N.Y. mental-health
service denies
abandoning patient

The group says it did not pay
the man's fare and didn't know
he'd be living in a shelter

By Helen Altonn

The head of a New York organization that cares for mental health patients adamantly denies that it is paying for a client to come to Hawaii and says the group wasn't aware that the man would be living in a homeless shelter.

Al Miller said FEGS (Federation Employment Guidance Service) contacted the Diamond Head Mental Health Center, where the client once stayed, for information about services because the client said he wanted to return to Hawaii.

"Everything flowed from Diamond Head," he said, pointing out his agency has no knowledge of resources in Hawaii. "We have to depend on professionals to tell us."

A FEGS caseworker subsequently called United Self-Help last week asking that someone meet a client when he arrives Monday and take him to the Institute for Human Services, the state's largest homeless shelter.

United Self-Help was told FEGS was paying the man's airfare. Honolulu mental health workers protested, saying they're having trouble caring for mentally ill islanders and sending the man to a homeless shelter is poor treatment planning.

Miller vehemently denied that FEGS was engaging in poor treatment practices or using Hawaii as a dumping ground for its clients as local mental health officials felt over the weekend.

"FEGS has no legal authority to stop the client from doing whatever he wanted to do," Miller said. "He's voluntarily leaving ... The fact that he has mental illness does not take away his rights."

He said the man is getting full service at FEGS in a residential facility and a day-treatment program, and FEGS doesn't want him to leave.

"We did try to encourage him to stay here and continue treatment, which he does not want to do. We absolutely did not pay for his airfare." He apparently has savings from SSI (Supplemental Security Income) payments, Miller said.

When it became clear the client was determined to return to Hawaii, FEGS asked the Diamond Head Mental Health Center for assistance so he wouldn't arrive without services, Miller said.

"We don't know facilities in Hawaii. We are trying to prevent him from getting off the plane and being alone. Diamond Head told our staff person who to call. ... I think we acted more than responsibly."

Department of Health spokesperson Janice Okubo said FEGS asked the Diamond Head center what kinds of programs and services were available in Hawaii. It also asked the mental health center to pick up the man at the airport, she said.

The center explained that it can't pick up the man or provide any services until he gets here, she said. The agency was referred to United Self-Help or Health Care for the Homeless to pick up the man up, she said.

Okubo said the agency subsequently made a Dec. 26 appointment for the client at the mental health center by calling the health department's 24-hour ACCESS line (832-3100) for support and services.

The patient also called the ACCESS line several times, and the Health Department asked the agency to ask him not to call because services can't be provided until his needs are assessed, she said.

Dr. Thomas Hester, chief of the state Adult Mental Health Services division, said his staff members are working with FEGS management to get a better understanding of the Hawaii-bound client's situation.

He said people with mental illness have a right to make decisions about where to live and where to go. "On the other hand, we would not support the idea of giving someone a ticket to get them out of their jurisdiction."

This is a sensitive issue in New York, which has been accused of sending hundreds of patients from New York State psychiatric hospitals to nursing and adult homes in New Jersey, he noted.

He said his staff has been in contact with New York's mental health commissioner to ensure that mental health clients there don't receive one-way tickets to come here, and the commissioner and his staff "have been really responsive to our inquiry.

"Our goal is to make sure we're not establishing a precedent," Hester said. However, he said, "We want to make sure we're establishing good continuity for services to people who come to Hawaii of their own choice."

Instead of waiting until Dec. 26, Hester said a "mobile assessor" will meet the New York client when he arrives for an assessment "to get a better handle on his situation.

"We don't know what kind of moneys and resources he may have. He may be eligible for many different types of housing options, depending on his disability.

He said his staff is following up with New York and FEGS on policy issues. "They've been very cooperative. I think we're going to learn a lot from this situation."

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