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NAMI Forum addresses keeping CVPH mental health units open

PLATTBSURGH The public has spoken and they want in-patient mental health units for adults and children to remain open at CVPH Medical Center. Members of the community and supporters of those with mental illnesses turned out in strong support as the Champlain Valley chapter of the National Alliance on Mental Illness, commonly referred to as NAMI: CV, hosted a discussion regarding the matter at Plattsburgh High School Nov. 27. According to NAMI: CV executive director Marguerite Adelman, the discussion was prompted by a phone call the local NAMI chapter received in October. A representative with the state Office of Mental Health called questioning if the organization had learned of the possible closure of CVPHs mental health units and asked if the organization could collect statements from the community regarding what impact the closure would have. Needless to say, we were disturbed to learn about the possibility of the closures from OMH, but promised to look into gathering impact statements, said Ms. Adelman. An ad-hoc committee was formed by the local organization which supports mental health rights, which began its course of action with last weeks forum. The state OMH representative also suggested the organization begin making preparations for a closure similar to the recent one felt at A.O. Fox Memorial Hospital in Oneonta, where two psychiatric units and a crisis center closed due to a lack of psychiatrists. However, a closure of units at CVPH was not considered an option, said Ms. Adelman. We did not want to plan for what could happen. Instead, we wanted to talk about how we would work with the hospital, OMH and our legislators to keep these units open, said Ms. Adelman. Meetings with CVPH president and chief executive officer Stephens C. Mundy, director of psychiatric services Mary Krakowski and other hospital administration ensued, leading to an open dialogue among all parties, said Ms. Adelman. While the CVPH administration has not filed to close the units to date, said Ms. Adelman, the hospital administration is still negotiating with OMH on a number of issues. The three major issues identified during the forum included a lack of adequate reimbursement from insurance companies for patient services, difficulty recruiting and retaining staff psychiatrists, and a more than $800,000 deficit facing the hospital as reported in October. There certainly is a complexity of issues for us to discuss and to be concerned about, but the issues confronted by CVPH, our nonprofit community hospital, are issues being faced by other community hospitals across the country, said Ms. Adelman. Regardless of whether or not CVPH ultimately closes its mental health units, the hospital would still need to receive patients with behavioral health disorders in need of care even if they would need to be referred to another hospital for treatment. The patients would likely be received at the hospitals emergency room, which could result in As access to appropriate continual psychiatric care services within a community diminishes, hospitals CEOs report a dramatic increase in the average length of stay for emergency room patients requiring psychiatric admission, said Ms. Adelman. The boarding of these psychiatric patients interrupts ER flow, delays disposition results in considerable inconvenience and distress for ER patients and their families. Significant under funding of public agencies historically responsible for behavioral health care is increasing hospitals utilization and shifting the cost of care of these patients to the community hospital, said Ms. Adelman. The continuing discrimination against psychiatric illnesses in medical care funding, the stigma associated with people with mental illnesses, and the fragmentation and under funding of agencies that serve the mentally ill, are fueling a system that is in slow collapse. Here in the rural North Country, we are feeling that collapse . According to the National Institute of Mental Health, about one in five Americans suffer from a diagnosable mental illness in any given year. In Clinton, Essex and Franklin counties, that amount equates to approximately 33,000 people. Of that figure, roughly 13,600 suffer from a serious mental illness such as depression, bipolar disorder and schizophrenia, which traditionally require medical treatment in a hospital. Being CVPH is the sole provider of in-patient psychiatric services in a 4,500-square-mile service area, a closure of its mental health units could be devastating, said Trix Niernberger, executive director of NAMI - New York State. If the hospital chooses to shut down one or both [of the mental health units], there will be serious repercussions to the people in the North Country, said Ms. Niernberger. Tracey Staub, a Plattsburgh resident who has been diagnosed with bipolar and post-traumatic stress disorders, agreed a loss of services in the area would be a terrible loss for the community. If we did not have a mental health unit here in Plattsburgh, I might be institutionalized at this moment, said Ms. Staub candidly. Like so many others, Ms. Staubs mental illness was fueled by substance abuse. Substance abuse led to problems with the law and her spending the majority of 2006 in Clinton County Jail, she said. She recalled being brought by law enforcement officers to CVPHs mental health unit from the hospitals emergency room, taken in restraints. Though for her own safety, the restriction was excruciating in her mental state and would have likely been unbearable had she needed to be transported elsewhere for treatment. I was in such a state, if I had been taken in cuffs or restraints for an hour-and-a-half- or two-hour drive, I probably would have snapped, said Ms. Staub. I have to credit CVPHs Mental Health Unit for my standing here right now, Ms. Staub continued. They have excellent counselors, excellent accessibility, and if they hadnt been there for me, I probably wouldnt be standing before you. We need expansion, not closure. With the help of CVPH and Behavioral Health Services North, which offers substance abuse treatment services, Ms. Staub has been sober for more than a year and is a patient advocate and members of the BHSN anti-stigma committee. In response to the statements made in favor of keeping the units open, which included comments from law enforcement officers, educators and others personally affected by mental illnesses, Ms. Krakowski, who represented the hospital at the forum, said it is the full intention to keep the units open to the best of the hospital administrations ability. We respect the opinions of those present and are listening to what is being said, said Ms. Krakowski. Were putting great effort into working with state agencies the Department of Health, the Office of Mental Health to the best of our abilities in hopes of finding solutions to increase the funding to keep these units open. We have made no decision yet about the future of the two units at the medical center. Ms. Krakowski further stated it is the desire of the hospital administration to be able to keep both units open, hoping to be in a position to know what the state can offer to help remedy the situation by the end of the year. Those unable to attend the Nov. 27 forum are still able to submit statements regarding the effect the closure of CVPH mental health units would have on the community, said Ms. Adelman. Statements, which must be received by Jan. 15, may be mailed to NAMI: CV at 14 Healey Ave., Suite D, Plattsburgh, N.Y. 12901. For more information, contact NAMI: CV at 561-2685.

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