LAW NIGHT AT THE 'JOE': Join
Timothy's Law supporters for a Tri-City Valley Cats baseball game
at the Joseph L. Bruno Stadium in Troy. Tuesday, June 20th at
7:00 p.m. For tickets, contact Ruth Foster at firstname.lastname@example.org
or 518-432-0333 x15.
PROGRESS ON TIMOTHY'S LAW - PHONE CALLS NEEDED:
With just 5 more days of the 2006 Legislative
Session left, developments in the pursuit of Timothy's Law appear
to be taking place. People demonstrating support for Timothy's
Law in the halls of the Capitol are hearing positive feedback
from Senators as they pass by about "getting something done
Therefore, we are cautiously optimistic about the propects for
Timothy's Law this year and ask everyone to contact their Senator
to urge passage of Timothy's Law before session ends next week
and they return home.
Please call your Senator to urge them to "Pass Timothy's
Law This Year."
Senators can be contacted by calling the NYS Senate switchboard
in Albany at 518-455-2800 and asking to be connected with your
Or, you can also contact your Senator's district office - a list
of each Senator and their district office phone numbers follows
NY SENATOR — DISTRICT# — COUNTY — PHONE #
Kenneth LaValle — District #1
— Suffolk — 631-696-6900
John Flanagan — District #2 — Suffolk — 631-361-2154
Caesar Trunzo — District #3 — Suffolk — 631-360-3236
Owen Johnson — District #4 — Suffolk — 631-669-9200
Carl Marcellino — District #5 — Nassau, Suffolk —
Kemp Hannon — District #6 — Nassau — 516-739-1700
Michael Balboni — District #7 — Nassau — 516-873-0736
Charles Fuschillo, Jr. — District #8 — Nassau, Suffolk
Dean Skelos — District #9 — Nassau — 516-766-8383
Ada Smith — District #10 — Queens — 718-322-2537
Frank Padavan — District #11 — Queens — 718-343-0255/718-746-2550
George Onorato — District #12 — Queens — 718-545-9706
John Sabini — District #13 — Queens — 718-639-8469
Malcolm Smith — District #14 — Queens — 718-528-4290
Serphin Maltese — District #15 — Queens — 718-497-1800/718-738-0039
Toby Ann Stavisky — District #16 — Queens —
Martin Malave Dilan — District #17 — Kings —
Velmanette Montgomery — District #18 — Kings —
John Sampson — District #19 — Kings — 718-649-7653
Carl Andrews — District #20 — Kings — 718-284-4700
Kevin Parker — District #21 — Kings — 718-629-6401
Martin Golden — District #22 — Kings — 718-333-0311/718-727-9406
Diane Savino — District #23 — Kings, Richmond —
John Marchi — District #24 — Richmond — 718-447-1723
Martin Connor — District #25 — Kings, New York —
Elizabeth Krueger — District #26 — New York —
Carl Kruger — District #27 — Kings — 718-743-8610
Jose Serrano — District #28 — Bronx, New York —
Thomas Duane — District #29 — New York — 212-633-8052
David Paterson — District #30 — New York — 212-222-7315
Eric Schneiderman — District #31 — Bronx, New York
Ruben Diaz, Sr. — District #32 — Bronx — 718-892-7513
Efrain Gonzalez, Jr. — District #33 — Bronx —
Jeffrey Klein — District #34 — Bronx, Westchester
Nicholas Spano — District #35 — Westchester —
Ruth Hassell-Thompson — District #36 — Bronx, Westchester
Suzi Oppenheimer — District #37 — Westchester —
Thomas Morahan — District #38 — Orange, Rockland —
William Larkin, Jr. — District #39 — Orange, Ulster
Vincent Leibell, III — District #40 — Dutchess, Putnam,
Westchester — 845-279-3773/914-245-6230
Stephen Saland — District #41 — Columbia, Dutchess
John Bonacic — District #42 — Delaware, Orange, Sullivan,
Ulster — 845-255-9656/607-746-6675
Joseph Bruno — District #43 — Rensselaer, Saratoga
Hugh Farley — District #44 — Fulton, Montgomery, Saratoga,
Schenectady — 518-843-2188/518-762-3733
Elizabeth Little — District #45 — Clinton, Essex,
Franklin, Hamilton, Warren, Washington — 518-743-0968/518-561-2430
Neil Breslin — District #46 — Albany — 518-455-2225
Raymond Meier — District #47 — Lewis, Oneida, St.
