by SUMATHI REDDY Newsday STAFF WRITER April 5, 2004

ROTTERDAM, N.Y. -- The closet is small, barely eight feet by 24 inches. There are two parallel rods designed for hanging clothes.

Not a 12-year-old boy.

But it was in this closet that Timothy O'Clair died. With a bathrobe sash laced around his neck and onto the rod, the weight of a bowling ball holding it in place, the mentally ill boy hanged himself.

Three years have passed since Donna and Thomas O'Clair found their youngest son dead in their home, a small Cape Cod in this blue-collar town near Schenectady.

Now, the death in that closet - the image of the dangling young body on a clothing rod - has been resurrected. The lanky boy with the cropped brown hair and toothy grin has become the poster child for a grassroots coalition of mental health advocates fighting to pass a statewide mental health parity bill.

The coalition's long struggle to persuade New York lawmakers to pass the bill offers a surprising civics lesson to those who don't frequent the statehouse's corridors: No matter how compelling the issue, no matter how much apparent support, passing a bill in Albany can be a mystifying process.

The bill, dubbed Timothy's Law a year and a half ago, would require insurance companies to lift limits on mental health and substance abuse treatments to make coverage equal to that of physical illnesses, a change opponents say would force many businesses to drop health care plans altogether.

The bill's passage consumes Thomas O'Clair, a bulky mechanic for the New York State Thruway whose late son's black-and-white profile is tattooed on his left shoulder, a permanent reminder.

"It definitely helps the grieving process to know that we're doing this in Timothy's name," said O'Clair, 44. "I'm confident that he would still be here if we could have gotten the care that we needed."

The O'Clairs have become regulars in the marble corridors of the Capitol. Over the initial awkwardness of being in the spotlight, Thomas O'Clair easily spouts off sound bites and numbers.

More than 30 states have passed a mental-health parity bill, he will tell you, and the cost to employers is just $1.26 a month per employee. But opponents counter that New York's proposal exceeds most other states' bills and dispute the $1.26 figure.

Though different versions of mental health parity bills have kicked around for nearly a decade, the issue has gained momentum over the past five years, passing the Democratic-majority Assembly, where it was approved once again March 3, two weeks before the O'Clairs marked the third anniversary of Timothy's death with a rally on the Capitol steps.

Since the O'Clairs came into the picture, Timothy's Law has gained support in the Republican-dominated Senate from all but two majority party senators. Democrats also have pledged to support it. But until Majority Leader Joseph Bruno (R-New Brunswick), who has reservations about the costs, gives the go-ahead, the bill remains stuck in the mental health committee.

Among the lessons the O'Clairs have learned is that politics is not confined to lawmakers. The Timothy's Law Campaign, which consists of about 10 groups, split over differences in tactics deployed to grab attention.

One of the campaign's founders - Joseph Glazer, president of the state's Mental Health Association - was removed from the group because of tactics he was involved with, which included delivering coal to senators and flying a banner urging the bill's passage over a Republican fund-raiser.

For Thomas O'Clair, the complicated political process is perplexing. "I knew it would be a tough process but it's much tougher than I actually thought it would be," he said. "It's very frustrating."

Full of energy

Timothy was born May 5, 1988, the youngest of three boys, an energetic and entertaining child dubbed the pretzel boy because he could tie his body into knots.

He played the piano and soccer, and had a strong compassion for animals and a love of the outdoors. When his father needed to learn sign language at work, Timothy picked it up, too.

Pictures of him growing up show a boy affectionately cupping a butterfly in his hands, mowing the lawn with a clown wig and beaming as he fishes in Vermont.

At the age of 11, Timothy described himself as "weird, smart, flexible and ticklish," a boy "who fears failing, dying and getting a girlfriend," say the words he penned, scrawls now memorialized in a scrapbook.

But in between Cub Scouts and camping trips and playing with his two dogs, a different boy emerged, one prone to violent rages, threatening himself and those around him.

By age 8, Timothy was diagnosed with attention deficit hyperactivity disorder and depression and began seeing a psychiatrist. Later, he was diagnosed with oppositional defiance disorder.

