New York State Office of Mental Health Public Information Office

Ben Rosen, Director of Public Information

MEDIA CLIPS APRIL 9, 2014

TABLE OF CONTENTS
PAGE 4-5 5-6 6-7 MEDIA West Seneca Sun OD WDT TYPE Article Article Article TITLE
WNYCPC to stay open for remainder of year Bassett to close psychiatric unit Medicaid cuts may leave 80 mental health patients in St. Lawrence County without transportation to treatment centers Psychiatrists call for more coordination with primary care THE COLLECTIVE CRISIS OF SOLITARY CONFINEMENT
Date of Appearance

------4-8-14 4-4-14

7-9

9-11

Clinical Psychiatry News Al Jazeera

Article

------

Article

4-8-14

OMH Clips 4/10/2014

ADE AE AP BBF BN CDS CL CNY DC DF DG DM DN DO DS FLT HET HP IJ JN LCN LFT LG LH LI ML MHN MNT ND NG NPR

Adirondack Daily Enterprise Altamont Enterprise Associated Press Buffalo Business First Buffalo News Cornell Daily Sun Corning Leader CNY News.com Democrat & Chronicle, Rochester Daily Freeman, Kingston, Ulster Daily Gazette, Schenectady Daily Mail, Catskill Daily News, NYC Daily Orange - Syracuse U Disability Scoop, disability focused Finger Lakes Times Herkimer Evening Telegram Huffington Post Ithaca Journal Journal News, Lower Hudson Livingston CO. News Little Falls Times Legislative Gazette, statewide Leader Herald, Gloversville LongIsland.com Metroland, Albany Midhudsonnews.com Medical News Today Newsday Niagara Gazette NPRs Health Blog

NYD NYP NYT OD ODD PS PSt PJ PR P&SB PT QC R RCT RO RS S SG SIA SPS THR TNW TPJ TR TU USW USA VV WDT WHN WP

New York Daily News New York Post New York Times Observer-Dispatch, Utica Oneida Daily Dispatch Post Standard, Syracuse Post Star, Glens Falls Poughkeepsie Journal Press-Republican, Essex, Franklin, Plattsburgh Press & Sun Bulletin, Binghamton Palladium-Times, Oswego Queens Chronicle Reuters Rockland County Times Rome Observer Rome Sentinel Saratogian Star Gazette, Elmira Staten Island Advance Saugerties Post Star Times Herald-Record, Middletown Times News Weekly, Queens/Brooklyn The Post Journal, Jamestown Troy Record Times Union, Albany US News & World Report USA Today Village Voice Watertown Daily Times WebMD Health News Wall Street Journal

OMH Clips 4/10/2014

Page 3

NEWS
WNYCPC to stay open for remainder of year

West Seneca Sun

Some good news was announced over the weekend for those who have been advocating tirelessly to keep the Western New York Childrens Psychiatric Center open. Senator Patrick Gallivan released a statement Saturday evening, which announced that funding had been included in the proposed 2014-2015 state budget to keep the center running for the next year. I am thrilled that this years state budget will include the vital funding necessary to keep the WNYCPC open, he said. I have fought hard during this budget process to ensure that the voices of the children, their families, and local mental health professionals were heard and I am grateful that the governors office realized the import ance of the WNYCPC to those in need. Assemblyman Michael Kearns also had a significant impact on restoring the funding. Since hearing the news of the centers closing, Kearns has worked with the community to advocate, holding press conferences and communicating with the Office of Mental Health every step of the way. Not too many people gave us a chance and I kept saying its not over yet, said Kearns. I think in the end, the governor and the Office of Mental Health made the correct decision to keep the facility open for another year. Kearns further stated that this small victory would not be possible without good team work. He praised Patricia Moran, Public Employees Federation (PEF) steward, for working with volunteers, families, and those affected by the change. If funding was not set aside for the center this year, children would have been moved to the Buffalo Psychiatric Center, a facility that houses sex offenders and mentally disturbed adults. The Buffalo Psychiatric Facility is a wonderful hospital and they do good work, said Moran. Its just that working with kids is very different than working with adults. The WNYCPC was designed to meet the needs of children; they can frolic outside and ride their bikes. Moran said it brings a calming feeling to kids who are made to feel as if they are in a school setting rather than a mental health hospital. We get them out in any way that we can, she said. Its a wonderful facility. Moran and family members who have close ties with the WNYCPC are meeting in the governors office on April 8 to plead their case. The families have even put their stories on film to debut that day. We are going to show why we feel the WNYCPC should stay where it is and the impact it has on these children and their families, she said. Kearns said while this is a step in the right direction, the work of the WNY delegation is not yet over. He will continue to fight to see that the center remains open on a permanent basis. We still have hope and the message is that we live to fight another day,

