resident who wanted to return to her apartment. MFJ successfully challenged the denial so she could receive additional therapy. She’s looking forward to returning home.
MFJ also advocates for residents who need help getting discharged from a nursing home. While Ms. G was in a nursing home, her landlord had illegally evicted her from her apartment. MFJ forced the landlord to provide her with another apartment. We also helped her obtain the home care and other services she needed to succeed in the community.
MFJ tracks trends in the complaints we receive to support policy advocacy and impact litigation. With pro bono help from Patterson Belknap Webb & Tyler LLP, we represent plaintiffs in a class action case against the Department of Health. The lawsuit alleges that many nursing home residents have waited years for services from the Nursing Home Transition and Diversion Waiver Program. The plaintiffs are among thousands of New Yorkers who remain trapped in nursing homes, when they could be receiving the care they need in their own homes.
MFJ hosts the Alliance of New York Family Councils (ANYFC). ANYFC is a group of leaders of nursing home family councils who share information and advocacy strategies to ensure their loved ones receive quality care. We also present trainings for the Long-Term Care Ombudsman Program and provide technical assistance to lawyers and other advocates.
In 2012, MFJ revised FRIA’s guide for residents and families, Nursing Homes and Alternatives. Called “the bible of long-term care for the elderly and their caregivers,” this book has been used by many families to ensure that their relatives receive the care they deserve in nursing homes. MFJ also developed short fact sheets on common problems faced by nursing home residents and their families, including residents’ rights, visitor policies, involuntary discharge, and medical decision-making.
For assistance with a legal problem affecting a nursing home resident, call MFJ’s Nursing Home Residents Project on Tuesdays between 10:00 a.m. and 5:00 p.m. at 855-444-6477.
Monday, June 18, 2018
Criminal Justice Forum Reveals New Information and Old Problems
Criminal
Justice Forum Reveals New Information and Old Problems
By
Carla Rabinowitz, Advocacy Coordinator, Community Access, Project Coordinator,
Communities for Crisis Intervention Teams in NYC (CCINYC)
Community
Asks Its Leaders, “What Is Taking So Long?”
The
Daily News, The Greenburger Center for Social and Criminal Justice, and Metro
Industrial Areas Foundation(IAF) hosted a forum on diverting people with mental
health concerns away from the criminal justice system.
The
February 14, 2018 forum was actually the 4th in a four-part series.
The
focus of the last forum was Crisis Intervention Team training and catching
people at the first intercept. An intercept is a step where people encounter
the criminal justice system. There are 4 intercepts:
·
Intercept
1 is on the streets, where people meet police;
·
Intercept 2 is from arrest to disposition;
·
Intercept
3 is diverting people when they are in jail away from longer sentencing; and
·
Intercept
4 is release and re-entry.
In
attendance were some heavy hitters in the field of mental health and criminal
justice. There was Dr. Gary Belkin, Executive Deputy Commissioner of the New
York City Department of Health and Mental Hygiene(DOHMH), Commissioner
Elizabeth Glazer, Director of the Mayor’s Office of Criminal Justice, and NYPD
Commissioner James O’Neill.
A
large part of the planning for this event centered not only on what the police
are doing but what the Mayor is doing to find solutions to the recent string of
nine police shootings of New York City residents with mental health concerns
during crisis calls, or Emotionally Disturbed Person(EDP) calls.
In
2014, Mayor de Blasio convened an impressive Taskforce to look into all the
intercepts where people with mental health needs encounter the criminal justice
system. Many city agencies and health care providers were on that Taskforce.
Each stage of encounter—intercept—had a committee.
I
was on the Taskforce committee that strategized about Intercept 1. We
brainstormed for a year and came up with the recommendation to train police
about how to respond to those in emotional crisis and to build two drop-off
centers where police could take people in distress, now known as diversion
centers.
At
the meeting in February, Elizabeth Glazer was asked about whether Mayor de
Blasio would revive his Taskforce on Criminal Justice and Behavioral Health.
Glazer
did not publicly answer the question. But as I caught her walking out the door
she said the Mayor was working on something, maybe not what we want, but some
version of a Taskforce. But politicians
always say that.
Dr.
Gary Belkin was grilled on why DOHMH has not yet built the two diversion
centers promised in 2014. Dr. Belkin noted that Project Renewal and Samaritan
Day Top Village were awarded contracts to build the diversion centers recently.
But the questions are still: where will they find the land to build the massive
diversion centers? And how long will the construction take? No timeline has
been given.
Commissioner
O’Neill was asked many questions and hit with many concerns, as one might
imagine. To his credit, the Commissioner answered all questions and remained
after the end of the Forum to speak to people.
Commissioner
O’Neill admitted that most EDP encounters occur quickly. He noted one shooting
occurred in the first 17 seconds of officers being on the scene. Usually
experts say the first 3 to 4 minutes is where violence occurs.
Many
people asked about non-police alternatives to answering the crisis calls.
Surprisingly,
O’Neill stated that Staten Island is piloting a program where some 911 calls
get screened to determine if police are needed or if social workers can field
the call instead. Little is known about this program to anyone. This program
was not mentioned in the quarterly NYPD advocate meetings I attend, nor is
DOHMH staff familiar with this program.
