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“Closing puts self-destructive people at risk”

  This is a great article that I found in the March 3, 2008 issue of the Pittsburgh Tribune-Review, it puts a lot of what I’ve found myself asking with regards to what happens to folks as they leave the facilities like Mayview that are being closed.  I found this article to be a little disturbing in that it demonstrates just how unprepared communities are to handle the influx of folks from Mayview.  The article was found at this address … http://www.pittsburghlive.com/x/pittsburghtrib/news/cityregion/s_555214.html   but can be read in full below as well.

Closing puts self-destructive people at risk

By Bonnie Pfister
Monday, March 3, 2008

One day before his 24th birthday, Anthony Fallert walked away from a South Side mental health crisis facility near the 10th Street Bridge.He had been staying there for about two weeks, waiting for space in a group home to become available, said his mother, Susan Williams of Allentown. In a phone call five days earlier, Fallert told his mother that he’d been feeling suicidal again.

It’s impossible to know what Fallert was thinking as he walked a dozen blocks east to the Birmingham Bridge, but Williams has a theory.

“We believe he said to himself, ‘These people won’t take me to the hospital for help. I’m going to walk across the bridge to Western Psych and sign (myself) in,’ ” Williams said. “But he was so upset in his schizophrenic state, he just said, ‘Forget it,’ and he jumped.” The Allegheny County Medical Examiner’s Office determined he took his own life.

Fallert’s Oct. 29 death underscores the challenges facing an estimated 37,000 severely mentally ill residents in Southwestern Pennsylvania. Advocates for these people say the situation is likely to become even more daunting as 180 patients at the soon-to-be-closed Mayview State Hospital in South Fayette take up scarce resources for those who need close monitoring.”The state does this shell game and says, ‘People have a right to live in the community,’ ” said Dr. Suzanne Vogel-Scibilia, medical director of Beaver County Psychiatric Services. While Mayview patients have first dibs on empty beds in the five-county area it serves, they in turn displace the mentally ill living in residential mental-health facilities, many of whom flow in and out of homes on a regular basis, she said.

“The people that have the bad consequences may not be the people leaving Mayview,” Vogel-Scibilia said. “It’s the people nobody is monitoring.”

The number of mentally ill people waiting to get into residential treatment is difficult to pin down because many are on multiple waiting lists, said Mary Fleming, CEO of Allegheny Health Choices, a nonprofit that assists Allegheny County’s Office of Behavioral Health and is coordinating planning around Mayview’s closing at the end of the year. It’s an ever-changing figure because two to three people are discharged weekly from the 1,207 beds in facilities across the county, she said.

Only 58 of those beds offer the most intensive support. With locked doors and on-site services for no more than 16 patients, these “long-term structured residences” often are where state hospital patients will go first, Fleming said.

Community residential rehabilitation programs, or group homes, offer a more independent setting. They are staffed around the clock, with clients traveling elsewhere for other services.

Supportive housing has even less monitoring, often an apartment building with a 24-hour staffer.

Fleming said the county is paying for 220 new supportive housing spaces to be available by 2009. It is adding 26 spaces in mental health personal care homes for people with more intensive needs. There are now 107 such beds in the county.

“Housing is needed for clients in the system, as it is for poor people in general,” Fleming said. “Most individuals with serious mental illness live on extremely limited incomes and experience the same issues around acquiring the things needed for daily living as any person living on a very low-income.”

Fallert was among those trying to find a home before he died.

Williams wonders if her son might have been heading for Western Psychiatric Hospital in Oakland, where he had been admitted numerous times since being diagnosed with schizophrenia at age 13.

He lived at Mayview from age 18 to 23 and moved in early 2006 to a group home in Clarion County, with his own room and workers who made sure he took the half-dozen medicines he needed. He told his mother he loved the place and never wanted to leave, Williams said. He even had a job — a volunteer position cleaning nearby stables, she said.

But services there changed from serving the mentally ill to the mentally retarded, Williams said, and Fallert was discharged in June. He was offered a space in a supportive housing apartment, but he didn’t feel responsible enough to live with that much independence, Williams said. So he moved into her Allentown home, twice attempting suicide by swallowing handfuls of pills.

“He was in the hospital for two weeks, home for two weeks. In the hospital for two weeks, home for two weeks,” his mother said. He moved to a Mercy Behavioral Health center about two weeks before his death, knowing he needed to be more closely monitored and craving things to do in a safe space.

“Here, he just stayed inside,” Williams said. “He was afraid of people.”

Mayview stopped discharging patients for two weeks in November after the deaths of Fallert and another former patient, Ahson J. Abdullah, 58, of Braddock. Abdullah, a father of six, was in and out of jail after his discharge from Mayview’s forensic unit. He was struck by a train in Braddock on Nov. 5. His death was ruled an accident.

The state Department of Public Welfare declined to discuss Fallert and Abdullah, but a spokeswoman said two events in the fall prompted a review. She said the department is urging counties to:

= Enhance monitoring when mentally ill people are transferred between counties.

= More aggressively enroll people in services after they leave jails.

= Improve coordination between jails and behavioral health staffers.

Williams hopes that will help prevent someone else from losing a loved one.

“Tony said, ‘I’m tired of being moved around. I want a group home,’ ” she said. “I feel that someone wasn’t doing their job, and my son got stuck in the middle.”

Bonnie Pfister can be reached at bpfister@tribweb.com or 412-320-7886

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