Dean's mental health policy. Don't pay attention to what I did in Vermont?

[blm]

http://www.boston.com/yourlife/health/mental/articles/2003/10/20/mental_breakdown/

Mental breakdown
Embracing change, Vermont neglected its state hospital

By Ellen Barry, Globe Staff, 10/20/2003

WATERBURY, Vt. -- When federal inspectors emerged from Vermont's tiny state mental hospital this summer, they described conditions that can best be called archaic.

>>>>>
In his run for president, former governor Howard Dean moved early to stake out the territory of mental health for himself, delivering a speech Sept. 12 that promised "real solutions to the mental health care crisis" and holding up the Vermont system as a model.

But the state's neglected mental hospital shows the limits of the Vermont success story. Last month the hospital lost its right to collect an annual $700,000 in funds from Medicaid and Medicare -- a rare sanction that was brought against only one psychiatric hospital in the country last year, of 477 that receive the funds. The small community of mental health activists and providers here found themselves examining the old shared dream that the state hospital would no longer be necessary. In the end, they say, what happened was that the most seriously mentally ill patients had fallen off government's radar.

"It's one of those attempts that never went as far as it should go. It clearly didn't close the hospital," said Ed Paquin, a former legislator who is now director of Vermont Protection and Advocacy, which advocates for mental health consumers. "What was left came off everybody's front burner," Paquin said. "It was not right to forget about it when we did."

In 1995, Governor Dean announced that the state hospital would be closed for good within two years. The red-brick campus was a potent reminder of a past when patients spent days in straitjackets; in a 1990 survey ranking Vermont as having the nation's best state mental health system, the Public Citizen Health Research Group said the state had "designated itself as a national experiment," discharging patients from the hospital "with an enthusiasm bordering on evangelistic fervor." The hospital population had dwindled from 1,300 to an average of 50 patients at any given time.
>>>>>>>>

[displacedtexan]

1. really disappointing

vermont has around 6 million people, mostly white, and the average income is about $40,000. i never expected dean to write off the mentally ill.

[Padraig18]

5. Population is 616,592, according to the Census Bureau's 2002 est. n/t

[quinnox]

2. Not something Dean should be touting

I guess Dean thinks he is like the man behind the curtain in Wizard of Oz, "pay no attention to the man behind the curtain!"

As more Dean information is released, the more damage to his "Vermont Miracle" it becomes.

[killbotfactory]

3. Here's a couple less sensationlist reports about it

http://www.cmonitor.com/stories/news/newengla2003/vt__statehospital_2003.shtml

http://timesargus.nybor.com/Local/Story/73099.html

Seems to be a problem with the staff, to me.

:shrug:

[foo_bar]

11. it's a problem with the profession, not the staff

It's human nature to play alpha dog on sick people, and clinical psychiatry doesn't make allowances for examining the examiner. "Quis custodiat" is the central flaw of psychology, coincidentally with its application.

[ModerateMiddle]

22. could also be a problem of priorities

from the article:

Years of state budgets, anticipating the hospital's closure, channeled money to community services instead. The nursing staff dwindled and the psychiatric technicians, who had increasing authority over the wards, were the lowest-paid people in state government, Besio said.

[La_Serpiente]

4. I mean, it's not they could force them to take their medication

it is mandated under state law that the patient be given the option whether to take their medication or not.

However, I can understand the apathy amongst the nurses and doctors.

[foo_bar]

6. I don't understand the criticism

Is the problem too many or too few patients in Waterbury State? Reducing the inmate population sounds like a good thing, if there's alternatives that don't involve solitary confinement and 5-pt restraints.

[killbotfactory]

8. Yeah...

Dean's against institutions, and wants to see people with mental illnesses treated like people with other illnesses. After seeing two of my family members in places like that, I really don't see the problem with that.

I also don't see how it's Dean's fault the staff wasn't doing a good job with the patients.

[killbotfactory]

7. "Vermont governor honored for work with mental illness insurance law"

The governor of Vermont was honored at the UA yesterday for his contributions to the adoption a new bill that prohibits insurance companies in that state from denying coverage to people suffering from mental illness.

http://wildcat.arizona.edu/papers/91/80/07_2_m.html

He's pushed for this bill since 1983.

http://rutlandherald.com/News/AtAGlance/Story/71492.html

Dean said that the country had to be ready to make a 20-year investment in breaking the cycle, but he pointed to Vermont’s success as proof it could be done. Citing figures from Vermont Blue Cross Blue Shield, he said the parity legislation had only added 1.9 percent of the cost of health care.

