Co-Chair, Jen Honig, called the meeting to order at 10:20 a.m. and welcomed all to today’s meeting. Introductions and the following announcements were made:

 

Evelyn Kaufman reported that CFAR members met several weeks ago to discuss the passing of the “Fresh Air” legislation (H.B. 1905, S.B. 1120) to make fresh air rights available to mental health patients confined to hospitals.  She explained how fresh air is important as a part of their therapeutic treatment.

 

[Editor’s note:  After today’s meeting, an email sent by Jon Dosick arrived.  He reported that there is a high probability that the “Fresh Air” bills will be heard by the Mental Health and Substance Abuse Committee on Monday, June 25, 2007. Jon requested everyone’s presence at the hearing.  The opposition to the bill was surprised by the turnout last time, so they will be prepared to fight the bill with many more people testifying against the bill and jeopardizes our right to fresh air access.  Jon urged that advocates of this bill respond in kind and pack the room with supporters and testimony and send a strong message that people always go before profit!  Jon can be reached at ambiente871@hotmail.com or at 617-947-6549.]

 

Cathy Levin spoke on the status of the two “Emergency Room” bills.  Members of M-POWER are lobbying vigorously for the passage of these bills in the state Legislature to protect people with mental illness symptoms in emergency rooms. 

 H.B. 2042 – “An Act to Protect the Mentally Ill in Emergency Rooms”, sponsored by Ruth Balser, Co-Chair of the Joint Committee on Mental Health & Substance Abuse, would require the DPH to write state regulations concerning psychiatric and behavioral health patients.

 

Currently, regulations concerning emergency rooms in Massachusetts are from the Federal Center for Medicare and Medicaid Services.  A state house hearing for this bill has been scheduled for November 20, 2007.

 H.B. 1891 – “An Act Relative to the Treatment of Mentally Ill Patients in Emergency Room Facilities”, sponsored by Co-Chair of the Joint Committee on Public Health, Peter Koutoujian, would shift the authority for licensing psychiatric areas in emergency rooms from DPH and give it to DMH instead.  A hearing date has not yet been scheduled.

 

Cathy briefly explained the history behind these bills.  She spoke of the emergency room situation in which a patient with a mental health and sexual abuse history had entered the hospital for medical treatment. When it was determined that the patient had a psychiatric history, she was ordered to remove all of her clothing and change into a hospital gown. When she refused, five male security guards forcibly removed her clothing and she was restrained.

 

Cathy continued by stating that she and several other M-POWER task force members met with the new Secretary of Health and Human Services, Dr. Judy Ann Bigby, where they presented their viewpoint of consumer/survivor/ex-patients on emergency room treatment. Areas of discussion included: eliminating the requirement that patients disrobe and use a hospital gown for psychiatric exams; restraint and seclusion; and informed consent regarding injections and other medications. 

 

Cathy noted that that Secretary Bigby was very pleasant. DMH general council, Lester Bloomberg, also attended this meeting.  M-POWER members presented Dr.

Bigby and Mr. Bloomberg with an information packet on their legislative agenda, including fresh air rights, affordable housing, and funding for peer specialists (especially in paid roles in emergency rooms).

 

The following week Cathy and other M-POWER members met with DPH Commissioner John Auerbach, Lester Bloomberg and other DPH high officials.  The response to this meeting was very positive. Additional meetings, as well as a Summit in the Fall with DPH, DMH, the Mass Hospital Association, the Emergency Nurses Association, the College of Emergency Physicians, NAMI, MHLAC, CPR and DLC are being planned.

 

Cathy requested that CLRD sign a letter of support addressed to Dr. Bigby, Commissioner Auerbach and Governor Patrick.  She offered to draft the letter.

 

Jen Honig reported that MHLAC will be distributing handbooks for families involved with DYS.  A special focus will be placed on mental health issues and how to obtain mental health services and special education. As of this meeting date, the handbook was not ready for distribution.  Jen will notify members when it’s ready.

Jen was pleased to introduce Kate Nemens, a Staff Attorney with the Clubhouse Family Legal Support Project (CFLSP) at the Mental Health Legal Advisors Committee (MHLAC).  In 2005, Kate was named by the Boston Bar Association as 1 of 8 “Public Interest Leaders” to spend the next 12 months in a special leadership development program. 

