Mental illness comes home
According to the New York state Office of Mental Health (OMH), over 600,000 mentally ill people are utilizing the state”™s mental health services annually. Of these, 356,000 are seriously ill, and between 140,000 and 156,000 are children.
In his recent testimony on Gov. Eliot Spitzer”™s 2008-09 Executive Budget, OMH commissioner Michael Hogan outlined some of the key challenges in serving the mentally ill:
”¢ Fragmentation of the industry, with a hodgepodge of county, state and privately run facilities providing services. Many individuals depend on mainstream benefits and programs, which “are not well aligned with the requirements of good mental health.” Medicaid is the largest payer for mental health care, but it doesn”™t cover many mental health services.
Ӣ Lack of affordable housing, particularly in downstate New York. The state has the highest proportion of renter-occupied housing in the nation. The problem is exacerbated for the mentally ill, of which 85 percent are unemployed.
Ӣ The incarceration of the mentally ill. The population of mentally ill people in the stateӪs prisons has almost doubled in the past 17 years, for a total of 8,400 prisoners, and it continues to increase, even as the overall population of inmates has declined. Sixty-six percent of the people in the juvenile criminal justice system are mentally ill.
Ӣ The stateӪs reliance on expensive in-patient care. Twenty percent of all mentally ill people discharged from the hospital are readmitted within a month.
OMH maintains 25 adult psychiatric centers and two research facilities in the state, providing 5,500 beds. The state has a total of 39,000 housing units for the mentally ill. Hogan said people in the system frequently change residences and often can”™t pay rent, adding to their stress.
Hogan outlined a number of state initiatives to improve care of the mentally ill, including creation of mental-health clinics in schools and other settings for better treatment of children; greater oversight and care of mentally ill sex offenders, be it through civil commitment to a secure OHM hospital or strict supervision and treatment under the Division of Parole; reform of Medicaid reimbursements; and collaboration with other state agencies for creation of more affordable housing units through the governor”™s newly established $300 million Housing Opportunity Fund.
State senator Thomas P. Morahan (R-C-I-WF, New City), chairperson of the Senate Committee on Mental Health and Developmental Disabilities, has reintroduced legislation that would establish a centralized waiting list for all mentally ill people seeking community housing and support services in the state. Last year, the legislation passed the Senate and Assembly, but was was vetoed by Spitzer. Morahan staff member Kristin Sinclair said Spitzer cited a number of technical concerns, which she said have been addressed in the new version of the legislation.
Andrea Kocsis, executive director of the Human Development Services of Westchester, a nonprofit provider of housing for the mentally ill, said the waiting list is essential to getting an overview of the need. The state Office of Mental Retardation and Developmental Disabilities, which serves the mentally disabled, has long had one. “They know who”™s waiting and for how long,” she said. “But in the world of mental health, there”™s no such thing. It”™s really hard to know how many people are waiting.”
(This is the second part to the Feb. 11 article: “Adrift, mentally ill drift into hospitals.”)