Instances
of projects being hidden like this show the need for the Mayor to bring a Taskforce
back together to look at alternatives like this, and at least to issue reports
to the public on what is already being done.
Beyond the Medical Model with Neesa
Beyond the Medical Model with Neesa
A Column by Neesa Sunar, Peer Specialist, Transitional Services for New York, Inc.
Changing the Language That is Used to Describe Us
Many of us who find ourselves in the mental health system have shared experiences as to how we got there. To speak on my own experiences, I first displayed “maladaptive,” saddening symptoms as a teen, which then led to my first hospitalization at around my fourteenth birthday. I was diagnosed with clinical depression and medicated with Zoloft. Upon returning to school, I labeled myself as “depressed,” which elicited within me a negative worldview amongst my classmates. My experiences with mental illness seemed alien to them, so my label further served to summarize my failures in forging meaningful friendships.
My condition turned for the worse when I developed schizoaffective disorder in my early twenties. Again, this diagnosis became a box I fell into, deeming me a “schizophrenic.” Adopting this label as a self-descriptor caused me to feel broken in mind and character. And even as I remained compliant with medications and psychiatric appointments, I continued relapsing, causing me to believe that my schizophrenia would haunt me for the rest of my life. Thus, the label seemed inescapable, thus sadly accurate.
My inability to work caused me to file for disability, which was an incredibly freeing experience. I began openly disclosing my illness to anyone who would serve as an audience, and even felt proud that my struggles had a name, instead of being some amorphous spiritual curse. At the same time, the label of “schizophrenic” still caused people to distance themselves from me. Perhaps my label served as a threat, indicating that I had lying dormant within me a sense of criminality.
When discovering the peer movement in 2014, beginning as a student at Howie the Harp Advocacy Center, I learned that I had been entrenched in the Medical Model for my entire mental illness “career.” I realized that I had completely internalized and unconditionally accepted the top-down dynamics of the therapeutic relationship between practitioner and consumer. I absorbed that my mental illness diagnosis served as a label that indicated who I was and the future trajectory for the remainder of my life. And that all this was an injustice.
I became appalled that I had never even heard of the Recovery Model as a counter to the Medical Model. Even in this massive city of New York, brimming with resources, I had never encountered peer specialists or Recovery Model enthusiasts. How could this be? Many of the peers I have since met proudly disown their diagnoses as descriptors, instead using more affirming language such as, “I am a person with schizophrenia,” or “I have past lived experience.” The peer community is a group of vibrant people with dynamic personalities, free from such labels. Bearing this perspective, we flourish and grow in our own recovery journeys as we influence and support one another.
Many of us peers are compelled to take action as mental health advocates in our communities. When we fight for widespread awareness of peers and the Recovery Model, we hope to challenge people in reevaluating their perspectives of those with mental illness. Part of our advocacy efforts should also include the request for creating alternative language that is person-centered, trauma-informed and affirming. A person “suffers from” or “experiences” mental illness and is not the illness itself. And what defines mental illness anyway? Descriptive words such as “crazy,” “insane” or “dysfunctional” also serve to obscure the personhood of one suffering. When insensitive language is used, a person can internalize this and develop a sense of shame and fear. This can prevent a person from reaching out to friends, family, and/or professionals. In the worst of situations, such silence can end in immense and irreversible tragedy.
As we advocate for change in language, we must also recognize that each individual has their preference for how they should be regarded. Some people prefer to be called “disabled,” while others eschew the term. Other terms can be preferred as well, such as “mentally ill,” “other-abled,” “neurodiverse,” “chronically ill,” “in remission,” or simply “a human being.” In the same way that the transgender community has fought for preferred pronouns, so too should we demand that mainstream society develops interest in engaging the mental health community with respectful language.
We each have our individual journeys towards recovery, as we leave behind our pasts to walk towards a bright future. The hope and vision that guides us in this process can be the foundation on which we stand, as we fearlessly share our stories of recovery. Part of our stories can include how we have reclaimed our lives by adopting affirming language. If we are able to incite curiosity in our audiences, we may enjoy immense success in this endeavor.
A Column by Neesa Sunar, Peer Specialist, Transitional Services for New York, Inc.
Changing the Language That is Used to Describe Us
Many of us who find ourselves in the mental health system have shared experiences as to how we got there. To speak on my own experiences, I first displayed “maladaptive,” saddening symptoms as a teen, which then led to my first hospitalization at around my fourteenth birthday. I was diagnosed with clinical depression and medicated with Zoloft. Upon returning to school, I labeled myself as “depressed,” which elicited within me a negative worldview amongst my classmates. My experiences with mental illness seemed alien to them, so my label further served to summarize my failures in forging meaningful friendships.
My condition turned for the worse when I developed schizoaffective disorder in my early twenties. Again, this diagnosis became a box I fell into, deeming me a “schizophrenic.” Adopting this label as a self-descriptor caused me to feel broken in mind and character. And even as I remained compliant with medications and psychiatric appointments, I continued relapsing, causing me to believe that my schizophrenia would haunt me for the rest of my life. Thus, the label seemed inescapable, thus sadly accurate.
