Need for mental health reform: ‘It’s just heartbreaking’

Eleven years later, Donna Icovino is still horrified by what her son, Michael, experienced when he went into a mental health crisis at his Cherry Hill group home.

Diagnosed with autism and bipolar disorder, Michael Icovino was taken to a crisis screening center at a nearby hospital before he was transferred by ambulance to Ancora Psychiatric Hospital in Winslow against his mother’s wishes. She followed him all the way there, and refused to leave without him.

Though an Ancora clinician told Icovino it was an “absolutely inappropriate” place for the 18-year-old, he was there because New Jersey had nowhere else to put him.

“To this day, I consider that the saddest day of my life, because I had lost complete control of his well-being and safety,” said Icovino, who now lives in New Hope, Pa. “I sat there all day long. They didn’t know what to do with this mom who wouldn’t go home.”

She got him out before the weekend and promised herself it would never happen again. Not to her child, or anyone else’s.

In 2008, state Department of Human Services Commissioner Jennifer Velez appointed Icovino as co-chairwoman of the newly created Dual Diagnosis Task Force. Charged with studying the problem, the task force brought together 100 experts, families and dually diagnosed clients from around the state. After months of work, the task force offered specific recommendations for reform.

Seven years later, little has changed.

Shirla Simpson, deputy director of the state Council on Developmental Disabilities, said young adults making the transition between services for children and adults are often stuck without appropriate treatment.

“There’s just not a real good place for them in the system,” Simpson acknowledged. “The (Department of Children and Families) is trying to build a better system for these kids, but it hasn’t been built fast enough to accommodate the need.”

Dually diagnosed young adults who need longer-term, out-of-home services should be placed in a specialized group home with 24-hour care with nursing, appropriate medication and a psychiatrist on staff, she said.

“We do not believe that people should be living in institutions,” Simpson said. “I worked in screening for 15 years. It’s just heartbreaking to send a young person like this to a state hospital. ... Even as a worker in the system, you don’t want to do that. You want another option for a family. There usually is not an option.”

More intensive in-home services are needed to keep patients from spiraling into a crisis, explained Joe Young, executive director of Disability Rights New Jersey, a federally funded nonprofit. The organization sued the state in 2007 for keeping people in psychiatric institutions long after they were cleared for release.

“We don’t believe individuals — particularly with a dual diagnosis such as (developmental disability and mental illness) — should be in a long-term, institutional setting like that,” Young said.

“There’s got to be in-between stuff, because Ancora is an acute care adult psychiatric hospital. Most of what it does is giving people medication and monitoring the medication. If somebody needs something different than that, they need to go someplace else.”

While fighting to get their son out of Ancora, the Icovinos showed up at the administrative offices of Bancroft in Haddonfield. He had done well in Bancroft’s Lindens Behavioral Stabilization Program as a 14-year-old, but there were no beds available this time. The family begged for a placement elsewhere. Michael hadn’t eaten or slept since arriving at Ancora, they said.

Bancroft found a bed on its campus, and the next day, Donna Icovino signed her son out of the state hospital.

Now 29, Michael Icovino is flourishing in his Cherry Hill group home. He volunteers for Meals on Wheels and runs an annual food drive for the Food Bank of South Jersey. Whenever his mother visits, he greets her with a big hug, and kisses both cheeks.

“He is doing wonderfully,” Icovino bragged. “I’m enormously proud of him. I keep at this work because Michael is an example of what can be accomplished if we reform the crisis intervention system with preventative measures and better intervention and post-crisis care. “There’s no reason that can’t occur for more people.”

On Dec. 7, three weeks before another dually diagnosed 18-year-old would be sent to Ancora from a South Jersey crisis screening center, Icovino sent her budget testimony to Velez, the state commissioner who appointed her co-chair of the task force. In it, the mother urged the commissioner to find a way to pay for the task force recommendations, in order to avoid “costly, ineffective care” in state institutions.

In an interview, Icovino said the cost to reform the system would save money in the long run, using a combination of state and federal funds.

“The fact that the state is not going forward with implementing the priority recommendations of the task force is, in my opinion, willful disregard and neglect,” Icovino said.

Since the task force issued its recommendations in 2008, the need for such services has only grown, Icovino said.

“I’m not going away,” she said. “I’m not going to give up.”

In a written response to a reporter’s questions, state Department of Human Services spokeswoman Ellen Lovejoy said “we’re surprised” by Icovino’s criticism.

“In light of the fact that the report was issued at the height of the recession, we think very critical strides have been made, with very limited resources,” Lovejoy wrote. Those include expansion of community services and residential programs, including 38 supportive housing beds for dually diagnosed people discharged from state psychiatric hospitals.

The state also has increased the number of specialized units treating dually diagnosed and special needs consumers in its psychiatric hospitals, Lovejoy wrote.

MORE INFO

To read a family crisis handbook co-written by Donna Icovino, visit http://tinyurl.com/n3tfksw