Dean told the crowd that he introduced the parity bill when he was a freshman House member in 1983, but had to wait 14 years before he could sign it as governor in 1997.

<...>

Ken Libertoff, executive director of the Vermont Association for Mental Health, who attended Dean’s speech Friday, said that while Dean was fiscally conservative as governor and didn’t approve all the money sought by mental health advocates, he was a strong supporter of greater care.

“He was a leader on this issue before it was popular,” Libertoff said.

[Rose Siding]

9. NAMI praised him for that also

NAMI Applauds Courage of Governor and Legislature

Montpelier, VT - Vermont Governor Howard Dean today took a significant step towards ending insurance discrimination against people with brain disorders. Governor Dean signed "An Act Relating to Health Insurance for Mental Health and Substance Abuse Disorders" (H57), the broadest and most comprehensive of the parity bills that have passed so far this year.

Vermont now joins 13 other states including New England neighbors Maine, New Hampshire and Rhode Island that have taken legislative action against insurance discrimination. Parity bills are also currently being considered in a number of other states such as California, Delaware, Massachusetts, New Jersey, New York, Ohio, North Carolina, and Pennsylvania.

snip>

It is particularly appropriate that Governor Dean should sign this bill into law. Not only is Governor Dean a physician who understands the medical nature of brain disorders, but he also has long been supportive of efforts to end discrimination against people with such illnesses. Back in 1985, when he was a state legislator from Burlington, then Representative Dean supported one of the first bills in Vermont to end insurance discrimination.

http://www.nami.org/Content/ContentGroups/Press_Room1/19971/June_1997/Parity_Becomes_Law_in_Vermont.htm

[sfecap]

10. Let's read on...

(snip)

...The hospital population had dwindled from 1,300 to an average of 50 patients at any given time.

(snip)

The 50 who are left represent the most seriously ill of Vermont's population, about a third sent for forensic examination after being accused of a crime, and the rest judged suicidal or dangerous. They range from patients with personality disorders who make repeated attempts to hurt themselves to patients who suffer delusions and hallucinations, said Susan Besio, Vermont's commissioner of developmental and mental health services.

(snip)

Yeah, this sucks. Keeping severely ill patients (some who refuse medication), and represent a danger to themselves and the community, in a hospital. Perhaps you'd like the Reagan 80's approach? Just throw 'em out on the street!

The population has been reduced from 1300 to 50, by utilizing a community based approach to treatment.

What a bad thing.

[Name removed]

12. Deleted message

Message removed by moderator. Click here to review the message board rules.

[blm]

13. Noone's allowed to put up articles that don't flatter Dean without whining

from those supporters who can't bear to see their FAVORITE COMPROMISING CENTRIST exposed at all to sunlight by those weepy liberals who DON'T TRUST THE FOCKIN' CORPORATIST who was the highest rated Democrat by the CATO Institute.

btw....YOU said my post is a lie. If you can't find a lie in my post, I think you should retract your accusation.

[killbotfactory]

14. I see a lot of facts and no whining.

Dean bashers can't stand the fact that Dean has a good record in Vermont to run on, and will do cartwheels trying to spin it into a negative.

[drfemoe]

16. me too

I appreciate the post. Gave me the opportunity to do more research, and I still like him. I don't see how Dean can be the bad guy in this siuation. He UNDERSTANDS medical care is an important issue and has actually passed laws to improve it.

from: http://rutlandherald.com/News/AtAGlance/Story/71492.html

"Vermont has been able to cut child abuse cases by 43 percent in the past 10 years, and child sexual abuse by 70 percent in the same time period, he said." .. what a bad guy

No whining here.

[blm]

20. Who spun it? If there is a lie in the article, point it out.

Why are liberals distrustful of Dean's record and who point to his centrist leanings called Dean bashers? Those who say it's a lie when there is no lie, no spin and call posters Dean bashers are the whiners.

[dsc]

23. The word the poster used was spin, not lie

To spin something means to leave a false impression without lying. Here is one example from the article.

In 1995, Governor Dean announced that the state hospital would be closed for good within two years. The red-brick campus was a potent reminder of a past when patients spent days in straitjackets; in a 1990 survey ranking Vermont as having the nation's best state mental health system, the Public Citizen Health Research Group said the state had "designated itself as a national experiment," discharging patients from the hospital "with an enthusiasm bordering on evangelistic fervor." The hospital population had dwindled from 1,300 to an average of 50 patients at any given time.

But in the eight years that have passed, that number has stayed virtually unchanged.

