It's time to fire New York State Office of Mental Health (OMH) Commissioner Michael Hogan. He has totally, intentionally, unapologetically, and disastrously abandoned helping individuals with serious mental illness, in favor of implementing politically correct programs to make the worried well less worried. This is not hyperbole. It's truth. And it needs saying.
While his efforts have been going on ever since he took office, his recent pro-active introduction of legislation to kill Kendra's Law, is the last straw.
Kendra's Law was first enacted in 1999, in a bipartisan (remember those?) effort to help the most seriously mentally ill and keep the public safer. Kendra's Law allows courts to require some potentially violent patients to accept treatment as a condition for living in the community. Even more importantly, the legislation 'commits' OMH to providing and monitoring the treatment. This is necessary because the ability get care from OMH is largely inversely related to need. Witness his continuing closure of NYS psychiatric hospitals and the resultant burgeoning of the number of mentally ill who get incarcerated.
Since it's enactment in 2000, independent and OMH funded studies show Kendra's Law
- Helps the mentally ill by reducing homelessness (74%); suicide attempts (55%); and substance abuse (48%);
- Keeps the public safer by reducing physical harm to others (47%) and property destruction (43%).
- Saves money by reducing hospitalization (77%); arrests (83%); and incarceration (87%).
81 percent of participants said that it helped them to get and stay well. Columbia University found a 4X reduction in violence in spite of the fact that Kendra's Law participants were more likely than the control group to be violent to begin with.
As a result this success, making Kendra's Law permanent has support from organizations as diverse as the National Alliance on Mental Illness and the NYS Chiefs of Police Association. Even Newsday, which opposed making Kendra's Law permanent in 2005, has reviewed the research and come down unequivocally in favor of making it permanent. Op-eds, editorials and letters supporting permanence have also appeared in Buffalo News, Forbes, National Law Journal, and other publications. There was even an op-ed by Pat Webdale, mother of Kendra whom the law was named after.
So: Patients satisfied. Money saved. Violence down. Quality of life up.
Then why is Hogan proposing a bill to kill Kendra's Law?
After a five-year statewide trial period initiated in 2000, Kendra's Law supposed to be made permanent in 2005 as a result of research showing it was successful. To prevent that, OMH raised new alleged 'concerns'. and demanded it be "studied" more. They were studied for five years and shown to be 100% unfounded in 2009.
Still not good enough for Commissioner Hogan. On March 25, 2010 he proposed a dangerous bill (S7254 by Morahan) that rather than making the law permanent, would end Kendra's Law in 2015.
His objection has nothing to do with helping the seriously mentally ill or 'concerns'. It has everything to do with his ideology and priorities. Mr. Hogan laid out his idealogy in his Statewide Plan for Mental Health Services:
Treatments that are theoretically the best but not accepted by an individual are unlikely to be effective
So much for the data on Kendra's Law's effectiveness.
As for his priorities, he also laid those out in his Statewide Plan. The important question for OMH is
How do we create hope filled, humanized environments and relationships in which people can grow?
So much for helping people with serious mental illnesses and for the medical model. OMH under Hogan dedicated itself to helping people 'grow'.
Mr. Hogan's plan for children's mental health services is no better than his one for adults. The 2008 plan was originally intended to be called the "Children's Mental Health Plan" but OMH changed it to "Children's Plan". As Commissioner Hogan wrote,
"What began as the "Children's Mental Health Plan" evolved into a broad cross-systems, multi-stakeholder document..."
The plan proposed a 'transformation'. No longer would services focus on the seriously mentally ill, they would focus on the
"...developmental, physical, emotional, social, spiritual, educational, and concrete daily living needs (e.g., housing) of children."
Serious mental illness out. Social programs in. The exact opposite of what is needed.
Kendra's law expires June 30, 2010. That would be cruel for people with mental illness and dangerous to the public's safety and wallet. What makes Hogan's bill even more unconscionable is that his Bill Memo lists all the reasons to make it permanent (reduced violence, incarceration, etc). But the bill itself ends it.
While Hogan introduced a bill to end the program that reduces violence by the mentally ill, in perhaps the ultimate act of hubris, he has proposed S7252 that would actually give OMH the responsibility to investigate acts of violence by the mentally ill. That way, he has a panel in place that can conclude the predictable act of violence wasn't his own fault.
Fortunately, New York State Assembly member Aileen Gunther has proposed A-10421 a smart and compassionate bill that would make Kendra's Law permanent and improve it. Comparing the bills, it is easy to see why Assembly member Gunther's approach is the more sane approach. It incorporates the findings from the research Hogan funded, but chooses to ignore.
Her bill would require OMH to provide a psychiatrist to small counties that lack a psychiatrist to evaluate patients and therefore don't use Kendra's Law. Fabulous idea.
In addition to making AOT permanent, Gunther's bill requires the state to consider mandatory community treatment whenever someone who was admitted to a hospital because they were 'danger to self or others' is being released. That's a great idea.
Her bill would require the state to consider mandatory community treatment whenever a prisoner who used mental health services in prison is being released. Another great idea.
No longer could OMH throw these individuals unsupported into the community, they would have to see if a treatment plan is needed and if so, enforce it. Assembly member Aileen Gunther's bill to make Kendra's Law permanent and improve it also includes provisions to save money, and streamline implementation.
The legislature should pass Aileen Gunther's bill A10421 to make Kendra's Law permanent and improve it.
If Commissioner Hogan won't support that bill, he should be replaced. Now. Before there is a another Kendra Webdale and before his self-appointed review panel determines it wasn't his fault.
(Note: The opinions expressed here are those of the authors, and not organizations he is affiliated with. Although they should be.)