Lawrence — 315-793-9072
James Wright — District #48 — Jefferson, Oswego, St.
Lawrence — 315-785-2430
David Valesky — District #49 — Cayuga, Madison, Oneida,
Onondaga — 315-478-8745
John DeFrancisco — District #50 — Onondaga —
James Seward — District #51 — Chenango, Cortland,
Greene, Herkimer, Otsego, Schoharie, Tompkins — 607-432-5524
Thomas Libous — District #52 — Broome, Chenango, Tioga
George Winner, Jr. — District #53 — Chemung, Schuyler,
Steuben, Tompkins, Yates — 607-732-2765/607-776-3201
Michael Nozzolio — District #54 — Cayuga, Monroe,
Ontario, Seneca, Tompkins, Wayne — 315-568-9816
James Alesi — District #55 — Monroe — 585-223-1800
Joseph Robach — District #56 — Monroe — 585-225-3650
Catharine Young — District #57 — Cattaraugus, Chautauqua,
Livingston — 716-372-4901/716-664-2430
William Stachowski — District #58 — Erie — 716-826-3344
Dale Volker — District #59 — Erie, Livingston, Ontario,
Wyoming — 716-656-8544/585-786-5048
Marc Cappola — District #60 — Erie, Niagara —
Mary Lou Rath — District #61 — Erie, Genesee —
George Maziarz — District #62 — Monroe, Niagara, Orleans
TO 'BOOT THE SHU': We also
strongly encourage everyone to call Senate leaders to urge them
to pass the legislation to ban the use of solitary confinement
in prisons and jails for inmates with psychiatric disabilities.
MONDAY, JUNE 19TH
CALL SENATE LEADERS TO PASS 'SHU' LEGISLATION
AND END THE TORTURE
Senate Majority Leader Joseph Bruno
Senate Finance Committee Chair Owen Johnson - 518-455-3411
"I am calling in support of S.2207-c, the SHU legislation.
It's time to do the right thing!
I'm a registered voter calling to urge you to pass S.2207-c this
increase safety for correctional officers and treatment for prisoners
with sever psychiatric disabilities!"
TIMOTHY'S LAW CAMPAIGN PRESS RELEASE - RENSSELAER
AND SUFFOLK COUNTY LEGISLATURES CALL ON STATE SENATE TO PASS TIMOTHY'S
Working for health insurance parity for mental health
and addiction treatment services.
737 Madison Avenue, Albany, New York 12208 518-432-0333 fax 518-434-6478
and Suffolk County Legislatures Calls on State Senate to Pass
June 14, 2006 – The crusade for
equality in mental health benefits gained unprecedented momentum
yesterday as both the Rensselaer and Suffolk County Legislatures
formally called on the New York State Senate to pass Timothy’s
Law this year.
before both the County Legislatures passed unanimously with bi-partisan
support. Tom O’Clair, Timothy’s father, was present
as the Rensselaer County Legislature lent its support to the initiative.
O’Clair commented later that “I’m thrilled to
have the support of the Rensselaer County Legislature in our campaign
for Timothy’s Law. It’s been a long hard battle and
I only hope that the overwhelming bi-partisan support I witnessed
tonight is a preview of what’s to come from the State Legislature
over the next several days.”
Kim Spicciate, a member of the Timothy’s Law Campaign on
Long Island, watched as the Suffolk County Legislature acted in
concert with Rensselaer legislators. “Not only did the measure
pass unanimously, but legislators were actually requesting that
their names be listed as co-sponsors of the initiative!”
by the expression of support at the local levels, Timothy’s
Law supporters will continue their efforts to enact parity legislation
in memory of Timothy O’Clair.
MHANYS AND SCAA HOST PRESS CONFERENCE AT WHICH MENTAL HEALTH ADVOCATES
WILL BE JOINED BY LEGISLATORS TO PUSH FOR HOUSING WAITING LIST
BILL PASSAGE BEFORE END OF SESSION: Media Advisory Follows
Health Housing Waiting List Legislation Pushed By
Advocates And Legislators Before Session End
Advocates Joined by Sponsors
Rivera and Morahan To Urge
Passage of A.2895-a / S.3653-a
Glenn Liebman – 518-788-1405
Davin Robinson – 518-463-1896, ext. 36
For years, advocates for New Yorkers with psychiatric disabilities
have been articulating an increasing need for housing for those
living with mental health needs. Progress has been made in recent
years to address this concern – most recently, the NY/NY
III agreement which will provide funding for 5,400 new beds for
individuals with psychiatric disabilities at risk of homelessness.
