Forum looks at mental health progress, challenges facing Berkshires


Photo Gallery | 2016 Berkshire County Mental Health Legislative Forum

PITTSFIELD — The life story of a 39-year-old Berkshire County woman named Tammy starts with childhood abuse, leading to lifelong bouts of depression, and multiple suicide attempts.

But the latest chapter of her life features more stability, a loving fiancée, and the ability to live at home and not in a hospital bed.

After sharing the details of her struggles and successes during the annual Berkshire County Mental Health Legislative Forum on Monday, Tammy received a standing ovation from the more than 60 mental health professionals, community members and a couple of state legislators gathered in the auditorium of the Berkshire Athenaeum.

The forum is a sort of state-of-the-state, as told by local legislators, of what's happening with state policies and proceedings designed to support the rights and care of people with mental health disorders. Experts working in the field then have the opportunity to offer feedback to delegates about what's working and what's not.

Tammy urged attendees to continue to advocate and support people like her, not through only legislation, but also through genuine attempts to understand and try to relate with the circumstances and experiences people with mental health disorders — like, anxiety, depression, addiction, stress and trauma — are going through.

"I feel like there is still a lot of stigma for people with mental illness," Tammy said. "But people change, people get better, people grow."

Some members of the Berkshire delegation were unable to attend due to the snow, but Sen. Benjamin B. Downing and Rep. Tricia Farley-Bouvier, both Pittsfield Democrats, were on hand to field questions during the 90-minute forum, introduced by NAMI Berkshire County Executive Director Brenda Carpenter, and moderated by Brien Center CEO Christine Macbeth.

Downing said future access to mental health services in Berkshire County, particularly longer-term and residential treatment programs, greatly hinges on the current development of the state budget and the formula and methods used to make allocations for such services. The senator said that population-based allocations hurt Berkshire County and don't meet needs.

The administration of Gov. Charlie Baker has elevated issues related to opioid addiction to a legislative priority in the commonwealth, which, the legislators said, is helpful to some extent.

"The issue that's stood out to me, an issue many of us in this room talk about and know about is the particular challenge we face in terms of access to the services we need," Downing said. "According to a report on access to treatment, there are something like 14 different modes of services needed to effectively treat substance abuse, but in the Berkshires they found that only three to five of these modes were even present in the county, and that's excluding the accessibility of them for different people."

Dr. Jennifer Michaels, a clinician for both the Brien Center and Berkshire Medical Center, said that there are some positive strides being made, including a new project known as Seymour House. The project, being co-developed with BMC, will provide a residential recovery home for women in Pittsfield.

The distribution of Narcan, an emergency treatment that can stop the potentially lethal effects of an opioid overdose, also has become more widespread, and now can be obtained through pharmacies.

But both Downing and Farley-Bouvier noted that not only are county residents inhibited by geography to accessing other kinds of services and treatments, they're also hindered by health insurance plans.

When Gov. Charlie Baker characterized the substance abuse bill he signed last month as a "bold" action for the state, Farley-Bouvier said she congratulated him, then said, "Governor, I need you to be bolder than you are being."

"You are asking a lot of doctors, of the communities and of law enforcement, but I have yet to see you ask anything of the insurance companies," she said.

In 2014, Gov. Deval Patrick signed the preface to Baker's bill that required state insurers to pay for up to 14 days of inpatient care for addiction treatment without prior authorization.

"Fourteen days is not nearly enough for sustainable treatment, but this is considered progress in the Legislature," Farley -Bouvier said. "It's time for us to be asking for [insurance companies to cover] a full four weeks. That's the next step."

Mental health legislation and insurance coverage also has to go beyond the scope of treatment of addiction, attendees said.

Roberta Russell, MSW, a licensed independent clinical social worker in Lenox, spoke about how disruption in insurance coverage is interrupting the continuum for care of thousands of patients, particularly in the Western Massachusetts region. This included 16,000 patients who were dropped from Health New England's MassHealth CarePlus plan, effective as of February. The provider cited a failure of state reimbursement rates covering the actual costs of care.

Russell said in the past year, 10 of her clients were dropped from their insurance, leaving them to scramble for coverage and often finding that their new providers don't include Russell in their network of therapists.

"The people who we see who are on MassHealth are among the poorest and most traumatized. They can't just switch and start over again. ... And they don't have the resources to shop around for the best insurance. They're in survival mode," Russell said.

Tammy, for example, who has been in care for the past 25 years, has been shuffled to services throughout the region, from residential care in Williamstown, to hospitals in Springfield and Holyoke. During some periods of treatment, she lost her apartment and her pets.

But, she said, it's been caring clinicians, dedicated social workers and understanding friends that have made her feel more like a human and less like a patient identification number on a case file. That kind of attention and help, she said, is anyone's best chance of recovery.

"I might have a mental illness, but that does not define who I am. I'm a human being," said Tammy.

She recounted a recent incident during which, due to a medication change, she had an adverse reaction and trouble breathing, and called 911. But because of her past record of suicide attempts, the dispatchers sent police along with the ambulance, who searched her home for drugs and asked her if she cut herself instead of immediately taking her to the hospital to help her breathing.

"They treated me horribly in the ER because of who I was in my past. They asked me, 'Do you need an Ativan,' and I said, 'No, I need to be treated with respect."

Contact Jenn Smith at 413-496-6239.


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