OMH Clips 4/10/2014 Page 4

Bassett to close psychiatric unit

Utica Observer Dispatch By Amy Neff Roth April 8, 2014

Bassett Medical Center in Cooperstown has enough patients to keep its inpatient psychiatric unit mostly full; however, it doesnt have enough staff. Bassett Medical Center in Cooperstown has enough patients to keep its inpatient psychiatric unit mostly full; however, it doesnt have enough staff. So the hospital will close the unit once it receives state approval, officials said. It already cut the unit from 20 beds to 10 in December over staffing issues. We did not make the decision to discontinue inpatient psychiatry services lightly and regret having to take this action, said President and CEO Dr. William Streck in a news release. However, it has been impossible to recruit psychiatrists and advanced practice clinicians who wish to participate in inpatient psychiatric care. The problem is not unique to Bassett. The shortage of mental health providers is a state and nationwide issue. The hospitals emergency room will continue to treat mental health patients, but Bassett will transition its crisis center services to a mobile crisis program, officials said. The closure means that Bassett patients with psychiatric emergencies will have to travel at least 40 miles to find inpatient care. It means other psychiatric units will have to care for those patients and coordinate discharge plans with far-flung mental health agencies. And it sounds an alarm for other hospitals. I actually do think its a real possibility that other units could close, said Dr. Robert Gregory, professor and chairman of the department of psychiatry at SUNY Upstate Medical University. The New York State Office of Mental Health is working with counties and hospitals throughout the region to ensure that the area has enough inpatient capacity and that existing patients will be able to transition to new providers should the Bassett unit close, officials said. St. Elizabeth Medical Center in Utica more than 40 miles from Bassett offers the nearest psychiatric unit. To be honest, at this point, I dont know how this is going to affect us, said Scott Buddle, St. Elizabeths psychiatry program director. Neither the psychiatric unit at St. Elizabeth nor the one at Faxton St. Lukes Healthcare is operating at capacity right now, but both have seen an uptick in patients since last year, Buddle said. And both are sometimes full, meaning would-be patients must find another unit or wait in an emergency room until a bed opens up. Rome Memorial Hospital recently received permission to add another bed to its senior behavioral health unit due to growing demand. A 2013 survey by the Healthcare Association of New York State found that 58 percent of hospitals and health systems have reported a shortage of psychiatrists. Rural hospitals and inpatient units face the biggest challenges. Changes in health care have made inpatient units less appealing to psychiatrists and other workers given the chaos caused by sicker patients and the shorter lengths of stay that make it harder to get to know patients, Gregory said.

