Wednesday, May 29, 2013
Saving lives one at a time!
For those of us old enough to remember, in the old movies and sitcoms, a scene would play out that would provoke laughter from the audience. When a character in the show would begin to act in a strange way, an ambulance would soon arrive, with two men in white coats carrying a straight-jacket. It was at this time that they would take the poor soul to a happy place, also known as a mental hospital. These spectacles brought a vast deal of amusement for those watching while at the same time, exploiting a dangerous situation. Those types of settings played out many times in old shows.
Additionally, as a child, I recall my father driving by one of those mental hospitals between Turney and Warner roads in Cleveland. It was named “The Northern Ohio Lunatic Asylum” but was affectionately known as “Turney Tech”. This facility, long since torn down, is now the site of condominiums.
All of that is from a bygone era; we no longer have those health care workers arriving to help people who are emotionally sick. They are now replaced by men and women carrying guns and handcuffs and called police officers. This transition from law enforcement officers to mental health workers did not go smoothly. There were high incidents of police brutality allegations, numerous, violent confrontations between these two groups, which included fatal shootings. For a long time, the mentally ill feared the police and the police did not relish the encounters with someone in crises. Nor were the police properly trained to understand mental illness, and they lacked the proper insight in how to de-escalate someone in crisis.
Times have changed, as a new, innovated form of training introduced called Crisis Intervention Team training (CIT). This program developed in Memphis Tennessee in the late 1980’s, stresses de-escalation, rather than standoffish encounters, and more importantly, humanizes those afflicted.
Sergeant Robert Brown, a twenty year veteran of the Lorain City Police department, was one of the first officers in Lorain County to become part of the CIT program. In those years, he has seen it all, hostage situations, suicide attempts, families in dangerous situations and even the occasional success story. He can stand as an authority on the positive attributes of this program and as a role model of this police department.
In recent years, he has witnessed an ever increasing reliance on law enforcement to help someone in a psychotic mindset, and to get them to a safe environment for treatment. In 2012, this department received approximately 500 direct calls for assistance with someone in a mental health crisis. This represents a 5 % increase over the number in 2011.
An added burden that Sergeant Brown pointed out is that many times the officers do not realize that they are entering a crisis situation. Often, the calls may first appear as a domestic situation, or truancy, or one of many other categories. People calling in do not always say it is a potential suicide, or that their loved one is mentally ill and off their medication. It is only when the police are on the scene do they determine that they are facing a mental health situation. This sergeant recalls one time answering a call, and when the suspect answered the door, he was wielding an axe. Fortunately, he was able to subdue the man with a taser, and no one was injured.
At first, Sergeant Brown was skeptical about the benefits of CIT. Charlie Neff, the Director of the board of mental health remembers that doubt well back in 2001. “Sergeant Brown was not initially convinced that CIT would be all that helpful, but once he started through the training, he quickly realized the programs benefit for the officers and for the individuals they encounter.” Now he and this entire department are strong supporters of this programs benefit. He also indicated that these techniques has been valuable in hostage negotiations.
One added problem exists, and that is the economic makeup of Lorain which brings additional challenges and roadblocks. Financial deficiency is a “double edged” sword with regards to the people in need of treatment. Poverty is both the result of mental illness, and it also acts as a trigger for the disease. The city of Lorain carries a poverty rate of over 17%, with is nearly doubled the national average of 9%. This in itself creates a higher demand for police intervention on many fronts.
For many years, the police were identified as collateral contacts with the mentally ill, but it is impressive that this department accepts that they are now the primary ones to intervene. Unlike hospitals, like Mercy Hospital, they cannot answer a call with the dispatcher telling the callers that they are diverting psych cases and will not answer their pleas for help. It must be added that this department has done an admirable job despite these added burdens.
In an interview last August, Sergeant Brown was asked what is the largest roadblock his department faces as mental health workers? Without hesitation, he answered the absence of treatment, namely, beds for those in need. He went on to explain that, in the past, the city had two hospitals, but with the closing of St. Joseph’s, Mercy Hospital is the only option available. It must be pointed out that this facility has just over thirty beds available for mental health and drug dependent patients combined. This represents far less than what is urgently needed. He, like many people in the mental health sector are frustrated with the “treat them and street them” disposition of the medical community.