My inability to work caused me to file for disability, which was an incredibly freeing experience. I began openly disclosing my illness to anyone who would serve as an audience, and even felt proud that my struggles had a name, instead of being some amorphous spiritual curse. At the same time, the label of “schizophrenic” still caused people to distance themselves from me. Perhaps my label served as a threat, indicating that I had lying dormant within me a sense of criminality.
When discovering the peer movement in 2014, beginning as a student at Howie the Harp Advocacy Center, I learned that I had been entrenched in the Medical Model for my entire mental illness “career.” I realized that I had completely internalized and unconditionally accepted the top-down dynamics of the therapeutic relationship between practitioner and consumer. I absorbed that my mental illness diagnosis served as a label that indicated who I was and the future trajectory for the remainder of my life. And that all this was an injustice.
I became appalled that I had never even heard of the Recovery Model as a counter to the Medical Model. Even in this massive city of New York, brimming with resources, I had never encountered peer specialists or Recovery Model enthusiasts. How could this be? Many of the peers I have since met proudly disown their diagnoses as descriptors, instead using more affirming language such as, “I am a person with schizophrenia,” or “I have past lived experience.” The peer community is a group of vibrant people with dynamic personalities, free from such labels. Bearing this perspective, we flourish and grow in our own recovery journeys as we influence and support one another.
Many of us peers are compelled to take action as mental health advocates in our communities. When we fight for widespread awareness of peers and the Recovery Model, we hope to challenge people in reevaluating their perspectives of those with mental illness. Part of our advocacy efforts should also include the request for creating alternative language that is person-centered, trauma-informed and affirming. A person “suffers from” or “experiences” mental illness and is not the illness itself. And what defines mental illness anyway? Descriptive words such as “crazy,” “insane” or “dysfunctional” also serve to obscure the personhood of one suffering. When insensitive language is used, a person can internalize this and develop a sense of shame and fear. This can prevent a person from reaching out to friends, family, and/or professionals. In the worst of situations, such silence can end in immense and irreversible tragedy.
As we advocate for change in language, we must also recognize that each individual has their preference for how they should be regarded. Some people prefer to be called “disabled,” while others eschew the term. Other terms can be preferred as well, such as “mentally ill,” “other-abled,” “neurodiverse,” “chronically ill,” “in remission,” or simply “a human being.” In the same way that the transgender community has fought for preferred pronouns, so too should we demand that mainstream society develops interest in engaging the mental health community with respectful language.
We each have our individual journeys towards recovery, as we leave behind our pasts to walk towards a bright future. The hope and vision that guides us in this process can be the foundation on which we stand, as we fearlessly share our stories of recovery. Part of our stories can include how we have reclaimed our lives by adopting affirming language. If we are able to incite curiosity in our audiences, we may enjoy immense success in this endeavor.
Nine Dead in Two Years in NYC and No One is Listening
Nine Dead in Two Years in NYC and No One is Listening
By Carla Rabinowitz, Advocacy Coordinator, Community Access, Project Coordinator, Communities for Crisis Intervention Teams in NYC (CCINYC)
The Mental Health Community Demands Change
On Friday, February 23rd, 2018, dozens of community members gathered to mourn the lives of people lost in NYPD encounters in the last two and a half years.
At the memorial, we talked about the need to get the newly trained Crisis Intervention Team (CIT) officers to the scene of crisis calls.
We talked about the need for Mayor de Blasio to revive an old 2014 Taskforce to come up with other alternatives to police responding to these calls. Whether it is diverting calls to social workers or therapists to meet police on the scene, or trained peers responding in the community. We need alternatives to police responding to crisis calls.
But mainly it was a day for family, friends, and the community to mourn our nine losses.
We read the names of each life lost, and after each name was read, we popped a black balloon to signify their death.
Steve Coe, CEO of Community Access, implored the Mayor to revive the Taskforce, get all the experts in the room to figure out what is working, what is not working, and to fix this.
Below is my speech in full. At the memorial we spoke, and here we print the names of our community members so that we can remember them:
“Mario Ocasio was killed June, 2016. He was 51 years old. Mario was an uncle and a boyfriend. Mario, you are missed.
“Rashan Lloyd was killed June, 2016. Rashan was only 25 years of age when he died. Rashan was a construction worker and Rashan was raising his 4-year-old son. Rashan you are missed.
“Deborah Danner was killed in October, 2016. Deborah was well known in both the mental health and faith communities. Deborah was a regular member of Fountain House, a clubhouse in NYC. And Deborah was a long timelong-time member of Trinity Church. She participated in the poetry and knitting groups. Deborah predicted her own death at the hands of police on a blog she wrote. Deborah you are missed.
“Dwayne Jeune was killed July, 2017. Dwayne was a Caribbean immigrant. He died at 32 years of age. Dwayne was a devoted son, who often helped his mother with groceries and could sometimes be found dancing in front of a mirror in the hallway outside his apartment. Dwayne’s cousin said Dwayne was a soft-spoken, mild-mannered person who never bothered anyone. Mr. Jeune you are missed.
