This essay was first published in Newsday. In a decision that seems as ill-timed as possible, the state Office of Mental Health announced last month that it will close its only inpatient children's psychiatric program on Long Island. Families in crisis, with delusional or suicidal children, will in the future be required to travel to Queens or the Bronx.
The added human misery that this decision is likely to rain down on some Suffolk and Nassau residents is immeasurable. That it comes so soon after a string of mass murders by people with mental illness - just seven months after Sandy Hook - is inconceivable.
"It came as a surprise," said Dennis Dubey, former executive director of the facility that is closing, Sagamore Children's Psychiatric Center in Dix Hills. "It's a surprise that throughout the rest of the state, OMH is saving money by consolidating children's centers into larger hospitals, but that only on Long Island are they totally eliminating beds."
After a six-week "listening tour" - geared to reassuring mental health employees that they will be eligible for other state jobs - the Office of Mental Health published a report on July 11 saying that the center will close in 14 months - but offered no plan for winding down services. Local leaders are supposed to suggest something by Oct. 1.
"To me that's sketchy," Dubey said.
The state report is titled "Regional Centers of Excellence," but you won't find any discussion of excellent treatment within its 57 pages. The entire focus is on cost and changes in insurance, Medicaid and the Affordable Care Act. The plan could save $20 million over three years. I'm in favor of government saving money, but dropping services to the most vulnerable - poor, possibly abused and desperate - is foolish.
The 57-bed Sagamore center is a waystation where children - usually between 9 and 17 - can step out of their lives, feel safe and begin getting support with their families involved. The facility also offers classes to keep students up-to-date with their schoolwork. Several current and former employees say there is a continual waiting list for the nationally recognized program.
OMH says it is committed to expanding Long Island's community-based services - outpatient care - which keeps kids close to their families and in school, and to minimizing the need for hospitalization.
But sometimes inpatient care is necessary. When it is, shipping children away could prevent families from participating in their recovery and worsen their prognosis, says Emily Engel, a psychologist who interned at Sagamore. She wrote a letter to leaders in Albany protesting the closure. "How many times does a mass shooting occur - when people then ask why warning signs were missed, why that clearly mentally ill individual did not receive help? SCPC is the type of facility that evaluates and treats the potential school shooters, that treats child victims of rape and violence."
Fern, a Sagamore worker who did not want her last name used, said many of the children improve and go on with their lives. "We see so many - we call them clients - who are now working and going to college."
To be sure, New York has more psychiatric hospitals than any other state - 24, compared with five in California. But Americans have begun to question the wisdom of the decision in the 1980s to dismantle the mental health care system. We only need to look to many of the homeless people wandering our streets, the high suicide rates - especially among teens and returning veterans - and the mentally ill people who pack our jails, receiving no support to help them get well. Abandoning people to their inner demons is not "excellent."
Dr. Ronald Marino, the associate chair of pediatrics at Winthrop-University Hospital, said general hospitals like his are ill-equipped to handle kids who come to the emergency room with suicidal thoughts, extreme panic, drug abuse and eating disorders. And yet, they're seeing more of them. Marino believes that media violence and economic pressure on adults to hold many jobs - among other stresses of modern life - are finding their way to young people.
We must stop pulling the supports out from under them.