However, these new resources are only available to homeless individuals
in New York City. Major housing needs remain throughout the state.
This need is not quantifiable due to the fact that the state does
not maintain a waiting list for such housing placements.
legislation would create a housing waiting list for individuals
with psychiatric disabilities; a model successfully used to create
housing for New Yorkers with mental retardation and developmental
disabilities. Further, a housing waiting list will assist the
State to be in compliance with the U.S. Supreme Court decisions
in Olmstead v. L.C. The Olmstead decision requires that persons
with disabilities be housed appropriately in the most integrated
setting possible. This legislation would establish a process that
is necessary for identifying institutionalized individuals who
want to live in the most integrated setting possible. After identifying
these needs, advocates, housing agencies, local and state government
can work together to meet those needs. Without such a waiting
list, there is little way to actually ascertain what the housing
needs are for individuals with psychiatric disabilities in any
parts of our state.
Mental Health Advocates
Assembly Mental Health Committee Chair Peter Rivera
Senate Mental Health Committee Chair Thomas Morahan
Press Conference to Urge Passage of Mental Health Housing Waiting
List Legislation (A.2895-a / S.3653-a)
10:00 a.m. June 15, 2006
LCA Press Room, 130 LOB
Pushes for Passage of Mental Health Parity Bill
North Country Gazette,
June 13, 2006
---Assembly leaders have called on the Senate to pass Timothy's
Law, a mental-health parity bill approved by the Assembly with
bipartisan support earlier this year so a joint conference committee
can work out a compromise between each house's legislation.
strongly urging immediate Senate action, Speaker Sheldon Silver
and Assemblyman Paul Tonko stressed the need to enact a law this
year that would end discrimination against mental health and addiction
treatment by insurance companies in New York State.
were joined by Assembly Insurance Committee Chair Alexander "Pete"
Grannis and Assemblyman Peter Rivera, chair of the Mental Health,
Mental Retardation and Developmental Disabilities Committee, in
urging the Senate to meet the Assembly in a conference committee
to resolve differences between the respective bills once the Senate
had passed its legislation.
bill is known as Timothy's Law, for Timothy O'Clair of Rotterdam
who took his own life before his 13th birthday. Tom O'Clair, Timothy's
father, and other members of the O'Clair family have participated
in many news conferences at the Capitol to explain their painful
loss and the suffering they continue to experience because they
lacked adequate health-insurance coverage required to provide
Timothy with the treatment he desperately needed.
Law has been a top priority of the Assembly for several years
now. Too many people are suffering because they don't have the
health insurance they need. This bill establishes the rights of
those who need mental-health care or addiction treatment so that
these individuals will no longer be second-class citizens in our
health-insurance system," said Silver. "We urge the
Senate to recognize the severity of this health-care crisis and
quickly pass this critical piece of legislation so we can meet
in conference committee and agree on a bill that can become law
year, health plans continue to cut back on coverage for mental-health
care and addiction treatment. Our parents, children, friends and
families cannot continue to stand by and watch insurance coverage
for these treatments erode from year to year. Most families can't
afford to pay out-of-pocket for expensive care, whether it be
outpatient counseling, rehabilitation or inpatient care,"
said Tonko, the bill's sponsor.
Law is supported by more than 320 state organizations united under
the Timothy's Law Campaign, including Alcohol and Substance Abuse
Providers of New York State; Coalition for the Homeless; Coalition
of Voluntary Mental Health Agencies; Families Together in New
York State; Mental Health Association in New York State; National
Alliance on Mental Illness in New York State; New York Association
of Psychiatric Rehabilitation Services; New York State Coalition
for Children's Mental Health Services; New York State Council
for Community Behavioral Healthcare; New York State Psychiatric
Association; New York State Psychological Association; New York
State Rehabilitation Association; and Schuyler Center for Analysis
Health Advocates Hope to Move Bill that would End Special Housing
Units in State Prisons.