“Ariel Galarza was killed November 2016 when police mistook a hot sauce bottle for a knife. He was 49-years-old when he was killed. Ariel was described as a peaceful, hardworking man. Ariel was a role model for his nephews and loved dearly by his little sister. Ariel you are missed.
“Andy Sookdeo died in August 2017. He was only 29 years old. Andy took his own life when confronted with police. Andy had been a school bus driver before things fell apart. Not only did Andy die in this encounter, but police were injured as well. Andy, you are missed.
“Miguel Richards was killed in September, 2017. Miguel was a college student from Jamaica living in NYC in an exchange program. He died at 31 years of age. Miguel was an IT expert with a bright future. Police had 17 minutes to talk Miguel down using de-escalation skills, but instead they just shouted commands at him, telling him they would shoot him if he did not comply. Maybe that’s what Miguel wanted at that moment. Miguel you are missed.
“Cornell Lockhart was killed in November, 2017. He was 67-years-old when he died. Lockhart had lived in a supportive housing residence for six years before his death. When police shot him, Cornell’s arms were down at his side and his back was against a wall. Cornell you are missed.
Dwayne Pritchett was killed in January, 2018. Dwayne was 48 years of age at his death. Dwayne was a barber. He was raising his 3-year-old son with his female partner., but left to live with his father about a week before his death. Mr. Pritchett you are missed.
Let these lives lost not be in vein. Let’s strengthen our resolve to continue the work to find new solutions to crisis calls that so many people in the mental health community face.
We demand the Mayor revive his Taskforce to find non-police responses to crisis calls before one more life is lost.
By Carla Rabinowitz, Advocacy Coordinator, Community Access, Project Coordinator, Communities for Crisis Intervention Teams in NYC (CCINYC)
The Mental Health Community Demands Change
On Friday, February 23rd, 2018, dozens of community members gathered to mourn the lives of people lost in NYPD encounters in the last two and a half years.
At the memorial, we talked about the need to get the newly trained Crisis Intervention Team (CIT) officers to the scene of crisis calls.
We talked about the need for Mayor de Blasio to revive an old 2014 Taskforce to come up with other alternatives to police responding to these calls. Whether it is diverting calls to social workers or therapists to meet police on the scene, or trained peers responding in the community. We need alternatives to police responding to crisis calls.
But mainly it was a day for family, friends, and the community to mourn our nine losses.
We read the names of each life lost, and after each name was read, we popped a black balloon to signify their death.
Steve Coe, CEO of Community Access, implored the Mayor to revive the Taskforce, get all the experts in the room to figure out what is working, what is not working, and to fix this.
Below is my speech in full. At the memorial we spoke, and here we print the names of our community members so that we can remember them:
“Mario Ocasio was killed June, 2016. He was 51 years old. Mario was an uncle and a boyfriend. Mario, you are missed.
“Rashan Lloyd was killed June, 2016. Rashan was only 25 years of age when he died. Rashan was a construction worker and Rashan was raising his 4-year-old son. Rashan you are missed.
“Deborah Danner was killed in October, 2016. Deborah was well known in both the mental health and faith communities. Deborah was a regular member of Fountain House, a clubhouse in NYC. And Deborah was a long timelong-time member of Trinity Church. She participated in the poetry and knitting groups. Deborah predicted her own death at the hands of police on a blog she wrote. Deborah you are missed.
“Dwayne Jeune was killed July, 2017. Dwayne was a Caribbean immigrant. He died at 32 years of age. Dwayne was a devoted son, who often helped his mother with groceries and could sometimes be found dancing in front of a mirror in the hallway outside his apartment. Dwayne’s cousin said Dwayne was a soft-spoken, mild-mannered person who never bothered anyone. Mr. Jeune you are missed.
“Ariel Galarza was killed November 2016 when police mistook a hot sauce bottle for a knife. He was 49-years-old when he was killed. Ariel was described as a peaceful, hardworking man. Ariel was a role model for his nephews and loved dearly by his little sister. Ariel you are missed.
“Andy Sookdeo died in August 2017. He was only 29 years old. Andy took his own life when confronted with police. Andy had been a school bus driver before things fell apart. Not only did Andy die in this encounter, but police were injured as well. Andy, you are missed.
“Miguel Richards was killed in September, 2017. Miguel was a college student from Jamaica living in NYC in an exchange program. He died at 31 years of age. Miguel was an IT expert with a bright future. Police had 17 minutes to talk Miguel down using de-escalation skills, but instead they just shouted commands at him, telling him they would shoot him if he did not comply. Maybe that’s what Miguel wanted at that moment. Miguel you are missed.
“Cornell Lockhart was killed in November, 2017. He was 67-years-old when he died. Lockhart had lived in a supportive housing residence for six years before his death. When police shot him, Cornell’s arms were down at his side and his back was against a wall. Cornell you are missed.
Dwayne Pritchett was killed in January, 2018. Dwayne was 48 years of age at his death. Dwayne was a barber. He was raising his 3-year-old son with his female partner., but left to live with his father about a week before his death. Mr. Pritchett you are missed.