OMH Clips 4/10/2014 Page 5

In general, Bassett has been a shining star when it comes to recruiting specialists to rural Otsego County, said Jean Moore, director of the Center for Health Workforce Studies at the University at Albany. If a group like Bassett cant successfully recruit, what does that mean to some of the other providers who may have less capacity than Bassett does? she asked. Follow @OD_Roth on Twitter or call her at 792-5166. Medicaid cuts may leave 80 mental health patients in St. Lawrence County without transportation to treatment centers

Watertown Daily Times By Sean Ewart April 4, 2014

CANTON Eighty county residents who rely on the St. Lawrence County Community Development Program for transportation to and from mental health treatment programs may be stranded in June if additional funding is not secured. Executive Director Norma S. Cary said recent changes to how Medicaid is administered in the state mean that transportation to certain mental health programs no longer will be covered. Formerly the county Department of Social Services administered Medicaid transportation. However, it is now managed by the Syracuse-based Medical Answering Services on behalf of the state Department of Health. Prior to the changes, the county Department of Community Services also was responsible for covering the costs of about 30 of the 80 people for whom the Community Development Program provided transportation. But, Mrs. Cary said, We switched them all to Community Support Services, which provides $112,495 for transit services. Mrs. Cary said an additional $150,000 is needed to continue operating the program. Once that $112,495 runs out in June, everybody is done, she said. The clock is ticking. The development program includes transportation to mental health treatment programs at the St. Lawrence Psychiatric Center, Seaway House and Step-by-Step in Ogdensburg. Although the programs are part of the patients treatment regimen, Mrs. Cary said, the newly reorganized Medicaid reimbursement program wont cover them. They are saying these arent medical sites, she said. Patients really depend upon these routines, Mrs. Carey said. They count on it.

OMH Clips 4/10/2014 Page 6

She said that without the programs in place, there is a potential for them to be roaming the streets. Representatives from the offices of state Sen. Patricia A. Ritchie, R-Heuvelton, and Assemblywoman Addie J. Russell, D-Theresa, said they have contacted people in the state Health Department to seek a solution. A request for comment from the state Health Department was not immediately returned. Mrs. Cary noted that the transportation service is crucial for patients receiving community-based mental health care. Its part of keeping them in the community, Mrs. Cary said. Were trying to make contacts to plead with Albany to make sure these folks get to the sites they need to be at for their treatment. It really is an important part of their treatment and their stability. The program operates four vans that are based in Heuvelton, and employs three permanent drivers and one parttime individual.

TRENDS/OTHER STATES/NATIONAL
Psychiatrists call for more coordination with primary care

Clinical Psychiatry News By Alicia Ault

WASHINGTON The American Psychiatric Association is putting out a call for much tighter integration of primary care and mental health care, saying that it will lead to better services for patients and a reduction in costs to the health system. "Studies have shown that concurrently treating behavioral and physical conditions leads to better control of the illness itself, but also better patient satisfaction, quality of life, and reduced costs," Dr. Jeffrey Lieberman, president of the APA, said at a briefing, sponsored by the American Psychiatric Association. The APA released a report that shows that effective integration could save $26 billion to $48 billion a year in general medical care. The report was written by the consulting firm Milliman, which the APA commissioned to take a look at integrated care models and the potential to improve care. Dr. Lieberman, who is also chairman of the psychiatry department at Columbia University Medical Center, New York, said the Milliman report was only the latest in a series of studies that have shown that addressing medical conditions and behavioral issues simultaneously is more effective and more cost-effective than creating silos to address each. A recent review by the Cochrane Collaboration of 79 randomized controlled trials, including more

