Bellevue Testimony
Testimony before the
New York City Department of Mental Health, Mental Retardation and Alcoholism Services in conjunction with the New York City Health and Hospitals Corporation
on The Effectiveness of Menta Health Outpatient Civil Commitment
presented by D.J. Jaffe, Coordinator
New York State Treatment Advocacy Coalition
on December 16, 1998.
Following is our testimony. The supporting attachments are in separate files.
My name is D.J. Jaffe. I am a former board member of the Alliance for the Mentally Ill of NYC, NYS and the National Alliance for the Mentally Ill, but I am testifying on behalf of the New York State Treatment Advocacy Coalition.
When you hear these names Colin Furgenson, Ted “Unabomber” Kaczynski and Larry Hogue what do you think?
Some people’s first reaction is disgust. They think of all the violence and loss of lives they’ve caused. “Lock ‘em up” they say. “Let’s think of the victims”. These folks often belong to real estate groups, business groups or block associations that have historically been less than receptive to localized services for people with brain disorders.
Other hearts instinctively go out to the perpetrators. “If only they had treatment” they say. “Poor Larry Hoag. Poor Ted Kaczynski.” I confess to being in that group as a result of having my own relative with schizophrenia.
But the Treatment Advocacy Coalition is the first group to bring together both these types of people, along with consumers, in a single organization. The purpose of that organization is to propose real world solutions that help every one.
Because when Reuben Harris, Colin Furgenson, Ted Kacyznski, Larry Hoag are forced to become “danger to self or others” before receiving treatment, that serves neither their interests nor that of the community they live in. It results in the most massive depravations of civil liberties imaginable: jail, suicide or death. We don’t require incapacity elderly alzheimer’s patients to go untreated. Yet when it comes to neurobiological disorders, that’s standard operating procedure.
Yet, the site of untreated psychotic individuals eating out of dumpsters offends both those who seek to improve quality of life in the community and those who seek to improve the quality of life of people with brain disorders.
We believe that mandated treatment is a lot kinder and compassionate than mandated non treatment. We believe it is the illness, not the treatment that deprives people of their civil rights. We believe treatment can free the ill from the Bastille of their psychosis and enable them to engage in a meaningful expression of their free will.
We believe that NY should join 37 other states by making Assisted Outpatient Treatment available statewide.
Right now, we are faced with the ludicrous and cruel proposition that if someone needs care in New York, they can only be committed to Assisted Inpatient Treatment. Assisted Outpatient Treatment is a more humane, gentler, less expensive, and less restrictive alternative. It is designed to keep people out of the hospital rather than in it. That is why progressive mental health advocates support it. It is ‘pro-consumer’
Greater use of outpatient assisted treatment would save the state and city money as people are diverted from more expensive inpatient services to less expensive outpatient services. Communities would be less likely to object to housing and services in their neighborhoods, because they would know the individuals were in fact being treated. And fewer individuals would go through what has been described as a “revolving door” but is more like a ‘trap-door’ that drops people into jails, shelters or death.
That is why 39 States already have enacted Assited Outpatient Treatment Statutes. New York is one of the last. Numerous studies of Outpatient Assisted Treatment show it’s effectiveness. In Washington, DC, admissions decreased from 1.81 per year to 0.95 per year before and after outpatient commitment; in Ohio the decrease was from 1.5 to 0.4; and in Iowa from 1.3 to 0.3 admissions. A study in North Carolina demonstrated fewer psychiatric admissions and shorter lengths of stay for patients who received case management services enhanced by a court order.
In the study just reported on by Dr. Steadman, the median individual without a court order spent almost two and a half times as many days in the hospital as the median person who did. Over the 11 months of the study, those who did not have court ordered treatment spent 14 weeks in the hospital, compared to only six weeks for those who did have a court order.
That’s success. We have to replicate it statewide.
Because time is limited, we have prepared attachments to this testimony which we would ask be entered in their entirety in the record. They include suggested changes to the legislation, a Critical Analysis of the Policy Research Associates Report, a description of outpatient asssisted programs in other states, a list of Preventable Tragedies in NY that talks about the Larry Hoags, Jorge Delgados, Kevin Cerbellis, and others; the NAMI policy on Assisted Treatment, etc.
In conclusion, the city and state have an opportunity to do the one thing that both conservative community activists and progressive mental health activists can agree on: Change the laws to allow mandated treatment rather than requiring mandated non-treatment. Stop Larry Hoag, Colin Fergenson, Kevin Cerbelli, Russel Weston and Ted Kaczynski from harming others--and in the process: from harming themselves. As a kind and compassionate society, we can do no less.
Thank you.
ATTACHMENTS
Learnings from Outside New York:
What other states have outpatient assisted treatment statues?
Are outpatient assisted treatment laws effective?
What are the consequences of mandated non-treatment?
Does Assisted Treatment violate Civil Liberties
Answer by Dru Anne X, Consumer
Answer by Hershel Hardin, Former Director British Columbia Civil Liberties Union
Answer by D.J. Jaffe, family member/advocate
What is the National Alliance for the Mentally Ill Policy on Assisted Treatment?
What are the policy perspectives that should be addressed?
Assisted Treatment in New York:
What changes should be made when taking law statewide?
Why should the burden of proof needed to select medications be reduced?
What are some NY tragedies that might have been prevented with this legislation?
What were the shortcomings of the Policy Research Associates Report?
What conclusions might be drawn from the Policy Research Associates report?
Should NY make greater use of “Conditional Discharge”?
What is the Treatment Advocacy Coalition?
(Posted 2/1999)
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