The 50 who are left represent the most seriously ill of Vermont's population, about a third sent for forensic examination after being accused of a crime, and the rest judged suicidal or dangerous. They range from patients with personality disorders who make repeated attempts to hurt themselves to patients who suffer delusions and hallucinations, said Susan Besio, Vermont's commissioner of developmental and mental health services.

end of quote.

The middle sentence is trying to give an impression that it is the same people or that it is somehow unusual for there to be a relatively stable number of people in a mental hospital. The next paragraph tells us differently.

[Name removed]

17. Deleted message

Message removed by moderator. Click here to review the message board rules.

[sfecap]

18. Kerry supports deregulation.

He voted to deregulate the Telecommunications industry while having personal investments in that industry.

Would he be a "corporatist", too? LOL.

[cindyw]

21. Your trying to spin Kerry as deregulating corprotist

PLEEEEESE. Can we think of a better lie. Next you will be saying that Kerry personally fired the first shot in the Iraq war and led the charge to Baghdad.

[sfecap]

27. A lie? Really?

Kerry didn't vote to deregulate the Telecommunications industry?

WASHINGTON, May 7, 2003 -- Sen. John F. Kerry, D-Mass., whose largest campaign contributor lobbies on behalf of telecommunication interests, pushed the legislative priorities of its clients in the wireless industry on several occasions, a Center for Public Integrity analysis of campaign, lobbying and congressional records has found. That analysis is part of the Center’s research for The Buying of the President 2004 (to be published by HarperCollins), which tracks the financial backers and interests of the major candidates for the White House.

Kerry, who is seeking the Democratic presidential nomination, has sponsored or co-sponsored a number of bills favorable to the industry and has written letters to government agencies on behalf of the clientele of his largest donor.

(snip)

Kerry and his wife Teresa Heinz Kerry have substantial holdings in telecommunications companies; between $17.6 million and $47.1 million of their combined fortune is held in companies with a stake in the industry, the Center’s analysis of his financial disclosure form revealed. That falls in a range of roughly 7 percent to 11 percent of the couple’s combined $165 million to $626 million in assets. Most of the fortune, and the stocks, belong to Heinz Kerry.

Some $3.9 million to $13.9 million of those holdings are in companies which are members of CTIA.

http://www.publicintegrity.org/dtaweb/bop2004/default.aspx?Section=ARTICLE&AID=8



Telecommunications Bill - Passage


Bill Number: S 652
Issue: Telecommunications
Date: 06/15/1995
Sponsor:


Roll Call Number: 0268
Passed
Full Member List


Senator John Forbes Kerry voted YES.

Pass bill to deregulate telecommunications industry.

S 652: Telecommunications-Communications Deregulation Act

Passage of a bill to deregulate the communications industry and allow competition between local telephone, long distance, and cable television companies. The bill also increases the number of stations one person/company can own; deregulates most cable service prices; and establishes penalties for persons who use telecommunication devices to harass or make obscene communications, among other provisions.
(Passed 81-18 on 6/15/95)

Bill Status:
Bill Number: S 652 - 104th Congress (1995-96)
House Passage Vote: 10/12/95 - Outcome: Passed by Voice Vote
Senate Passage Vote: 06/15/95 - Outcome: Passed
House Conference Report Vote: 02/01/96 - Outcome: Passed
Senate Conference Report Vote: 02/01/96 - Outcome: Passed
Presidential Action: Signed on 02/08/96
Public Law Number: 104-104 110 Stat. 56

http://vote-smart.org/issue_keyvote_detail.php?vote_id=604&can_id=S0421103

[blm]

28. Clinton was for it, and that largest donor you try to SMEAR Kerry

with is a firm that his brother works at and they have COLLECTIVELY, as individuals, donated 170,000 thousand dollars over an 18 year period. Kerry doesn't take corporate pac money. Bush's donors give more than that in ONE year. This figure points out how CLEAN Kerry is on this issues, yet you try to spin it into a character deficit. Bad move considering that Dean's financed his campaign ala Bushlite with his energy donors.

Care to disclose the entire truth, sfecap, or do you insist with your cherrypicking ways?

I'm proud that supporters of other candidates don't take cheap shots at candidates' wives.

[sfecap]

29. The truth?

Here it is, read it again:

Kerry and his wife Teresa Heinz Kerry have substantial holdings in telecommunications companies; between $17.6 million and $47.1 million of their combined fortune is held in companies with a stake in the industry, the Center’s analysis of his financial disclosure form revealed. That falls in a range of roughly 7 percent to 11 percent of the couple’s combined $165 million to $626 million in assets. Most of the fortune, and the stocks, belong to Heinz Kerry.