The O'Clairs soon learned that like most insurance plans, theirs had limits - 20 outpatient visits a year and 30 days of inpatient care, the industry standard. As the O'Clairs experimented with nearly a dozen medications, Timothy's school days and family nights blurred into violent episodes - holding a knife inches from his chest, kicking his mother black and blue and threatening to hang himself on a tree.

One night when he was about 10, Timothy threw a bunch of rags into the furnace in the basement, an unsuccessful arson attempt.

Shortly thereafter, Timothy had two separate, short stays in residential hospitals, both visits limited by the family's insurance plan, Capital District Physicians Health Plan. Insurance company representatives said patient information is confidential and declined to comment.

Social Services placed Timothy in a state-run group home for 1½ months, but after that, the O'Clairs' options were running low. So they made the difficult decision to relinquish partial custody of Timothy to Schenectady County so he could be eligible for Medicaid.

"It's very, very common to give up parental rights," said Paige MacDonald, executive director of Families Together, an Albany-based nonprofit organization, and co-chair of the Timothy's Law Campaign. "And it's just ludicrous."

Some treatment success

Timothy eventually got a spot at Northeast Parent and Child Society, an upstate residential treatment facility, where he thrived for seven months.

Regaining custody of a child can pose challenges the longer you wait, MacDonald said. Because of Timothy's progress, the O'Clairs decided it was time to regain full custody of their child.

He returned home on Jan. 30, 2001, Donna's 41st birthday. All seemed well the first few weeks, but Timothy's behavior deteriorated rapidly.

March 16, 2001, is a night played in the O'Clairs minds over and over again. Thomas O'Clair was leaving for his second job at Home Depot when he got into an argument with Timothy, who refused to take one of his medications. Thomas ordered him to remain in his room until he took it. Donna ran out to the store with Christopher, leaving their oldest son, John, then in high school, with Timothy.

When she returned, she found Timothy's room a wreck, broken trophies strewn on the floor, his drawers dumped out. She looked in his closet, a space he would curl into to cry himself to sleep. It was there she found him hanging.

"At first, when I saw him in there, I just thought he was fooling around once again," said Donna. "Then I realized he was serious," that her 12-year-old boy, seven weeks shy of becoming a teenager, had taken his life.

"He was dead," she says.

The weeks after bleed together. Both Thomas and Donna, an aide at a nursing home, didn't work for at least a month, the what-ifs percolating in their minds.

Taking action

In the fall, they became involved with the Samaritans Suicide Prevention Center in Albany. It was through Samaritans that the O'Clairs were asked to be the family behind the mental health parity bill.

Mental health advocates were thrilled when the O'Clair family easily agreed to be the faces behind the bill.

The O'Clairs story would help separate the bill from the roughly 15,000 bills introduced during every two-year cycle, of which only about 1,500 are acted on, said Blair Horner, chief legislative lobbyist of the New York Public Interest Research Group.

But opponents of Timothy's Law, such as the New York Health Plan Association, a lobbying group for the insurance industry, warn that the emotion and hyperbole of a personal story can mask the real issues.

Even if Timothy's Law is passed, it would not apply to many of the larger companies that have self-insured plans, they note.

And they point to a study that found for every 1 percent increase in health care costs, 30,000 employees lose health insurance. "If you want to provide more for some, you also have to recognize that other people are going to end up with zero, are going to lose everything," said Paul F. Macielak, president of the association.

Such arguments don't speak to advocates or the O'Clairs, who believe they are the ones who paid the ultimate cost, losing their son.

But as the possibility of passing a bill by Timothy's 16th birthday wanes, the O'Clairs are realizing that they may have to fight longer and harder.

Bruno has said he has serious reservations about the cost of the current bill and would like to see it scaled back. Gov. George Pataki's office says it is studying the financial implications of the law.

Meanwhile, Sen. Thomas Libous (R-Binghamton), chairman of the mental health committee and sponsor of the Senate's bill, has said he is looking at revising it to include a waiver for small businesses.

But the O'Clairs say they would not support such changes to the bill, meaning that their work could all be futile, time spent fighting for something that may end up transforming into something they may not even want.

"It will be the law that we want in the end," Thomas O'Clair said, "because it's named after Timothy."