Barbara Briggs Ward left Wednesdays state Office of Mental Health listening tour session on the future of state mental health services feeling just as uneasy as she did before the meeting.
Having dealt with OMH in the past because of my son, what you see is not always what you get, she said Thursday. In the end, the bottom line is the almighty dollar. Its not patient care.
OMH Acting Commissioner Kristin M. Woodlock was at the psychiatric center Wednesday to spread the word about upcoming sweeping changes to the states mental health service delivery system that will downsize inpatient treatment and expand community outpatient support.
The proposed changes have community members worried that the St. Lawrence Psychiatric Center will close, putting 520 people out of work and leaving more mentally ill people to fend for themselves in communities without adequate outpatient support.
Mrs. Woodlock said she hopes to have a plan in place by Monday for which facilities will be designated regional centers of excellence, which in concept bring in universities and hospitals as partners to support care and research and bring more equality between how behavioral health care and primary health care are managed. A majority of officials and community members attending Wednesdays meeting urged her to consider Ogdensburgs facility for the designation, touting as advantages its current emphasis on community-based care, proximity to colleges and hospitals and reputation for good patient outcomes.
Ms. Ward, a member of the psychiatric centers Board of Visitors who has a mentally ill son, said more community-based services and the phrase center of excellence sound nice. But, she said, the state has failed to provide adequate community-based care since it first downsized the psychiatric center in the 1980s.
She said a vast majority of those who remain under inpatient care are in the hospital for a reason.
So many of the mentally ill are incapable of holding down even a simple job, she said. A lot of them cant function in the community. They have to keep the hospital open for the patients. Do I want a better future for them? Of course. But realistically, youre dealing with mental illness.
Ms. Ward, who is also an employee of Northern New York Newspapers, said since a plan is expected as soon as Monday, it is clear OMH has already decided the psychiatric centers fate.
They can say they came up here and listened and allowed everybody to speak, but four hospitals out of 24 have to be closed, she said. Weve heard for a long time that its going to close because its census is so low. When the bottom line is money, people let the mentally ill suffer.
Glenn D. Liebman, CEO of the Mental Health Association of New York State, said community-based care is a winning strategy for the state and patients, but the state needs to ensure funding for that care can meet the demand for it.
Mr. Liebman said the money saved from downsizing inpatient hospitals in the 1980s went to the states general fund rather than community outpatient support.
If you look even over the last 10 years, rarely do we get any more enhanced funding for community services, he said. Its now been five years since we have even had a basic cost of living adjustment for community services.
He stopped short of saying he is optimistic about the states plans to revamp mental health.
What I would love to see happen is to have 100 percent reinvestment in community programs, to have language in legislation that says if you close a bed, a ward, a facility, 100 percent of that money gets directed right into community-based mental health services, he said.
David A. Bayne is the executive director of Step-By-Step, Ogdensburg, a peer-run organization that provides support programs for those with mental health and addiction issues. He also attended Wednesdays meeting, and left unsure how to feel about the future.
They cant have a vision if theyre not going to provide the community with the support to provide the services each community needs, he said.
Mr. Bayne said he likes the states vision for the future, and said the state cant realistically close the hospital because there will always be a need for inpatient services. Even if those services are downsized, he said, those providing inpatient care could find work in an outpatient program.
I think were in a time of change, and as scary as it is, it can also be a time for new growth and new possibilities, he said. I hope we can count on them to do what they say theyre going to do. If not, we think we have a lot of people on the streets now? It will only get worse.
Whatever the future may bring, St. Lawrence County Industrial Development Agency CEO and psychiatric center task force member Patrick J. Kelly said the community put its best foot forward Wednesday in trying to convince the state of the centers value.
We have a very positive story to tell, and I think the community conveyed that message clearly and passionately and comprehensively, he said. I think anyone who was there yesterday hearing all of the comments would have to be optimistic.
About 300 people attended Wednesdays session in Ogdensburg, which OMH spokesman Benjamin Rosen said was the highest attendance among the states 12 listening tour stops. In total, 1,626 people registered to attend listening tour sessions across the state.