Wednesday, June 03, 2020

Teaneck—A forum on Mental Health took place on a recent Sunday at Temple Emeth in Teaneck to get people acquainted with the mental health services in Bergen County and offer guidance as to when and how to use them.

Just a month earlier, the room where the forum was being held was filled to capacity with about 300 people who came to learn about the problem of human trafficking in Bergen County and around the world. A similarly sized crowd was expected for the forum on mental health, but only about two dozen people came. Weather conditions may have held some back, but there was speculation  about why so many would advocate on behalf of human trafficking victims, with whom they probably have little personal connection; while few came to deal with mental health issues, a much more widely experienced personal and family problem. One in four families is struck with mental illness. Because of the small attendance, what was planned as a panel presentation to be followed by questions and answers was turned into a very informative group discussion. Moderator Sandi Klein introduced the panel and gave JLBC their background information.

Patrick Hughes is an LCSW (licensed clinical social worker and Director of Behavioral Health Services for the Bergen County Sheriff’s Department since 1990. Michele Hart-Loughlin is Program Coordinator of the Bergen County Department of Health Services-Division of Mental Health. For the past 25 years, she has been helping people navigate the county’s complex mental health system.

Vicki Sidrow is President and CEO of Vantage Health System, with outpatient facilities in Dumont and Englewood. Vantage is a private, not-for-profit behavioral healthcare organization founded in 1957. It serves over 3,000 children, teens, and adults annually with mental health, addiction, developmental disabilities, and elder-care challenges.

Beth McPartland is Acting President of NAMI (National Alliance on Mental Illness) of Bergen County. NAMI is a grassroots support organization founded in 1979 and run mostly by volunteers who have family experience with the problems and stresses of mental illness.

Peggy Whelan is NAMI’s coordinator of the Family to Family Program. Also participating were Rabbi Steven Sirbu of Temple Emeth and Senator Loretta Weinberg of the 37th Legislative District, which includes Teaneck.

The panelists focused on the wide-spread problems of mental illness, too often associated with violence in the media and in people’s minds,  that affect all of us as patients, family, friends, and neighbors. The mentally ill, who are a significant part of our population, are actually less violent than most people. However, their problems in coping with their lives can flare up dramatically and suddenly. This very serious problem is not being satisfactorily dealt with by society. There is a great deficiency of resources and facilities, inadequate coordination among the service providers, and only the beginning of an understanding of mental illness.

There are also some laws that restrict what can be done for adult patients because of their rights to privacy and to determine how they want to live. They even have the right to refuse contact with their families, which they do all too often. Some patients, when they are feeling well or because they don’t want to tolerate side effects, on their own stop taking their medications. This can result in the return of their problems.

One participant spoke about her adult son’s case. She said that often the family is the first to notice abnormalities in the patient’s behavior, but service providers will not listen to them as HIPAA privacy laws give family members no say in the treatment of an adult child, or even access to information on how the patient is doing. Her son was repeatedly hospitalized and ended up killing his girlfriend. He will now spend many years in prison.

Another participant talked about her adult daughter. She suffered from HIV and alcohol abuse. Two of her partners died from self-abuse, and she attempted suicide four times. When released from the hospital, she was given a weak discharge plan, and there was no follow-up. The mother found very little useful education or support that was available to families. There are more mentally ill people housed in prisons and jails than there are in psychiatric wards.

Bergen County provides better services than were found in most places. A county board that meets monthly has budgeted $1 million for community mental healthcare programs for this year. Services are offered on a sliding scale. However, recovery varies greatly in length of treatment, duration of improvements, and the quality of life experienced.

Hughes, of the Sherriff’s Office, explained that the county jail’s average daily population is around 900 inmates. This includes a high percentage with mental illnesses. Often these are people who have resisted using regular mental health services and find themselves in trouble for violating laws. The severely mentally ill spend three times as much time in jail as does the average inmate. As a result, Bergen County is investigating the establishment of mental health courts that would direct people to effective treatment rather than imprisonment.

Those who can be taken for treatment involuntarily must be evaluated as being either suicidal or homicidal or who cannot take care of themselves. Often their family has detected that their relative is having problems, but the patient refuses to acknowledge that they are. It is difficult for anyone, be they close relative or mental health professional, to predict whether the patient will present a safety problem to themselves or others. Many police officers are trained on how to recognize and deal with those who are mentally ill. When relatives feel threatened, they should take proper precautions. Even if they recognize that there is a serious problem, they often don’t know what to do about it. One step might be to call 262-HELP for a county mental health screening.

Almost anyone can be said to suffer from some category of mental illness. Who should seek treatment and who should be treated? These are complex problems and bureaucracies have a hard time dealing with ambiguities and maintaining good communications among their departments and through layers of management. Some people do fall through the cracks. But as Huges said, “We don’t want Big Brother clamping down on all of us and making all the decisions for us.

Bergen County has four mental health facilities throughout the county. They treat voluntary patients only. Although the field of mental illness is a relatively new one within healthcare, treatments are improving. We have moved away from common lobotomies in the 1950s to a more effective range of drugs, though their curative effects and side effects vary for each individual and are hard to predict. Electro-convulsive therapy (ECT), now used more judiciously, can help many patients. It was noted that the Affordable Care Act (ACT) requires behavioral health plans.

It was suggested by one audience participant that the HIPAA laws be modified to allow caring family members to be more involved with the treatment of their adult children, and to be able to determine that some adult patients are not competent to make decisions in their own best interests. In addition, there must be better public education about the many types of mental illness. They should not carry a stigma. Rather they should be treated like other behavioral problems, such as abuse of drugs, alcohol, and tobacco, and maintaining an unhealthy weight, diet, or lifestyle. Emotional wellness and conflict resolution techniques should be taught in schools and to adults, just like first aid, cardiac resuscitation, and the treatment of choking. The emotional state of the perpetrators of violence and the emotional toll for their victims, and those connected to each, must be better understood.

Some advice was given to the relatives of mentally ill people. Document what behaviors you observe, what you have communicated to doctors, and what results you observe. Ask doctors to explain what they are planning and what they are doing. Knowing that you keep files may help the doctor take a relative more seriously, and will influence most judges. Sometimes interventions, like calling the police, are necessary. Sometimes stepping away from the problem is the only solution. Neither makes a family member a bad person. Many flyers and pamphlets describing a variety of services were made available to program participants.

By Stephen Tencer