By Joseph M. Gerace
Legislative Gazette, June 12, 2006
group Mental Health Alternatives to Solitary Confinement came
to Albany for the third time in less than a year to continue pressing
the State Senate to pass a bill ending the use of solitary confinement
for the mentally ill.
legislation, introduced by Sen. Michael F. Nozzolio, R,C-Fayette,
would require the state to provide an alternative to in-prison
housing, sometimes known as special housing units, or SHU, and
treatment for prisoners with psychiatric disabilities and mandate
the state to provide
40 hours of comprehensive mental health training for all state
Assembly version of the bill was passed earlier this year while
Senate bill S.2207-C marched quickly through the Senate Crime
Victims, Crime and Corrections Committee, which Nozzolio heads.
bill is being held up in the Senate Finance Committee chaired
by Owen H. Johnson, R,C-Babylon.
actuality, this measure doesn’t cost taxpayers a dime this
year and would only require a relatively small down payment in
next year’s budget,” said Harvey Rosenthal, executive
director of the New York Association of Psychiatric Rehabilitation
of a comprehensive mental health prison safety and treatment improvement
plan would include a redirection of existing state dollars by
converting and maximizing the use of existing facilities and would
show savings from decreased use of costly inpatient services and
decreased time served by untreated disabled inmates.
asked about the real cost if the bill if it were to become law,
Rosenthal said that no hard numbers had yet been established.
He contended that it was the responsibility of the Senate Finance
Committee to conduct the research.
the bill is “stuck in the finance committee because it is
too costly, and that is false and unacceptable,” said Rosenthal,
“There is no data.”
from the cost issue, the advocates spoke about humanitarian concerns
related to a person’s confinement in the SHU.
is a sickening way of treating human beings who are sick, it is
incompetent from top to bottom,” said Ray Ortiz, a former
inmate who now works for the Urban Justice League and says the
existence of special housing units in prison is torture.
you treat people like animals in a cage,” said Ortiz, “they
come out as caged animals.”
the bill were to pass in the Senate, it would have to be signed
by Gov. George E. Pataki and then implemented by the Office of
Mental Health and Department of Correctional Services after 18
measure must be passed this year,” said Jack Beck of the
Correctional Association of New York State. “In the long
run, it will save New York millions of dollars. In the short term,
it will save lives.”
Chief Defenders Group Says Civil Confinement
Bill is Unnecessary. By Joseph M. Gerace
Legislative Gazette, June 12, 2006
Chief Defenders of New York State, who represent the majority
of those unable to afford an attorney in criminal cases statewide,
have issued a statement opposing civil confinement legislation.
statement comes as the Assembly and Senate discuss the possibility
of reconvening a committee to reach a compromise on their civil
Chief Defenders, part of the New York State Defenders Association,
says the bills in the Senate and Assembly that would allow state
courts to detain sexually violent predators beyond the terms of
their prison sentences are unnecessary. A recent court decision
allowed the state to use existing provisions of the Mental Hygiene
Law to civilly confine sex offenders determined to be dangerously
Appellate Division case Consilivo v. Harkavay was decided in March
and supported Gov. George E. Pataki’s 2005 decision to civilly
confine those considered to be dangerous sexual predators prior
to the passage of a true civil confinement law, which the governor
has called for since 1998.
document released by the Chief Defenders also raises a concern
that a civil confinement bill lacks “meaningful standards
to guide judges and juries charged with applying the law which
would result in arbitrary lifetime confinement of persons with
a low risk of re-offending.”
coalition of legal groups, mental health advocates and public
advocate groups including the state Bar Association, the Mental
Health Association in New York State, the New York State Alliance
of Sex Offender Service Providers, the New York Civil Liberties
Union and The Innocence project joined with the sentiments of
the Chief Defenders.
Diabetes, One More Burden for the Mentally Ill.
