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Project provides homeless better care at lower cost Treatment Advocacy Center E-News Date: Friday, July 20, 2001 1:55 PM Treatment Advocacy Center Visit our web site http://www.psychlaws.org/ July 20, 2001 ****************************** [Editor's Note: Despite the impression you might get from talking to some, we at the Treatment Advocacy Center have never contended that assisted treatment is, in general, superior to voluntary treatment. To the contrary, we believe that voluntary treatment is by far better for most people with mental illness. Assisted treatment should only be used when there is no other option. Take the admirable intensive outreach program described in the article below. We wish that something similar was available in every state, in every county, in every community. But, also note that what most would no doubt describe as "voluntary" outreach services are not without a measure of assisted treatment. As stated in the article, "The team members work closely with court and jail officials, often assuring that clients agree to treatment as a condition of parole or probation."] 3. THE WASHINGTON POST May 21, 2000 Project provides homeless better care at lower cost; They spend less time in hospital, jail. August Gribbin, a Rochester, N.Y. psychiatrist, has found an innovative way to cope with the deranged, drug-abusing and sometimes homicidal homeless languishing under bridges, in doorways and atop the air vents of the nation's cities. Dr. J. Steven Lamberti, a psychiatrist affiliated with the University of Rochester Medical Center, last week released results of a five-year program called Project Link. Among other measures, the program utilizes a mobile team of medical, psychiatric and social service providers to locate, assist and then monitor the mentally ill who wander the streets and repeatedly land in jail. The team provides medical assistance and counseling. It arranges for clients to get food, clothing and the basic social services street people desperately need but often resist. By special arrangement, it maintains 10 beds for housing clients at a facility for mentally ill chemical abusers. Project Link is funded by county, state and private foundation grants of roughly $600,000 yearly. The program serves a disheveled population that has frustrated for years the efforts of conventional social work and mental health systems and their special initiatives. The program's clients are the bizarre people who scrub windshields at traffic stops; slouch aimlessly, mumbling over their stuffed and stolen shopping carts; have repeated run-ins with the law and occasionally attack innocents. In a paper prepared for delivery at the American Psychiatric Association's annual convention in Chicago, Dr. Lamberti explained he recently tracked 44 of the hundreds of mentally disabled and mostly drug-abusing participants in his program. He found that in the year before their involvement with the project, the individuals had spent an average of 104 days in jail and 114 days in the hospital at an average cost to the public $74,500 per individual. Since their involvement with Project Link, the same participants have spent an average of 45 days in jail and eight days in the hospital at an average per person cost of $14,500 - including Project Link project costs. Stephen Dungan, director of the Monroe (N.Y.) County Office of Mental Health, calls the project "remarkable." He notes the average monthly cost of mental health treatment for the studied patients was $4,300 per patient before Project Link's intervention. Afterward it dropped to $900 per month. Beyond that, Dr. Lamberti says the program's clients dramatically improved their ability to care for themselves. They took greater pains with personal hygiene, managed money better and reduced drug and alcohol consumption. In a phone interview Dr. Lamberti said, "This program can help stop the disasters." He was referring to such senseless slayings as the July 1998 murder of two U.S. Capitol guards that Russell Weston admitted committing while delusional and the killing last year of the young Kendra Webdale, whom Andrew Goldstein admitted pushing into the path of a New York subway train. Goldstein, a schizophrenic, had previously assaulted 13 others. Rochester lies in Monroe County, and a key to Project Link is the coordinated involvement of five city and county service organizations, including the Monroe County Clinic for Socio-Legal Services and the Urban League of Rochester. Each group has a representative on the project's management team. However, just seven persons do most of the daily work. A forensic psychiatrist, a nurse practitioner and five advocates or case managers form the mobile team. They find clients in crack houses, homeless shelters, jails, and hospitals. They treat clients on the spot then shepherd them back to their parole officers, social workers and others. The project case managers typically come from racial and ethnic groups represented by the majority of their clients. Thus they're familiar with their clients' languages and customs. The team members work closely with court and jail officials, often assuring that clients agree to treatment as a condition of parole or probation. "The seven are the hands-on persons responsible for seeing the clients have adequate resources to live in the community," Dr. Lamberti says. "And," concludes Edward J. Nowak, the Monroe County public defender, "The system works. It makes sense and it makes a difference." ******************************** Treatment Advocacy Center E-NEWS is a publication of the Treatment Advocacy Center. This E-NEWS is provided as a public service by the Treatment Advocacy Center. There is no fee. If you would also like to receive a free subscription to the Catalyst, our bimonthly hardcopy newsletter please forward your mailing address to info@psychlaws.org. The Center does not accept donations from pharmaceutical companies. Support from individuals who share our mission, however, is essential to our ability to effectively help our most vulnerable citizens. The Treatment Advocacy Center is a 501(c)(3) not-for-profit organization. All contributions are tax-deductible to the extent allowed by law. Donations to the Treatment Advocacy Center should be sent to: 3300 N. Fairfax Drive TO SUBSCRIBE send a message to info@psychlaws.org with your name, address, affiliations (if any), relationship (if any) to someone with a neurobiological disorder; and interest in laws surrounding the treatment of individuals with neurobiological disorders. This information assists us in providing quality service and will be kept confidential. Requests for subscriptions will be processed without this information in the event you cannot provide the information for personal reasons. |
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