OMH Clips 4/10/2014 Page 7

than 24,000 patients worldwide, compared collaborative care with routine care for depression and anxiety (Cochrane Database Syst. Rev. 2012;10:CD006525). The review found that collaborative care is more effective, increasing patient satisfaction and quality of life. "The jury is now in, that integrated care is effective," said Michael F. Hogan, Ph.D., the former commissioner of the New York State Office of Mental Health, at the briefing. He said the specialty mental health system is not the solution to helping people with mental illness and comorbid conditions improve. Almost half of people with a mental disorder first consult with a primary care physician. On average, it takes 9 years after the first symptoms for a patient to receive a diagnosis, Dr. Hogan said. Given that the average age at which those symptoms appear is age 14 years, that means a lot of individuals are struggling without a diagnosis during adolescence, he said, calling that a "bad approach."
And, about 50% of the 38,000 people who commit suicide each year have seen a primary care physician within a month of the completed attempt, he added. Dr. Hogan said that not only do primary care physicians need the tools and education to help them do a better job in diagnosing and treating patients with mental disorders, but that they also need a team that includes a psychiatrist or behavioral health specialist. Dr. Frank V. deGruy III, the Woodward-Chisholm Professor and chair of the department of family medicine at the University of Colorado Denver, agreed that primary care physicians needed a psychiatrist as a team leader for the roughly 20% of patients seen in primary care practices who have mental disorders co-occurring with chronic health problems. The "relative neglect of behavioral care" has been a major reason for the lack of comprehensiveness in collaborative care, said Dr. deGruy, who is also a past president of the North American Primary Care Research Group. He added that the Milliman report helps provide a missing piece and made him feel that "comprehensive, effective, coordinated care is right at our threshold." The Milliman report which drew on claims data for 20 million people enrolled in commercial insurance, Medicare, or Medicaid found that only 14% of those who had a mental disorder were receiving treatment but that they accounted for 30% of the spending by those insurers. That totaled about $525 billion for 1 year, according to the report. Even though they are insured and are being treated for their mental illnesses, the lack of coordinated care represents lost opportunities, said Dr. Paul Summergrad, president-elect of the APA. The Milliman report found that general health care costs were two to three times higher for people with a mental disorder and a chronic condition, compared with those without a mental condition. The higher costs were mostly attributable to patients falling through the cracks or not getting proper care which showed up in more emergency room visits, more hospitalizations, and hospital readmissions, said Dr. Summergard, who is also chair of the psychiatry department of Tufts University and psychiatrist in chief at Tufts Medical Center, Boston "Theres no way were really going to deal with the total issues around health care and health care costs unless we reach out to everyone," he said, adding that "we need to make sure were all working together to provide that care." aault@frontlinemedcom.com

OPINIONS/BLOGS/EDITORIALS
THE COLLECTIVE CRISIS OF SOLITARY CONFINEMENT Al Jazeera America By Michelle Chen Opinion April 8, 2014

OMH Clips 4/10/2014 Page 8

Americas prison system is having a breakdown. And the people best positioned to speak about the psychological crisis playing out behind bars are, ironically, the hardest to hear. The recent death of a mentally ill inmate in solitary confinement at New York Citys Rikers Island jail complex apparently due to neglect in an overheated cell exposed the brutality of forced isolation, an established practice in U.S. incarceration. The tragedy lies not in the particular neglect of that cell but in the systemic neglect plaguing the entire institution. Ismael Nazario, 25, who was locked up as a teenager at Rikers, recently spoke in a PBS NewsHour interview about the estimated 300 days he collectively spent in the box. Start talking to yourself, speaking out loud, just start pacing back and forth. Like, oh, this is crazy, he said. He recalled yearning for any kind of human contact, talking with other inmates by yelling through a little crack in the side of the door. You get real close to it and just you scream, you know? Some are starting to listen. Many state policymakers are rethinking solitary confinement the practice of placing people in complete social isolation for extended periods, from days to decades and seeking to move toward more rehabilitative criminal justice interventions. Last month New York state corrections authorities announced plans to curb the practice as part of a broader reform effort, including a ban on solitary confinement for adolescents. Meanwhile, city, state and federal policymakers, attuned to growing public health needs, acknowledge that mental illness is a major factor driving people into the penal system. One national study found that about 17 percent of adults entering jails and state prisons suffer from serious mental illness. Nonetheless, thousands of psychologically troubled people remain trapped between twin crises in criminal justice and mental health. Despite growing public criticism of solitary confinement as both inhumane and ineffective, its advocates still cling to the concept of isolation as discipline. Some officials insist that solitary confinement is not only necessary but also beneficial. Last month Virginia Attorney General Mark Herring filed an appeal in federal court seeking to overturn a ruling that solitary confinement for death-row inmates violated the constitution. He argued the courts decision intrudes into the core professional judgment of state corrections officials. With similar law-and-order brazenness, the head of New York Citys correction officers union has contended that solitary is effective for restraining disruptive inmates and protecting security staff. The people on the receiving end of this treatment, however, experience it differently as a phalanx of social alienation, emotional despair and consuming neurosis. A 2006 psychiatric assessment (PDF) of the effects of solitary found that inmates often experience hypersensitivity to tiny stimuli like that crack in the door or develop a mental fog that leads to a loss of focus and social withdrawal. One interviewee spoke of repeatedly cutting his wrists, recalling that every time I did it, I wasnt thinking lost control cut myself without knowing what I was doing. Security officers might put an inmate in solitary confinement for a disciplinary infraction, getting into a fight or just being threatened by violent fellow inmates. The isolation may last days, months or even years. The arbitrariness of the practice reveals how confinement eventually stops serving a particular disciplinary purpose and instead amounts simply to banishment. In prison-crazed America, state violence is exercised not through bloodshed but through the civilized torture of solitary confinement.

