Families decry mental health system

In the more than 20 years since the state began emptying its psychiatric centers, the number of community-based programs for the mentally ill has increased dramatically, yet some say problems remain.

"If your loved one has a mental illness, it is very hard to get them into the system," says Jeffrey T. Keller, Albany, deputy director of the National Alliance on Mental Illness of New York State.

Maureen Klages, Waddington, says county officials failed to heed warnings that her stepson, Harry E. Klages II, 25, was a hazard to society when he mixed alcohol with the powerful psychiatric medicines he takes. He had twice pleaded guilty to attempted assault, once after a July 2005 hammer attack on a man in Potsdam and again after stabbing a man outside an Ogdensburg tavern in August 2006.

"I saw the potential that he could kill someone," Mrs. Klages said.

Massena village police say Mrs. Klages's fears nearly came true early Jan. 31 when Harry Klages stabbed and slashed Andrew W. Lesperance, 51, Massena, after a night of heavy drinking at Klages's 441 S. Main St. apartment. They charged Klages, who is being held without bail, with first-degree assault. He is expected to face additional charges, up to and including attempted murder, once the case has been presented to a grand jury.

Mr. Lesperance, who lost his right eye and genitals, had his stomach slashed and suffered stab wounds to the hip, leg and chest, remains hospitalized at Fletcher Allen Health Care, Burlington, Vt. He was reported to be in fair condition Friday.

Unaddressed mental health issues may have contributed to the Dec. 28, 2006, slaying of Renea L. Bodah, Gouverneur, by her estranged husband, Michael, according to William A. Bodah, his father.

Bodah's mother, Heather, requested counseling for her son from the St. Lawrence County Health Department, but couldn't get an appointment for three months, according to a letter to the community written by Bodah's father following his daughter-in-law's death.

Mrs. Bodah asked for assistance from the St. Lawrence Psychiatric Center but was told she couldn't demonstrate her son was suicidal, Mr. Bodah wrote.

Difficulty accessing mental health services is a statewide problem, according to Mr. Keller.

"You virtually have to be suicidal to get into a hospital emergency room. Or you have to be a danger to others," Mr. Keller said.

In St. Lawrence County, Claxton-Hepburn Medical Center, Ogdensburg, operates the only secure ward for the treatment of the acutely mentally ill, some of whom may be committed against their will.

"The standard for involuntary commitment is 'a danger to yourself or others' and they aren't keeping them very long," Mr. Keller said. "They could be back on the street in three days. If they are not stabilized, and psychiatric medicines often take more than three days to work, they are going to wind up back in the hospital or jail."

"The jails are the asylums of the millennium," said William J. Serafin, interim public health director for the county.

Mr. Serafin was deputy director of the Gowanda Psychiatric Center in Western New York when it was closed.

"Back in those days, it wasn't a struggle to get someone in. Now it is very hard to get someone into a psychiatric center," Mr. Serafin said. "I am not saying we should go back to loading up the psychiatric centers. But we went way beyond in the numbers who should be discharged."

The inpatient census at St. Lawrence Psychiatric Center, Ogdensburg, peaked in 1955 at 2,264. It has dropped ever since and now averages 65 adult inpatients a day, according to Jill Daniels, acting director of public affairs for the state Office of Mental Health. The center also houses 26 children, and has 24 adults in its sex offender treatment unit.

At the same time, the center, which serves St. Lawrence and five surrounding counties and has about 530 employees, provides outpatient treatment for approximately 1,271 adults at mental health clinics in Massena, Ogdensburg and Gouverneur and day treatment programs for 240 children and adolescents.

The psychiatric center also operates outpatient residential programs: Northwood Manor is a 24-bed community residence on the psychiatric center campus, and approximately 90 people receive residential services through the Family Care Program, a network of certified private homes in St. Lawrence, Jefferson and Clinton counties, Ms. Daniels said.

St. Lawrence County operates its own mental health clinic in Canton, bringing the total number of people of all ages receiving services to approximately 1,800, according to Ruth I. Ayen, director of community services.

St. Lawrence County is reviewing how it offers mental health and related services, County Administrator Karen M. St. Hilaire said.

"The state wants to cut back on its expenses and its responsibilities and push people back onto the county," Ms. St. Hilaire said. "We are asking, 'What do we have for them?'"