By N.R. Kleinfield
The New York Times, June 12, 2006
John Newcomer is a psychiatrist who generally treats people with
severe ailments of the mind and spirit. But before his patients
sit down, before he hears about their clammy paranoia or renegade
voices, Dr. Newcomer wants to know about their waist size.
steers them to a scale to learn their weight. He orders a blood
sugar test. If big numbers come up, he begins a conversation about
Type 2 diabetes, a disease associated with obesity that is appearing
with alarming frequency among the mentally ill.
diabetes can ruin a person's life as much as uncontrolled schizophrenia,"
said Dr. Newcomer, a professor of psychiatry at Washington University
School of Medicine in St. Louis.
fact, among the mentally ill, roughly one in every five appear
to develop diabetes — about double the rate of the general
population. This is a little-recognized surge, but one that is
jolting mental health professionals into rethinking how they care
for an often neglected population.
decades, psychiatrists have worried primarily about patients'
mental states, making sure they did no harm to themselves or others
because of unrelenting voices or a smothering depression.
more of the mentally ill, however, die today from diabetes and
complications like heart disease than from suicide. Given that
mental health specialists are often the only doctors a mentally
ill diabetic ever sees, some have begun to debate the customary
limits of psychiatric practice, deciding to pay much more attention
to physical ailments.
particular, psychiatrists must confront the fact that diabetes,
marked by dangerously high blood sugar, is often aggravated, if
not precipitated, by some of the very medicines they prescribe:
antipsychotic pills that have been linked to swift weight gain
and the illness itself.
bad enough that these people have mental illness, and then they
take treatments and they bring on diabetes," said Dr. Jeffrey
Lieberman, chairman of the psychiatry department at the Columbia
University College of Physicians and Surgeons.
the diabetic mentally ill can be formidable. The regimen of blood
testing, dieting and exercise that controls Type 2 diabetes is
often beyond the attentions of the mentally ill. For patients,
the task of taming two debilitating illnesses can haunt their
lives. Michael Schiraldi, 44, a Manhattan man who has both schizoaffective
disease and diabetes, said his mental illness, now stabilized,
was the lesser of his concerns.
can't really control the diabetes," he said. "I might
die from it."
doctors who regard diabetes as a galloping threat to the mentally
ill acknowledge that many in their profession still dispute, or
ignore, its consequences. Dr. Newcomer said colleagues often whine
about how hard it is to weigh patients. " 'Oh', they'll say,
'there's no scale' or 'It's in a closet someplace,' " he
he says he hopes other doctors will eventually share his perspective
as diabetes expands among the mentally ill and deepens into an
even graver problem.
OF BODY AND MIND
Carole Ernst doesn't know how she got diabetes.
Her mother had it.
She eats more than she should, exercises less than advisable.
was it the pills that shushed the TV?
TV no longer speaks to her. She stared levelly at the set in her
messy room. It was blessedly quiet.
is 53 and has battled mental illness since childhood. The pills
for her illness, diagnosed as schizoaffective disorder, have helped.
But she feels they have also made her fat around her abdomen,
the kind of fat that can lead to diabetes.
even though Ms. Ernst feels better mentally — she no longer
imagines everyone despises her — diabetes has been a crippling
insult to her troubled psyche. In the late hours, alone in her
room on the Lower East Side of Manhattan, trapped in the undertow
of two potent diseases, she runs on empty.
nights, the only thing I can do is read my Bible," she said.
"I look in there to find answers. They're hard to find."
on top of mental illness asks a lot of a person, and of society.
Mental illness is itself a money sponge, an expense borne largely
by tax dollars. But that cost may be dwarfed by the bill to manage
the heart attacks and amputations that diabetes bestows.
numerous mental institutions emptied, patients often live in lightly
supervised settings. Many occupy adult homes that struggle, for
good reasons and bad, at providing basic services and are poorly
equipped to treat diabetes. Others live on their own, sometimes
in boxes beneath bridges or crumpled in doorways.
taking on diabetes if you live alone and find living itself to
be a handful.
try not to drink sugared sodas, but sometimes I forget,"
Ms. Ernst said. "I'll buy candy — Mary Janes or banana
cookies. I know I'm not fooling anybody — it's my arms and
legs they're going to cut off — but sometimes I get the
craving for something sweet."
sat at a round table in her room, a cool evening of early spring,
cradling a stuffed bunny. She flicked a small smile. "I'm
sorry it's not neater," she said, looking around. "I'm
Ernst embodies the difficulty of confronting the two diseases
with all their complexities. She takes clozapine for her mind
because she can't manage without it. She has diabetes and can't
defeat her weight.
that clozapine," she said. "Makes you eat everything
under the sun." She takes a lineup of other drugs, too, not
all positive for her weight. She had hit 250, fought her way to
198, and is now at 221.
lives at Gouverneur Court, a residence run by a nonprofit organization,
where about 15 of the 66 mentally ill residents have diabetes.