Let these lives lost not be in vein. Let’s strengthen our resolve to continue the work to find new solutions to crisis calls that so many people in the mental health community face.
We demand the Mayor revive his Taskforce to find non-police responses to crisis calls before one more life is lost.
After Things Go Wrong Sometimes Amazing Things Happen
After Things Go Wrong Sometimes Amazing Things Happen
Book Review by Carl Blumenthal
Some Stories Have No Ending
How many of us could survive one day in New York City’s notorious Rikers Island Jail, given we have behavioral health issues? Wouldn’t admission to a psychiatric hospital be safer and more therapeutic?
Until recently I worked as a peer counselor in the psychiatric ER of Brooklyn’s Kings County Medical Center. I admit that I approached with caution what the police call “emotionally disturbed individuals” (EDI’s) charged with crimes. Even with one wrist handcuffed to a gurney, they were liable to react aggressively. Unfortunately, the sooner they calmed down and went to Rikers, the sooner our staff could focus on less agitated patients.
Having “done time” on psychiatric units as a non-forensic inpatient, I expected a lot more heartbreak than hope in psychiatrist Elizabeth Ford’s Sometimes Amazing Things Happen: Heartbreak and Hope on Bellevue Hospital’s Psychiatric Prison Ward (2017). I was surprised to discover a role model who all mental health providers should copy.
Due to the revolving door between Bellevue and Rikers—the hospital has 68 beds to treat the most distressed of 5,000 inmates with mental illness—she admits, “I have come to see my success as a doctor not by how well I treat mental illness but by how well I respect and honor my patients’ humanity, no matter where they are or what they have done.”
Ford shines a light not just on the jail’s insufferable conditions but also on prisoners’ lives that are too often defined in psychiatric and legal terms. The list of their challenges—addiction, homelessness, poverty, illiteracy, racism, etc—is as long as an indictment. To paraphrase African American psychologist, Amos Wilson, these men have learned to be the best at doing the worst.
Ford proves one wo(man) can make a difference by never giving up on her patients even when society has cast them aside. And they do their part merely by surviving. As one peer tells another in group therapy, “You are worth it, man. You got mad courage. You just hang on and keep going one day at a time. That’s all you got to do.”
Elizabeth Ford may never have taken a course in conflict resolution, but she’s a natural at calming potentially (self-) abusive patients and keeping the peace among staff—mental health providers and corrections officers alike. Even as she climbs the career ladder, there is always someone telling her what to (and not to) do. Yet she’s not afraid to speak truth to power.
Her calling is to assume more and more responsibility for events others consider beyond their control, in the end becoming the current head psychiatrist of the city’s correctional health services. She prefers the intensity of working with psychiatric inmates than other populations in other settings.
For example, Ford is in her glory (or God’s), when, like a modern-day Noah, she evacuates the prisoners to an upstate hospital during super storm Sandy and finds refuge elsewhere for those re-housed on Rikers Island, where she discovers just how poorly those with mental illness and substance abuse are treated.
Is Elizabeth Ford too good to be true? Except for a few moments of self-congratulation, burnout seems to be her only shortcoming, but that’s because she cares too much. Her family and therapist keep her on an even keel; she recognizes her racial, social, and economic privileges. And there are events out of her control, such as the beatings, murders, suicides, and escapes she learns about second-hand.
Ford’s memoir has the pace of a well-directed movie with enough drama to satisfy the most avid consumer of stories about abuses at mental hospitals. Her prose is straight-forward. Her eye for detail demonstrates the mindfulness necessary to survive amidst daily trials and tribulations. She enables us to witness what others can’t or refuse to see.
Thus, it’s the small blessings that give her and us hope: A phone call home by a scared teenager, a grungy prisoner’s unexpected shower, proper clothes for a court appearance, a sing-along in community meeting, ping-pong on a makeshift table, and a patient forgiving a doctor’s mistake.
She concludes Sometimes Amazing Things Happen with these words: “A story without an ending is still a story worth telling.” Meaning these are snapshots of lives—sometimes like our lives—that we must honor, no matter how difficult to appreciate.
Yet, much as she treats our peers humanely, Ford doesn’t hesitate to use both diagnostic labels and psychiatric medication for what she believes is our own good.
Based on my experience in the psychiatric department at Kings County, I now see the language is a shorthand and the meds are shortcuts to get people out of the hospital as quickly as possible. (After all, who wants to be confined in a mental hospital?) It may be only with long-term community services that peers have a better chance to educate clinicians.
I volunteer for the American Friends (Quaker) Service Committee’s Prison Watch to end solitary confinement, which causes and worsens mental illness. Agencies such as CASES, the Fortune Society, and the Osborne Association now rely on peer specialists to connect with ex-prisoners living with behavioral health challenges. I recommend that readers of City Voices get involved in these efforts if not doing so already.
Book Review by Carl Blumenthal
Some Stories Have No Ending
How many of us could survive one day in New York City’s notorious Rikers Island Jail, given we have behavioral health issues? Wouldn’t admission to a psychiatric hospital be safer and more therapeutic?
