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From the CEO's Desk

When I was a much younger woman, I viewed the warehousing of people in a state institution because of mental illness or mental retardation as a barbaric practice. I have since come to understand how that came about. However, with the advent of new medications and new services, it has become unnecessary and unpopular to keep individuals with mental disabilities in state hospitals for a prolonged period of time. In my mind, this is a wonderful thing, and so I applaud the closing of yet another institution such as Mayview, our local state hospital. I am concerned, though, about every individual being properly supported in the community after the closure.

This means that services are of the right nature and sufficient enough to support a population that has serious and persistent mental illness. While I believe that we are on the right track with utilizing peer specialists (those with mental illness and in recovery themselves) and implementing services like mobile meds (professionals bringing medications to the individual daily), that isn’t the total answer. Many of those served in the mental health system receive a variety of services from one to three different providers; and therein lies the rub. It is often difficult for providers to agree on what is best for the individual. Many still believe that an individual must be totally independent with their living skills to live in their own apartment in the community. The truth is that individuals can live in the community with the right supports around them; getting everyone to see that and be able to cooperate on that point is another matter. For many of us raised on the medical model, it is difficult to be anything but paternalistic and behave as though we know exactly what is best for everyone.

In order for the closing of Mayview and other state hospitals to work, I believe there are several things that we need to do. We must educate those who provide the direct care service, whether they are case managers or residential workers, about the more effective methods of working with people (i.e., psychiatric rehabilitation approach). We must find ways to reinforce those providers who are doing it right, perhaps with financial incentives. Finally, we must ensure that the system doesn’t only get a one-shot deal with money coming into the community as individuals leave the hospital. There needs to be continual funding for these services because, as every administrator knows, the operating costs of programs increase on a yearly basis. In essence, I agree with our Board member, Mr. Weis. Unless we can better collaborate and fund the system, the closure of state hospitals is doomed to fail.

Sharon Alberts
CEO Transitional Services, Inc.

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Hospital Closure Opens Doors to New Challenges

The announced closure of Mayview State Hospital has generated much controversy and debate. Supporters of the hospital’s closure state that it will be a positive change, offering persons who have long been institutionalized a chance to live meaningful lives in the community. Opponents argue that the closure will tax an already burdened county mental health system unable to handle the influx of new individuals requiring intensive services and supports. Speculation and comparisons are being made to the closing of Woodville State Hospital in 1992. That hospital’s closure resulted in many individuals becoming unable to access needed services because funding and services were not adequate to support the need. There is much concern that closing Mayview will have the same result.

In order to get a better understanding and appreciation of this controversial event, Christopher Weis, a Transitional Services, Inc. board member, agreed to share his perspective on the matter. Chris said he remembers the closing of Woodville State Hospital and the problems to the mental health system that resulted. He said that he has attended meetings and discussed the plans to close Mayview and therefore has a good vantage point to compare the two.

When asked directly if the Mayview closing will be another Woodville causing increases in homelessness, incarceration and general drains upon the community, Chris optimistically replied, “No, absolutely not. Things are so much different now than sixteen years ago.” The whole state, specifically Allegheny County, is better prepared to successfully manage the closure of Mayview because of the recoveryoriented philosophy and approach in place.” When asked to elaborate on how the community is better prepared to handle the closure, Chris presented a laundry list of reasons for why the closing will be successful and benefit those once again fully joining the community.

The number one difference, Chris explained, is that there is a better, more informed plan for the whole process. He elaborated: “There have been several years of planning meetings that have preceded Mayview’s announced closure, and all of the key stakeholders have been involved in the planning process since its beginning. Advocate groups like Mental Health America and Peer Support and Advocacy Network are involved to assist and ensure the individuals coming out of Mayview have a smoother transition into the community. This type of support process was not available or even thought of when Woodville closed.”

Chris admits he is an optimist but does see some potential challenges. He also said two things could cause the Mayview closing to go badly: poor collaboration among all involved and under-funding. “If service providers do not communicate openly about the service needs of discharging individuals and the new challenges encountered, then there will be many problems. Everyone involved needs to discuss how to make things happen successfully. There needs to be an approach of ‘how can we do this together’ instead of ‘this cannot be done’ or ‘it’s not my responsibility.’ There has to be belief in the individual and his or her ability to work with everyone through the process.” Unfortunately, Chris said none of the things he mentioned will really matter if the money is not made available to support the community integration process. Chris said the money that has been used to support the individuals while they were in Mayview needs to be connected with them and be used to support them when they finally transition into the community. Much funding will be needed to provide recovery-oriented clinical supports in the community to enable the individuals to be successful.

“The closing of Woodville did not go well. But we cannot let past mistakes keep us stuck in our thinking about the potential for persons with mental illness to recover and live meaningful lives in the community. We need to use the past experiences to inform our present action to ensure a successful transition. There are about two hundred people who are really counting on us.”

Chris Weis has been a TSI board member for the past six years and a mental health recovery advocate for nearly two decades. Chris actively serves as a cochair on Allegheny County’s Coalition for Recovery Public Awareness Committee. He is an active member of “Let Our Voices Be Heard,” a political consumer rights advocacy group. He also participates in The National Alliance for the Mentally Ill (NAMI) “In Our Own Voice” program, which educates the public about the experiences of living with mental illness and the journey of recovery.

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