If there is one thing that he is grateful for, is that, in Lorain County, they have the NORD center to help with long-term treatment. The center, funded mostly through the Lorain County Board of Mental Health by two property tax levies the citizens of Lorain County have passed, is a safety net for people in dire need and has been utilized by the local police. This center helps to offset, in a small way, the 13% decline in mental health treatment beds statewide over the last seven years.
In spite of this challenge, the Lorain police have done an excellent transition into being the new mental health workers. Since 2002, they have had 36 officers go through this unique and essential training. Though only 12 are on the road because of promotions and turnover, this is still a significant percentage of their department. The long term goal is to have 25% of the road officers certified in CIT. In this era of tight budgets, that is an extraordinary intention that they are committed to achieving.
It is clear that the Lorain police have learned how to look past the internal disfigurement of mental illness and see real human beings, not animals, or psychos. I have found that many members of this department do their best to humanize sick people and not demean them. Empathy is a term that is synonymous with CIT and this group of men and women understand that definition in its entirety.
So often, perception is not always reality, and the Lorain City police are no exception. It is a department that has been maligned many times in the local media. Over the last several years, I have met many of these officers in different training programs and found no evidence that they deserve the negative connotations associated with them. All of whom that I have come in contact with have been officers like Sergeant Brown; good, hardworking, and dedicated law enforcement officers, with a strong desire to do their job well. More importantly, they prove that they care about doing what is right in helping people. That is something that should create a sense of pride to this entire community.
Sunday, May 5, 2013
In mythology, during the Trojan war, ancient Rome was celebrating the retreat of the Greek army. In their haste to withdraw, they had left statues bearing the likeness of Trojan horses, which the Romans accepted as gifts. Believing in the spoils of war, they were now rightfully theirs, and they moved them inside the walls of the city and began to celebrate their apparent success. Unbeknownst to them, inside the statues were members of the Greek army who then attacked and destroyed the Roman army. That is a lesson that is played over and over again throughout history. "Beware Greeks bearing gifts"
With that as a backdrop, it is becoming increasingly likely that a similar situation occurred in Columbus during this current budgetary debate. Sadly, if it turns out to be true, it will end up hurting societies must vulnerable and defenseless citizens.
Not long ago, Governor John Kasich was lauded with his ambitious plan to expand Medicaid by 500 million dollars in this upcoming budget. Many people that I know in the mental health sector were ecstatic with the news that scarce dollars available for treatment were finally going to be increased, and perhaps, the downward spiral of the entire system would be reversed. It was a proposal that would have restored dignity to groups of people who have been sick and down and out for many years, and at the same time, save lives. I personally knew families who were literally brought to tears of joy over this and all expressed enormous gratitude for this change. Well, almost everybody, as I thought of the old saying, beware of Greeks bearing gifts!
Immediately, I became skeptical of the true intentions of this proposal, but hoped that I was wrong. However, based on the historical ignorance of the leaders of the Ohio Statehouse, I knew that another old saying could be valid. "If it seems too good to be true, it most likely is!" It did not last long for my skepticism to become a crystal clear prophecy.
First off, lurking in Columbus like hungry piranha's, is Speaker of the House Bill Batchelder, State Senate Leader Keith Faber and their personal cast of degenerates. These are groups of people who will rail against what they consider wasteful programs that help people, and at the same time, provide tax breaks for those that are wealthy, or in specific fraternal organizations. All seem to possess a hidden agenda to harm those who are not part of their hedonistic social network.
Predictably, as the budget moves out of the House into the Senate, Batchelder pulled out his scalpel and took out that expansion, and then indulged himself with self praise. In a recent article, he proclaimed, "Budget passed by (the) house is a step in the right direction." He is actually proud that along with proteges like State Representative Nan Baker of Westlake, they have metaphorically slit the throats of many people in desperate need of help. Even more disconcerting is that they seemed to find joy and satisfaction in this accomplishment. In reality, their past actions have damaged the lives of people being punished for just getting sick.