Until recently I worked as a peer counselor in the psychiatric ER of Brooklyn’s Kings County Medical Center. I admit that I approached with caution what the police call “emotionally disturbed individuals” (EDI’s) charged with crimes. Even with one wrist handcuffed to a gurney, they were liable to react aggressively. Unfortunately, the sooner they calmed down and went to Rikers, the sooner our staff could focus on less agitated patients.
Having “done time” on psychiatric units as a non-forensic inpatient, I expected a lot more heartbreak than hope in psychiatrist Elizabeth Ford’s Sometimes Amazing Things Happen: Heartbreak and Hope on Bellevue Hospital’s Psychiatric Prison Ward (2017). I was surprised to discover a role model who all mental health providers should copy.
Due to the revolving door between Bellevue and Rikers—the hospital has 68 beds to treat the most distressed of 5,000 inmates with mental illness—she admits, “I have come to see my success as a doctor not by how well I treat mental illness but by how well I respect and honor my patients’ humanity, no matter where they are or what they have done.”
Ford shines a light not just on the jail’s insufferable conditions but also on prisoners’ lives that are too often defined in psychiatric and legal terms. The list of their challenges—addiction, homelessness, poverty, illiteracy, racism, etc—is as long as an indictment. To paraphrase African American psychologist, Amos Wilson, these men have learned to be the best at doing the worst.
Ford proves one wo(man) can make a difference by never giving up on her patients even when society has cast them aside. And they do their part merely by surviving. As one peer tells another in group therapy, “You are worth it, man. You got mad courage. You just hang on and keep going one day at a time. That’s all you got to do.”
Elizabeth Ford may never have taken a course in conflict resolution, but she’s a natural at calming potentially (self-) abusive patients and keeping the peace among staff—mental health providers and corrections officers alike. Even as she climbs the career ladder, there is always someone telling her what to (and not to) do. Yet she’s not afraid to speak truth to power.
Her calling is to assume more and more responsibility for events others consider beyond their control, in the end becoming the current head psychiatrist of the city’s correctional health services. She prefers the intensity of working with psychiatric inmates than other populations in other settings.
For example, Ford is in her glory (or God’s), when, like a modern-day Noah, she evacuates the prisoners to an upstate hospital during super storm Sandy and finds refuge elsewhere for those re-housed on Rikers Island, where she discovers just how poorly those with mental illness and substance abuse are treated.
Is Elizabeth Ford too good to be true? Except for a few moments of self-congratulation, burnout seems to be her only shortcoming, but that’s because she cares too much. Her family and therapist keep her on an even keel; she recognizes her racial, social, and economic privileges. And there are events out of her control, such as the beatings, murders, suicides, and escapes she learns about second-hand.
Ford’s memoir has the pace of a well-directed movie with enough drama to satisfy the most avid consumer of stories about abuses at mental hospitals. Her prose is straight-forward. Her eye for detail demonstrates the mindfulness necessary to survive amidst daily trials and tribulations. She enables us to witness what others can’t or refuse to see.
Thus, it’s the small blessings that give her and us hope: A phone call home by a scared teenager, a grungy prisoner’s unexpected shower, proper clothes for a court appearance, a sing-along in community meeting, ping-pong on a makeshift table, and a patient forgiving a doctor’s mistake.
She concludes Sometimes Amazing Things Happen with these words: “A story without an ending is still a story worth telling.” Meaning these are snapshots of lives—sometimes like our lives—that we must honor, no matter how difficult to appreciate.
Yet, much as she treats our peers humanely, Ford doesn’t hesitate to use both diagnostic labels and psychiatric medication for what she believes is our own good.
Based on my experience in the psychiatric department at Kings County, I now see the language is a shorthand and the meds are shortcuts to get people out of the hospital as quickly as possible. (After all, who wants to be confined in a mental hospital?) It may be only with long-term community services that peers have a better chance to educate clinicians.
I volunteer for the American Friends (Quaker) Service Committee’s Prison Watch to end solitary confinement, which causes and worsens mental illness. Agencies such as CASES, the Fortune Society, and the Osborne Association now rely on peer specialists to connect with ex-prisoners living with behavioral health challenges. I recommend that readers of City Voices get involved in these efforts if not doing so already.
Tuesday, March 6, 2018
Mobilization for Justice Helps Nursing Home Residents Live More Independently
By Daniel A. Ross
Mobilization for
Justice (MFJ) (formerly MFY Legal Services) offers nursing home residents
advice and representation in a wide range of legal matters. MFJ’s Nursing Home Residents Project
continues the work of Friends and Relatives of the Institutionalized and Aged
(FRIA), which provided information and advice to nursing home residents and
their families for 35 years.
Callers to the
Nursing Home Residents Project’s intake line receive advice about residents’
rights, decision-making, Medicaid and Medicare, and discharge planning. We also represent individuals in
administrative hearings and litigation to preserve their apartments in the
community, obtain home care, and protect residents’ rights.