"Some say they don't have it, but they do," said Abby
Stuthers, the nurse who works there. "Or they say they have
a little diabetes."
Ernst freely recounts her callused life. Her marriage exploded.
Once she was smacked in the face with a glass ashtray. She opened
her mouth — every tooth was missing.
diabetes. Her blood sugar has been O.K., but her vision has worsened.
And she is inconsistent, prey to the fury of her demons.
Rendeiro, a family nurse practitioner who serves as her primary
care physician, said Ms. Ernst misses half her appointments. Recently,
in reviewing her drugs, Ms. Rendeiro asked about her blood pressure
pills. Puzzled, Ms. Ernst said she was not on blood pressure pills.
Rendeiro said she had supposedly been taking them for two years.
want to be the best I can be," Ms. Ernst said. "Nobody
AND CRUEL IRONIES
There was always a lot else wrong with the mentally ill —
heart problems and cancer and H.I.V., as well as diabetes. But
for psychiatrists and clinicians it was enough to worry about
mental needs that beggared the imagination.
spread of diabetes, however, is making the physical conditions
impossible to ignore. "Psychiatrists are literally watching
patients balloon up before their eyes," said Dr. Gail Daumit,
an assistant professor of medicine at Johns Hopkins Medical Institutions.
has been especially true since the advent of so-called atypical
antipsychotic drugs in the early 1990's. Studies indicate that
these drugs can alter glucose metabolism and stimulate weight
gain, particularly in people predisposed to diabetes.
of a cruel irony in this," said Dr. Lieberman of Columbia,
"is that all of the drugs do it to some degree, but the ones
that have the most effect cause the most weight gain and metabolic
side effects. There's increasing discomfort that these are driving
up deaths and lowering quality of life."
cases have been striking: a patient packing on 50 pounds in mere
months, for example. Diabetes arrived as quickly, and sometimes
subsided if the drugs were halted. In certain instances, there
was no weight gain, but still diabetes came, often in patients
who were already heavy. Studies have indicated that dozens of
these patients died from diabetes-related complications.
Food and Drug Administration requires atypical antipsychotics
to bear warning labels about diabetes risk, though drug makers
say patients taking them who develop diabetes were destined to
get it anyway.
Stigliano's psychiatrist has her taking Haldol by injection as
well as one of the drugs most closely associated with weight gain,
Zyprexa. They have helped her schizophrenia, but Ms. Stigliano,
37, who lives in a Brooklyn adult home, has seen her weight soar
to 241 pounds from 150. And when she gets her Haldol infusion
every three weeks, all she wants to do is sleep. "It's my
favorite activity," she said.
the drugs, psychiatrists believe, many high-functioning patients
would find themselves in institutions or jail. "These drugs
are enormously beneficial," said Dr. P. Murali Doraiswamy,
head of biological psychiatry at Duke University. "But they
have an Achilles heel."
few years ago, Dr. Doraiswamy reported a case of a mentally ill
person who got diabetes and was prescribed insulin. The impact
of having two serious conditions overwhelmed him. He wound up
trying to kill himself by insulin overdose.
researchers think it is possible the rash of diabetes stems in
part from mental illness itself. Studies associate the onset of
diabetes with depression. The mentally ill are also at high risk
because they tend to eat poorly, get little exercise and have
limited access to health care.
a 2003 survey, the city's health department found that about 17
percent of adults who reported symptoms of a mental illness, or
52,000, have diagnosed diabetes. Elsewhere, rates are as great
or greater. Even these estimates may be low, experts said, because
the mentally ill see doctors sporadically and their illnesses
may be underdiagnosed.
rates of diabetes and obesity are nudging Dr. Doraiswamy and others
in his field — in modest ways thus far — toward prevention,
toward screening people for diabetes before choosing drugs and
connecting better with primary care doctors.
wouldn't be a big problem if most mentally ill patients had a
primary care provider, but they don't," said Dr. Newcomer
at Washington University. "And it's never been part of the
game plan for the psychiatrist to write the prescription for your
blood pressure medicine or your diabetes medicine."
feels change is imperative. "The days when I don't do windows
can't go on," he said.
