USA Attacks NY’s Treatment of Mentally Ill

BROOKLYN (CN) - New York City's mental hospitals "foster learned helplessness" by failing to provide services to mentally ill patients in the most integrated setting, the United States claims in a lawsuit against New York State; a separate class action from patients makes similar claims.

In the federal government's Americans with Disabilities Act lawsuit, Uncle Sam claims New York City places mentally ill patients in for-profit institutional residential care, known as "impacted" adult homes, though they could be better served in a more integrated setting.

"For the most part, adult homes have the characteristics of an institution," the lawsuit states. "Residents live with other persons with disabilities, and have limited opportunity to interact with individuals who do not have disabilities.

"They are assigned to small rooms that they share with at least one other resident. Bathrooms are also shared with at least one other people." (Citation to 45 C.F.R. omitted.)

The federal government says the approximately 4,000 residents living in the 24 adult homes in New York City "have very little autonomy over their daily lives, including over with whom they live and eat meals, and what they eat and when, and are afforded virtually no privacy."

Patients are denied the right to administer their own medication, but are "required to line up at a medication station at specific times of day." Many of the care homes have curfews and don't allow residents to cook for themselves or do their own laundry.

Also at issue is the way the facilities dole out a "personal needs allowance" of $187 a month from the patients' Social Security Supplemental Social Security Income.

"The remainder of the resident's SSI benefits is paid to the adult home," the lawsuit states.

"Adult homes do not afford people with mental illness opportunities to achieve greater independence and community integration. Consequently, the facilities foster learned helplessness."

Placement of people with mental illnesses in adult homes "is not based on a determination that such placement is clinically necessary," the complaint states. "Instead, people with mental illness tend to end up in adult homes following a hospitalization or homelessness because there are no available residential placements in integrated community settings, such as supported housing."

The federal government says that "supporting housing is a successful, cost-effective program that gives residents the same privacy rights as any other tenant in a landlord-tenant relationship. In supported housing, people with mental illness live much like their nondisabled peers. ...

"Compared to residents of adult homes, residents of supported housing have far greater opportunities to interact with non-disabled persons and be integrated into the larger community."

And, the government says, supported housing can save the state money: "Serving those individuals in supported housing will likely save money, thus freeing state funds to use for other individuals with disabilities."

Uncle Sam seeks declaratory judgment that the state's practice of shuffling mentally ill patients into adult homes violates the Americans with Disabilities Act and the Rehabilitation Act.

In the separate, class action lawsuit, named plaintiffs Raymond O'Toole, Ilona Spiegel and Steven Farrell sued Gov. Andrew Cuomo, and the state's Department of Health and Office of Mental Health.

The class claims that 80 percent of the residents of the city's 23 adult homes have serious mental illnesses, and little to no privacy or autonomy.

This lawsuit backs up several issues raised in the federal government's lawsuit, including schedules, assigned roommates, lack of privacy and residents' inability to cook, clean or do their own laundry.

"Plaintiffs do not need to be consigned to adult homes," the complaint states. "More integrated residential settings that are appropriate to plaintiffs' needs already exist within defendants' system of provision of mental health services, or can be made available. ...

"Unlike residents of adult homes, residents of supported housing live much like their non-disabled peers and are integrated into their communities."

The complaint cites a similar lawsuit filed a decade ago on behalf of people with mental illness living in impacted adult homes. After an 18-day trial, the court found that defendants violated the Americans with Disabilities Act and the Rehabilitation act.

The 2nd Circuit then found that the plaintiff in that case, Disability Advocates Inc., lacked standing, but it "did not disturb, or even question, any of the factual findings made by the district court," according to the new complaint.

Earlier this year, the New York State Office of Mental Health made a clinical determination, which was recognized by the New York Department of Health, that adult homes "are not conducive to the recovery or rehabilitation of residents," and "do not foster independent living due to institutional practices," the class claims.

"But plaintiffs continue to languish in institutionalized adult homes, their only alternative to homelessness," according to the complaint.

The class action accuses the state of violating the Americans with Disabilities Act and the Rehabilitation Act.

The class is represented Andrew G. Gordon with Paul, Weiss, Rifkind, Wharton & Garrison.

The federal government's lawsuit was filed by Joselyn Samuels, acting assistant attorney general in the civil rights division.

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