Kerry has financial interests in legislation he supports and sponsors. The interest is thru his investments, not PAC money. Do you understand the difference? Did I mention PAC money...no I didn't.

Kerry has investments in the telecommunications industry that profit from deregulation.

Kerry voted to deregulate an industry in which consumers have seen their costs go up and up.

There is the truth.

Can you stand it?

[blm]

31. You said his largest donor, implying that he was doing their bidding

when that is noone near the truth. You chose to twist it into something else.

Should Dean be smeared for his stock in GE? Is that why he won't cut the defense buf=dget?

Dean is for deregulation PERIOD. It's part of his core principles.

Kerry is not a fan of deregulation, and there was much BSing going on about the telecommunications bill, and many broken promises. Kerry and other senators have said it was a mistake and expect to correct parts of the bill further down the line.

You can cancel cable, btw, but electricity is a necessity. No comparison.

[dsc]

32. Now words have meaning

funny how that works. FTR both words are used so you are both correct but it is hilarious for me to see you reacting like you are here after your repeated name calling of me for asking you for similar record corrections.

[sfecap]

33. Gee, does Dean sponsor legislation to benefit GE?

I must have missed it.

Sure you can cancel cable, telephone, cell phone, internet. How many do? How would businesses survive?

You can generate your own electricity, too. LOL.

Let's review this....Kerry own large anounts of stock in Telecommunications companies. Kerry sponsors legislation and votes to deregulate an industry in which he owns stock. No conflict there! LOL.

Kerry is not a fan of deregulation, but votes for deregulation. (Just coincidentally benefitting himself...) I get it. Kinda like the IWC tapdance....Kerry didn't really want to attack Iraq, but he voted to give the chimp the authority to do so.

But...but....bbbbut...he was lied to! Just like the Telecommunications Bill! How convienient!

Keep going, this is getting good!

[DianeK]

15. vermont is a shining example of how human beings..

of all walks of life should be treated. around the mid 70's they began to empty the state mental institutions. they did this not by setting a deadline and then throwing them out onto the streets, but by methodically educating and working with the ciizens of vermont and licensing those who were willing to open their own homes as 'community care homes'. those with the most severe disabilities...both mental and/or emotional, were found homes where they would be the only resident, so to speak...i think this is a good thing and personally had some experience with this as my parents took a lady in. she was with them from 1975 until her death in 1999. she was very much a big part of our family and never did she fall off the radar screen. the state continued to be there for her medical needs and she lived and participated in community life as we are all able to do....long gone are the days where we hide these people from our view

[KittyWampus]

25. Dean Is Sometimes Unable To See The Big Picture

Before You Get The Mentally Ill Into Residential Settings there has to be an institutional setting where they can be evaluated and stablized.

It seems that Dean had good intentions but poor systematic planning.

Same with the commuter train he pushed for... it went over budget by MILLIONS and then got very little use. How the HECK did Dean get suckered into that one? Weren't there studies showing it would or wouldn't be used? Didn't Dean know that the train would only succeed under a comprehensive transportation plan.

Same with Energy Deregulation... why did Dean push so energetically for it. Quebec's experience doing same was a disaster and cost taxpayers loads of money.

[drfemoe]

26. Do you realize

that when the east coast was in a blackout in August 2003, Vermont had power?

Someone did something right.

[mzmolly]

30. It would seem he got 1250 people out of the hospital...

so the systematic planning worked to a large extent.

[Egnever]

19. I think all of the candidates would love it if....

No one paid attention to what Dean did in vermont. Thier life would get so much easier.

[jburton]

24. So tell me what is bad about this?

quote

The 50 who are left represent the most seriously ill of Vermont's population, about a third sent for forensic examination after being accused of a crime, and the rest judged suicidal or dangerous. They range from patients with personality disorders who make repeated attempts to hurt themselves to patients who suffer delusions and hallucinations, said Susan Besio, Vermont's commissioner of developmental and mental health services.

unquote

First of all it's 50 people who are dangerous to themselves or others.

50 people statewide is a remarkably low number. Would you rather more people be institutionalized rather than live in society with outpatient care? In other words, put everybody in a straight jacket?

Or perhaps put them in jail?

[Feanorcurufinwe]

34. The problem is that Dean's typical all-or-nothing approach

wasn't just to stress residential treatment -- but to close the hospital altogether. Well reality intruded with the fact that for some patients the hospital setting is the appropriate one. So the hospital stayed open. It's really a fault of planning. What I see here is an opportunity wasted -- surely with only 50 people, sufficient resources could be made available to treat them properly. Instead because they don't fit Dean's model of what a mental health patient should be like, they've been abandoned.