For example, one of
our clients, Ms. L, is a nursing home resident in Far Rockaway. She wanted to attend her granddaughter’s
graduation ceremony in the Bronx. She
contacted us when the nursing home refused to approve a day pass. MFJ filed a lawsuit that forced the nursing
home to allow her to attend the graduation.
Ms. L explained that a day pass “is important because it helps me relax,
gives me something to look forward to, allows me to visit my family and reconnect
with friends.” We published a report
about this widespread problem called Imprisoned
in Their Homes.
In another case, Medicaid
denied rehabilitation services for Ms. H, a nursing home resident who wanted to
return to her apartment. MFJ successfully
challenged the denial so she could receive additional therapy. She’s looking
forward to returning home.
MFJ also advocates
for residents who need help getting discharged from a nursing home. While Ms. G was in a nursing home, her
landlord had illegally evicted her from her apartment. MFJ forced the landlord to provide her with
another apartment. We also helped her obtain the home care and other services she
needed to succeed in the community.
MFJ tracks trends
in the complaints we receive to support policy advocacy and impact litigation. With pro bono help from Patterson Belknap
Webb & Tyler LLP, we represent plaintiffs in a class action case against
the Department of Health. The lawsuit
alleges that many nursing home residents have waited years for services from
the Nursing Home Transition and Diversion Waiver Program. The plaintiffs are among thousands of New
Yorkers who remain trapped in nursing homes, when they could be receiving the
care they need in their own homes.
MFJ hosts the
Alliance of New York Family Councils (ANYFC).
ANYFC is a group of leaders of nursing home family councils who share
information and advocacy strategies to ensure their loved ones receive quality care. We also present trainings for the Long-Term
Care Ombudsman Program and provide technical assistance to lawyers and other
advocates.
In 2012, MFJ revised
FRIA’s guide for residents and families, Nursing
Homes and Alternatives. Called “the
bible of long-term care for the elderly and their caregivers,” this book has
been used by many families to ensure that their relatives receive the care they
deserve in nursing homes. MFJ also
developed short fact sheets on common problems faced by nursing home
residents and their families, including residents’ rights, visitor policies,
involuntary discharge, and medical decision-making.
For assistance with
a legal problem affecting a nursing home resident, call MFJ’s Nursing Home
Residents Project on Tuesdays between 10:00 a.m. and 5:00 p.m. at 855-444-6477.
Friday, December 15, 2017
My Mental Health Journey: Stand Up Against Stigma!
By Jacquese Armstrong
I Educate the Next Generation by Disclosing My “Mental Illness”
I’ve lived most of my life literally walking through the valley of the shadow of death. And yet, hope and resilience follow me as if I know the way out. But the one thing I have no hope of changing or getting over is being considered a throw-away person in this society.
These are the words I choose to start the introductory essay in a memoir of essays I call Informed Naivete. One could think that my assertion is a bit skewed or harsh, but these are my thoughts associated with the aftermath of the dreaded “s” word.
Often, I’ve thought that if everyone who has, or cared about someone with, a mental illness stood up against stigma, we would outnumber the rest. Where would the stigma be then? And stigma is real. It can not only make your social life uncomfortable, but it can greatly affect your ability to earn a decent living.
So, why do I choose to disclose my mental health challenges? Why would I publish articles under my birth name, publish a poetry chapbook on my mental health challenges and welcome the chance to speak on mental health challenges and stigma and why am I so adamant about it, knowing what I know?
Although I am a psychiatric survivor of 35 years, I have only disclosed since 2006 when I agreed to be interviewed for a documentary on mental illness and minorities. Now, I have many projects that would be all but impossible to do without disclosing. Of course, it was a journey.
Before 2006, my “mental illness” was my most well-guarded secret. I lost a lot of friends in those first couple of years in the 80s and there were whispers and stares, but then I moved more than once. Because I was still in and out of the hospital, I developed lies and kept them going.
The lies were used to patch the holes in my resume, explain the eight years it took me to finish college, the many colleges I attended, the disappearances, and the work absences. The world definitely doesn’t make it easy for you to resume the race and the charade becomes a job within itself. It also led to undue stress and anxiety. It fueled my paranoid symptoms, which at the time, were not under control at all. I was always in a state of flux, wondering who knew.
I came to realize that I was stigmatizing myself by living in fear and shame, playing into the stigma game. I asked myself, “How can I call for an end to stigma and discrimination if I am ashamed myself.”
It’s almost like making the decision to go natural with your hair. When I did, it wasn’t popular and it’s still not aesthetically pleasing to some employers. I looked at myself in the mirror one day as I blow-dried my hair and curled it with a curling iron and asked, “What’s wrong with my hair?” This was the day of a huge self-embrace. The 2006 documentary I participated in was another. Looking back, that decision was the beginning of my making sense of this mess.
Self-disclosure provided me with the freedom to come out of the shadows into the sun and be the person my Maker intended me to be; who I am. It was a tremendous boost to my self-esteem.
Years ago, at the age of 34, my grandparents had a discussion with me about my illness. They said, “Jacquese, this is God’s Will for you…you have to accept it.” Then, I thought they were “crazier” than I was, but now I see the wisdom in what they told me.