Kenneth Duckworth, medical director for the National Alliance
on Mental Illness, agreed. "I think the field has been passive,"
he said. "We viewed it that we do symptoms and you run your
change is not easy. Psychiatrists have a problem simply getting
patients to stay on their drugs. Resources are inadequate.
is historically a couch and the chair," Dr. Duckworth said.
"How do you get movement into the equation?"
said that he weighed his patients, checked sugars. But
few psychiatrists are set up to do this. Treating diabetes, they
say, was not what they were trained to do. And where, they ask,
do they find time in 15-minute appointments?
psychiatrists barely look at their patients," said Dr. Donna
Ames Wirshing, a staff psychiatrist at the West Los Angeles Veterans
Administration Medical Center. She recently asked 30 how many
weighed their patients; 3 hands went up.
Wirshing and her husband, Dr. William Wirshing, are experimenting
with the use of nutrition and exercise coaches for mentally ill
could be replaced with exercise bikes. Or, as Dr. David Hellerstein,
associate professor of clinical psychiatry at Columbia's College
of Physicians and Surgeons, noted, "Instead of having the
patient lie down and you say, 'So tell me why you fight with your
brother,' you could say to the patient, 'Let's take a walk around
the block while you tell me about why you fight with your brother.'
the most part, however, psychiatrists confront the knotty questions
without ready answers.
some 10 percent of schizophrenics kill themselves, and clozapine
is the only antipsychotic medication demonstrated to significantly
reduce suicide, but it has grave side effects, like its association
with diabetes, is it miracle or monster? Or both?
I chat with patients, about clozapine, I say, 'This may give you
your mind back, but it may hurt your body,' " Dr. Duckworth
said. "I think of it as psychiatric chemotherapy. Your hair
won't fall out, but you may get diabetes."
do patients respond? "Some say, 'If this will give me my
mind, I'll take anything,' " he said. "Some say, 'There's
nothing wrong with me, why are we even having this conversation?'
About 60 percent of schizophrenics don't recognize that they have
it. There are very few easy answers in my line of work."
THE ILL AND DIABETIC
Surf Manor squats on the tip of Coney Island, one of the dozens
of profit-making adult homes in the city where thousands of the
mentally ill live. Residents complain about the food. Activities
are light on exertion. The week's offerings are taped to the wall:
dominoes, blackjack, manicures, jewelry class.
the men and women eat, sleep, smoke, watch TV, sleep — then
do it all over again. Unsurprisingly, those who live there say,
dozens of the 200 residents struggle with diabetes.
often-troubled homes where so many of the mentally ill are housed,
frequently grumbling about inadequate attention to their needs
and their dignity, can be hideously difficult places for someone
at high risk for diabetes. And that is basically everyone who
Hinden, a chatty man of 51, sat listlessly in the lounge, near
the junk food dispensers. He'd be buying sweets but was broke
has had schizoaffective disease — characterized by symptoms
of schizophrenia and depression — for most of his life.
Sometimes he hears Indian war whoops in his head. About 17 years
ago, he picked up diabetes, too.
blood sugar was 289 that morning, he said. A normal fasting blood
sugar reading is below 126 milligrams per deciliter.
cheated," he said. "Last night I ate two eclairs. Had
a Coke. A lot of times I don't cheat and it goes up to 300. I
don't know what to do."
the binge last night?
don't know," he said. "I felt scared."
recent State Department of Health sampling of 19 homes found that
nearly a quarter of residents had diabetes. The homes say they
do what they can. Some have diabetes sections in the dining halls,
where occupants get a sugar-free dessert.
not a doctor, but we're very helpful," said Mordechai Deutscher,
the case manager at Surf Manor, who said he did not think the
home had many diabetics. "The people here are doing very
mental health advocates have not given diabetes much attention.
The Commission on Quality of Care and Advocacy for Persons with
Disabilities, a state watchdog agency, said it has never examined
diabetes prevalence or care.
Surf Manor, Mr. Hinden, like the other diabetic residents, cannot
have a blood sugar meter or give himself insulin. Needles are
considered perilous. He depends on the staff. But no one prescribes
motivation or understanding. And where diabetes requires vigilant
self-management, illnesses like schizophrenia often mean memory
problems and lack of drive.
be honest with you, I don't understand diabetes," Mr. Hinden
said. "I don't understand it at all."