OMH Clips 4/10/2014 Page 9

It makes sense, then, that studies of incarcerated populations in New York, California and Texas have linked solitary confinement to elevated suicide risk. That reaction is not so irrational if one considers daily life reduced indefinitely to an eight-by-10-foot cell, with no foreseeable exit. Michel Foucault theorized in Discipline and Punish that isolation was key to the logic of the modern prison system, in which such penalties appear to be more humane than outright physical abuse but, in reality, inflict a more insidious psychological damage. In prison-crazed America, state violence is exercised not through bloodshed but through civilized torture. Because this treatment is imposed outside of public view, the public discourse on crime and justice remains conveniently walled off from the extreme practices of our penal structure. Outside the U.S., however, human rights advocates, including United Nations authorities, widely condemn solitary confinement as torture and a violation of basic ethical and public health precepts. On a community level as well, solitary confinement does not work as public policy. Driving people into psychological hell in prison does not make them more responsible citizens upon release; more likely, they will return to the outside world with even more inner turmoil (PDF) than they had going in. Meanwhile, even corrections officials recognize that solitary confinement is both a symptom and a cause of mental health problems. A large portion of people held in solitary suffer from psychiatric problems or may develop them over time after being isolated. Cook County Sheriff Tom Dart testified before Congress about the dangers of cutbacks to state mental health budgets, noting that county jails and state prison facilities are where the majority of mental health care and treatment is administered. But jails and prisons are not designed or equipped to serve as mental health facilities, and the needed treatment is often not even available which in turn compounds the crisis, inside and outside the cell. Even in monetary terms, solitary comes at an unsustainable cost (PDF). A year in solitary costs taxpayers about $75,000 per person, three times the price of less restrictive forms of detention. Thats money not spent on public services for the people disproportionately affected by incarceration poor, black and Latino communities where police patrols are rife and social service programs anemic. Paradoxically, the people most vulnerable to this institutional trauma are those most in need of protective institutions. U.S. jails and prisons have placed many young people under the age of 18 in solitary confinement. Solitary is sometimes used to punish misbehaving children at juvenile facilities, but some kids are placed in protective confinement, supposedly to shield them from attacks from other inmates. Whether theyre being protected or punished, these youths often end up being denied access to medical and psychological treatment and basic social resources, such as educational programming and contact with family. Its an environment that sets them on a path to further turmoil; boys like Nazario are released back to their neighborhoods, yet many will remain caged by the effects of their mental trauma for years to come. This inequity will roil on until we dismantle the institutional violence that enforces it. The horrors that unfold in the solitary confinement cell represent not our worst criminals but the worst within ourselves. The more people we banish to solitary, the more we deny our own humanity.

OMH Clips 4/10/2014 Page 10