First of all, you can’t heal from something you don’t accept and you must try to heal. You can fight against it, but in the end, you’re fighting against yourself.
Second, most people want to find purpose and meaning in life. Why am I here? Why am I suffering? For me, if I have to suffer (and I have), then let me help someone else to rejoin society without missing too many steps. Let me enable them to embrace the opportunities I lost because of my challenges.
I started Project Onset, still in its infancy, which is a part of the African-American Outreach program of NAMI-NJ (National Alliance on Mental Illness-New Jersey). Through testimonies from a person with mental illness whose onset happened in college (me), a parent of a college-age student and a mental health professional, young adults and their families receive an education on how mental illness can occur in those crucial years.
In the end, I just want to be able to make some sense of my pain and helping people is the best way I know to do that. So, I educate, motivate and inspire on a grassroots level because I know it’s needed. It is a purpose-filled life, driven by the desire to help eradicate stigma for the next generation of survivors. That is why I make the decision to disclose my psychiatric illness. It helps me to take control of my destiny. I know that only I can control whether I feel ashamed or not. Stigma feeds on shame.
So, imagine if everyone with, or who cared about someone with, a “mental illness” stood. Then, we could all just get back to the business of living.
I Educate the Next Generation by Disclosing My “Mental Illness”
I’ve lived most of my life literally walking through the valley of the shadow of death. And yet, hope and resilience follow me as if I know the way out. But the one thing I have no hope of changing or getting over is being considered a throw-away person in this society.
These are the words I choose to start the introductory essay in a memoir of essays I call Informed Naivete. One could think that my assertion is a bit skewed or harsh, but these are my thoughts associated with the aftermath of the dreaded “s” word.
Often, I’ve thought that if everyone who has, or cared about someone with, a mental illness stood up against stigma, we would outnumber the rest. Where would the stigma be then? And stigma is real. It can not only make your social life uncomfortable, but it can greatly affect your ability to earn a decent living.
So, why do I choose to disclose my mental health challenges? Why would I publish articles under my birth name, publish a poetry chapbook on my mental health challenges and welcome the chance to speak on mental health challenges and stigma and why am I so adamant about it, knowing what I know?
Although I am a psychiatric survivor of 35 years, I have only disclosed since 2006 when I agreed to be interviewed for a documentary on mental illness and minorities. Now, I have many projects that would be all but impossible to do without disclosing. Of course, it was a journey.
Before 2006, my “mental illness” was my most well-guarded secret. I lost a lot of friends in those first couple of years in the 80s and there were whispers and stares, but then I moved more than once. Because I was still in and out of the hospital, I developed lies and kept them going.
The lies were used to patch the holes in my resume, explain the eight years it took me to finish college, the many colleges I attended, the disappearances, and the work absences. The world definitely doesn’t make it easy for you to resume the race and the charade becomes a job within itself. It also led to undue stress and anxiety. It fueled my paranoid symptoms, which at the time, were not under control at all. I was always in a state of flux, wondering who knew.
I came to realize that I was stigmatizing myself by living in fear and shame, playing into the stigma game. I asked myself, “How can I call for an end to stigma and discrimination if I am ashamed myself.”
It’s almost like making the decision to go natural with your hair. When I did, it wasn’t popular and it’s still not aesthetically pleasing to some employers. I looked at myself in the mirror one day as I blow-dried my hair and curled it with a curling iron and asked, “What’s wrong with my hair?” This was the day of a huge self-embrace. The 2006 documentary I participated in was another. Looking back, that decision was the beginning of my making sense of this mess.
Self-disclosure provided me with the freedom to come out of the shadows into the sun and be the person my Maker intended me to be; who I am. It was a tremendous boost to my self-esteem.
Years ago, at the age of 34, my grandparents had a discussion with me about my illness. They said, “Jacquese, this is God’s Will for you…you have to accept it.” Then, I thought they were “crazier” than I was, but now I see the wisdom in what they told me.
First of all, you can’t heal from something you don’t accept and you must try to heal. You can fight against it, but in the end, you’re fighting against yourself.
Second, most people want to find purpose and meaning in life. Why am I here? Why am I suffering? For me, if I have to suffer (and I have), then let me help someone else to rejoin society without missing too many steps. Let me enable them to embrace the opportunities I lost because of my challenges.
I started Project Onset, still in its infancy, which is a part of the African-American Outreach program of NAMI-NJ (National Alliance on Mental Illness-New Jersey). Through testimonies from a person with mental illness whose onset happened in college (me), a parent of a college-age student and a mental health professional, young adults and their families receive an education on how mental illness can occur in those crucial years.
In the end, I just want to be able to make some sense of my pain and helping people is the best way I know to do that. So, I educate, motivate and inspire on a grassroots level because I know it’s needed. It is a purpose-filled life, driven by the desire to help eradicate stigma for the next generation of survivors. That is why I make the decision to disclose my psychiatric illness. It helps me to take control of my destiny. I know that only I can control whether I feel ashamed or not. Stigma feeds on shame.
So, imagine if everyone with, or who cared about someone with, a “mental illness” stood. Then, we could all just get back to the business of living.
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