Franklin, 47, sat down, all 300-plus pounds of him. He said he
has been taking diabetes drugs for seven years. "It's just
in case," he said.
said he was bipolar: "I couldn't see people with shoes on.
If I saw someone with shoes on, it could do something to my forehead."
spread out some greeting cards he had made. He leaned close. "Listen,
I don't want everyone to hear this," he said, "but it's
very possible that, unless the doctor made a mistake, I do have
stoic man of great girth named Lee Symons, 57, nodded. He had
it, too. He hears guitars and banjos thrumming in his head.
he trying to diet?
one told me to," he murmured.
about the diabetes?
long as it doesn't hurt, I don't mind it," he said. "It's
CDC Study Reveals Hispanic Youth More
Prone to Suicide
Mental Health Weekly, June 12, 2006
students are much more likely than black or white students to
report attempted suicide, according to a new report on youth risk
behaviors released last week by the Centers for Disease Control
and Prevention (CDC).
national report, Youth Risk Behavior Surveillance, United States,
2005, monitors priority health risk behaviors that contribute
to the leading causes of death, disability and social problems
among youth and adults.
provided data representative of 9th through 12th grade students
in public and private schools throughout the country. Nearly 14,000
U.S. high school students participated in the 2005 National YRBS.
report found that fewer U.S. high school students are engaging
in health risk behaviors compared to their counterparts from 15
years ago. Despite an overall decrease in health risk behaviors
among high school students since 1991, racial and ethnic differences
continue to be evident, the report noted.
reasons for these racial and ethnic differences are complex. More
research is needed to assess the impact of education, socio-economic
status, environment, and cultural factors that may contribute
to health risk behaviors among high school students,' said Howell
Wechsler, Ed.D., MPH.
the United States, 71 percent of all deaths among persons aged
10-24 years result from four causes: motor vehicle crashes (31
percent), other unintentional injuries (14 percent) homicide (15
percent) and suicide (11 percent).
8.4 percent of students actually attempted suicide one or more
times during the 12 months preceding the survey. Overall, the
prevalence of having actually attempted suicide was higher among
female (10.8 percent) than male (6 percent) students; higher among
white female (9.3 percent), black female (9.8 percent) and Hispanic
female (14.9 percent) than white male (5.2 percent) black male
(5.2 percent) and Hispanic male (7.8 percent) students.
the prevalence of having actually attempted suicide was higher
among Hispanic (11.3 percent) than white (7.3 percent) and black
(7.6 percent) students; higher among Hispanic female (14.9 percent)
than white female (9.3 percent) and black female (9.8 percent)
study found the prevalence of attempted suicide was higher among
Hispanic male (7.8 percent) than white male (5.2 percent) students.
to the study, the prevalence of having actually attempted suicide
was higher among 9th grade (10.4 percent) than 11th grade (7.8
percent) and 12th grade (5.4 percent) students. It was higher
among 9th grade female (14.1 percent) than 10th grade female (10.
8 percent) and 12th grade female (6.5 percent) students.
male students, the study found the prevalence of attempted suicide
was higher among 10th grade male (7.6 percent) than 11th grade
male (4.5 percent) and 12th grade male (4.3 percent) students.
During the 12 months preceding the survey, 28. 5 percent of students
nationwide had felt so sad and hopeless almost every day for more
than two weeks in a row that they stopped doing some usual activities,
the report noted.
the prevalence of having felt sad or hopeless almost every day
for more than two weeks was higher among female (36.7 percent)
than male (20.4 percent) students; higher among white female (33.4
percent), black female (36.9 percent) and Hispanic female (46.7
percent) students than white male (18.l4 percent), black male
(19.5 percent) and Hispanic male (26 percent) students, respectively,
according to the report.
the 12 months preceding the survey, 13 percent of students nationwide
had made a plan about how they would attempt suicide. Overall,
the prevalence of having made a suicide plan was higher among
female (16.2 percent) than male (9.9 percent) and higher among
white female (15.4 percent) black female (13.5 percent) and Hispanic
female (18.5 percent) students than white male (9.7 percent),
black male (5.5 percent), and Hispanic male (10.7 percent) students.
a copy of the full report visit, www.cdc.gov.