I attempted to get a response from Speaker Batchelders office about his budget, and all I received was the usual, "we will get back to you", which has become his trademark response when the public demands clarity. It is becoming widespread agreement that transparency and integrity are not two of his strong talking points. He mentioned in that same story that they are dealing with the results of poor budgetary decisions in the past. Revisionism aside, he neglects to mention that many of those decisions were made by him!
I contacted Nan Baker's office with a question; why she was more than willing to cut off funding to those most in need while allowing tax cuts that will enrich her family business? Like Batchelder, she hides behind a wall of secrecy and personal hatred of those deemed unworthy of her attention. However, I am convinced that the local Chamber of Commerce will award her another plaque of honor for her work providing its members with additional corporate welfare. With the next teenage suicide, she and Batchelder can also add another notch on their gun barrels.
Which now brings us the Ohio Senate and awaiting the likes of State Senator Keith Faber. In a recent conversation, his staff member defended taking that expansion out of the budget. He said mental health funding "should be discussed outside the context of the state budget." He indicated that this discussion will take place at a later date. Hopefully, this will occur prior to the next resurrection, but I am not holding my breath, as these types of discussions rarely, if ever occur.
Again, when the history of Faber is examined, an ominous trend unfolds, so there is not an massive deal of hope for anything positive. This is a person who once proposed placing violent sex offenders in mental hospitals. Somehow, he equates a woman with post-partum depression, with that of a child molester or a serial rapist. He is living proof that a keen intellect is not a requirement to hold public office.
Now comes the difficult part, and that is, did Governor Kasich propose this plan, giving people hope, gaining an significant wealth of publicity, knowing that it stood little chance of getting past the hatchet wielded by Speaker Batchelder? To paraphrase a famous question, "What did the Governor know, and when did he know it?"
The evidence, though little empirical, does cast doubt on Kasich's intentions. He has been close to Representative Batchelder for many years and knows his true motives. In fact, it was Mr. Batchelder who, many years ago, introduced me to John Kasich. With that in mind, and Nan Bakers hatred, whom Governor Kasich supported, it points to this bill being proposed strictly for positive press, rather than for anything worthwhile and genuine. Once again, I do want to be proven wrong, but that does not appear to be a likely outcome.
After several attempts, I did finally reach a subordinate of Governor Kasich. He defended the Governor wholeheartedly and said repeatedly that no one had worked harder and more openly on this issue than Mr. Kasich. He did not respond when I challenged him on their unequivocal support of Baker and Batchelder, who have become roadblocks to any significant positive expansion in the mental health field. Another old saying, "Show me whom you are with, and I will tell you who you are!"
With this budget now in the Senate, it is still possible for that growth to be reinstated, but, after my conversation with Senator Faber's office, the chances of that are severely diminished. However, with an army of advocates still pushing forward, a possibility for some compromise is still on the table.
It is essential to add that State Senator Shirley Smith, a Democrat out of Cleveland, has made a proposal to restore those cuts. I hope she succeeds, but in a Republican controlled house and Senate, she will be seriously outgunned. Also to her credit, she has done marvelous work with mental health issues in the past so I would not write her efforts off just yet.
As far as Governor Kasich is concerned, let us now witness how many resources he puts forward to convince the people he helped put in office that this program is needed. Let us see if he tells the likes of Nan Baker's that he will support her opposition if she continues to harm the ones that are in dire need of help. However, that is about as likely as a return call from Speaker Batchelders office.
To formulate a possible epitaph on this proposal, I need to point out that one of the dynamics of those afflicted with mental illness is that it affects everyone connected with that person. It tears loved ones to shreds as they conduct a seemingly helpless campaign for treatment. So often, the resources needed have never been provided, and the families suffer an subsequent tragedy. One of the few things that sustains people dealing with a mentally ill loved one is hope. Many times that are all they have to bolsters their lives, and in time that can be dashed. If this proposal of Governor Kasich turns out to be nothing more than false hope, that is an unforgivable sin. However, with all the people mentioned in this article sleeping well at night knowing the damage they have done to people's lives, I am not sure any of them will sincerely care.
Once again, I do hope Governor Kasich proves me wrong!