 

Kate thanked Jen for allowing her to present on this topic and provided some background on the initial stages of the Clubhouse Family Legal Support Project (CFLSP).  She stated that the CFLSP originally started in 2000 as a two-year project.  At that time, it was funded by the Massachusetts Bar Foundation and Equal Justice Works and co-led by Employment Options (a clubhouse in Marlborough, MA) and MHLAC. 

 

The CFLSP provides effective legal assistance and representation to low-income parents, many of who are members of a clubhouse, who are diagnosed with a mental illness and are at high risk of losing custody of, and/or all contact with, their children because they are assumed to be unfit to parent. This assumption is unfounded and grounded in stereotype.  Many of these parents lose access to, or custody of, their children without the benefit of counsel, or proper judicial process.  Lacking representation, and under pressure from  the Department of Social Services (DSS) and relatives, these parents often feel forced to relinquish rights in the family court that they did not know how to protect. 

 

And yet, for many of these parents, their contact with their child is a critical factor in their recovery process. Losing custody of their children can be a barrier to a parent’s successful rehab and cause additional distress for an entire family. The combination of legal advocacy and rehabilitation programs focused on parenting needs can provide a positive impact on preserving a family unit.  The Project staff believes that a person’s ability to be a successful parent has less to do with mental disability and diagnosis, and more to do with parenting abilities, resources and support.  Furthermore, the vast majority of children who have parents with mental illness can cope relatively well with adequate support.

 

CFLSP’s goal is to aid parents with mental health issues to increasing their access to, and possibly regain custody of their children.  Kate works directly with the Clubhouse staff, DMH case managers, therapists, psychiatrists and other service providers in assisting her clients. 

 

She tries to understand the best way to support these individuals in trying to be the best parents they can be and reach whatever goal they need to meet.  For example, DSS may state that the parents need to have a two bedroom home and/or a job in order to regain custody of their children.  Kate will work with the necessary people to help the parent(s) meet such a housing or employment goal.  The Project attempts to apply a team approach when working with a family. 

 

Annually, CFLSP represents 20-30 families across the state, along with another family law attorney at MHLAC.  She would like to expand the Project and add another part-time attorney to this team as well as working with Boston area clubhouses.  This would increase the number of parents they could assist who are in need of legal assistance.

 

Kate gave several examples of the challenges these parents face when working on their recovery process while there is an open court case regarding their children.  The courts are constantly aware of timelines for open cases, and this often is a much shorter time frame than it may take for a parent to show significant progress with respect to their illness.  This is a particular challenge for parents involved with the cases in which DSS has removed the child from the home, usually in the juvenile court.  In these cases, if a parent is unable to achieve certain goals or successes in a short enough time period, they run the risk of the court needing to make a permanent placement for the child outside of their home, or unfortunately, sometimes placing the child up for adoption and terminating the parent’s rights.  With access to legal advocates who have an understanding of both the legal system and the mental health system, these parents stand a better chance for a positive outcome.

 

What can be particularly difficult for parents who also have a mental health issue, when they are before the court, is that the focus will often be on the individual’s mental health history, including times in their lives when they were not stable or unmedicated, rather than focusing on what the parent has recently accomplished and their current level of stability.  While the court’s focus is always as to what is in the child’s best interests, when the judge must consider a parent’s fitness, it can be extremely important in these cases to point the judge to a parent’s current situation rather than just be focused on the history of their illness.

 

Currently, there is some interagency collaboration between DSS and DMH, to better serve parents with mental health issue among both systems.  However it is a challenging process for real systemic change to take place within both of these large government agencies, and progress often seems slow.

 

The project is now funded by grants from the Department of Mental Health and the Massachusetts Bar Foundation.  This funding will ensure that the Project continues to assist low-income parents with a mental illness in getting custody and/or contact with their children.

 

Recently, the Project has applied for additional funding with the Boston Bar Foundation.  The hope is that with the additional monies, CFLSP will be able to obtain a part-time attorney and take on more cases. 

 

Due to limited resources, it is important to recognize the critical work that is being done by CFLSP for low-income parents with mental health issues that is not being met by any other agency in the Commonwealth.