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CNN Sunday Morning
Interview With Clifford Levy of 'NY Times'
Aired April 28, 2002 - 11:38 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
FREDRICKA WHITFIELD, CNN ANCHOR: There are limited resources for seriously mentally ill patients. Some may end up in prison. Others may end up in privately run facilities. The New York Times investigated these homes and found a trail of neglect and death. The author is "New York Times" reporter Clifford Levy, and he joins us live from New York this morning. Good morning, Clifford, thanks for joining us.
CLIFFORD LEVY, NEW YORK TIMES: Good morning.
WHITFIELD: Well today, the "New York Times" had the first part of your three-part edition. It is a culmination of a yearlong study in which you found some pretty enlightening and very shocking discoveries about the New York state mental health system, isn't that right?
LEVY: That's right. We looked at a system of care in New York called the adult home system. It shelters roughly 15,000 mentally ill people, pretty chronically sick people in New York State. We looked most closely at roughly 26 of the largest and most troubled adult homes in New York City. Those homes shelter roughly 5,000 people.
What we focused mostly on was death of residents of these homes. We felt that death would probably be the best indicator of what sort of care the residents of the homes were getting.
WHITFIELD: So why, what provoked this?
LEVY: We had not really known very much about the system. In fact, a lot of us were very surprised to learn of it. We kind of stumbled across it last year. I think many people in New York City are aware that the state closed a lot of its psychiatric wards a few decades ago because they noticed the increase in mentally ill homeless people on the streets of New York City.
What most people didn't realize was that there was a whole class of mentally ill people that ended up in adult homes. They were discharged from psychiatric wards, and they were pushed into this new system of care.
So we decided to look more closely at it. It was the first time we had ever looked really closely at it, and in fact, the system has really escaped the scrutiny of a lot of its institutions, whether it's journalists or government or even advocacy groups. WHITFIELD: So what seems to have been the root of the problem? So many state run facilities get a bad wrap because there are accusations that there aren't enough skilled workers. They don't have the resources. There are significant budgetary cutbacks. What did you find may be the root cause in this case?
LEVY: What we found is that the state has basically put all these people in homes that are not mental health facilities that are not run by people with mental health training or staffed by people with mental health training.
As a result, the state has essentially created a whole network of de facto psychiatric hospitals but, in fact, they're not hospitals at all. They're just residential facilities.
Some of these places have 200 or 300 beds. They're larger than many of the remaining psychiatric hospitals in the United States, and as a result you have people who have enormous needs, who are being looked after by people with no skills to take care of the mentally ill.
WHITFIELD: So you said you look at 26 homes in the New York area, New York City area, correct?
LEVY: That's right. That's right.
WHITFIELD: And about 200 interviews and 5,000 pages of state inspections later, how did the facilities in new York city compare to those of others across the country, or in other, you know, comparable metropolitan areas?
LEVY: Well, we focus mostly on New York City, but in fact there are facilities like this all over the country. When the deinstitutionalization movement swept across the United States in the 1960s and '70s and '80s, states across the country started shutting down psychiatric wards and trying to find other places for the mentally ill.
So what you have in New York City are called adult homes. In other states, they're called board and care facilities. And what little research has been done on these facilities has shown, in fact, there are many problems with them.
In 1989, a congressional committee did somewhat of a look on them and essentially called them a national tragedy, where again, as we had in New York City, you have facilities that are not really capable of caring for the mentally ill being essentially entrusted with the lives of chronically needy people.
WHITFIELD: So, Clifford, won't some mental ill hospital advocates argue that the intent was to go out and underscore the inadequacies of the system there, and that their contention is there are an awful lot of good things that happened because there are so many families that feel relieved, knowing that there are facilities that can offer help to their loved ones that they really are not equipped to do? LEVY: Well, I don't think anyone would argue that the psych, the old psychiatric hospitals were great places. In fact, they were also places where people were, mentally ill people were, the term of art is often used, warehoused. In New York State, the old psychiatric hospitals had tens of thousands of people.
The issue is really that when the states shut down a psychiatric ward, they really took very little time planning out what it was going to do with the mentally ill. And while at the time they state said, we're doing this because we believe we can get more -- we can provide more humane care for the mentally ill in neighborhood settings, in fact the greatest motivation for deinstitutionalization was financial.
New York and other states realized that if they could shut their psychiatric hospitals, they could actually shift the financial burden for caring for these people to Washington. The people that we looked at in the survey of these homes in New York City, most of their care, while it's regulated by the state, most of their care is paid for through federal programs, like Medicare and Medicaid, and SSI.
As a result, the state ended up shifting a whole, a great financial burden off from its budget.
In the 1950s, mental health programs consumed about a third of New York State's budget. Right now, they consume maybe two or three percent.
WHITFIELD: OK. Clifford Levy, the three-part series is called Broken Homes. It begins in today's "New York Times," runs through Tuesday. Thanks so much for joining us from New York on that.
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