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Who cares for the disabled


Panel hears how poor health services compound problems

 HUDSON–Persons with mental illness, intellectual/developmental disabilities or chemical dependency, as compared with the general public, have poorer physical health, face greater problems accessing medical care and, when they do need care, are less likely to receive help that meets their special needs.

A dozen consumers, family members and professionals who testified at a public forum on physical health care held by the Columbia County Community Service Board and the Department of Human Services Thursday, September 17, addressed one aspect or another of the “health disparities” faced by persons with these three disabilities.

Dr. Nancy Hoag, CSB chairperson, told the approximately 25 people in attendance that the forum was intended to give consumers, their family members and service providers an opportunity to voice their concerns about the challenges encountered in receiving health care.

Michael Gelfand, quality assurance director at the Mental Health Association of Columbia-Greene Counties, noted that of the more than 600 consumers for which his agency collected data in 2008, one-third had a diagnosable health problem such as diabetes, hypertension, asthma, obesity, emphysema and heart disease. He referenced national studies that found that on average, people with serious emotional disturbances die 25 years younger than the general population.

Gary Spellman, a suicide prevention consultant, testified that these studies also found that 87% of the years of life lost to premature death were due to medical conditions as opposed to suicide. Contributing to this statistic are the long-term health effects of psychotropic medications.

In regard to accessing healthcare, several persons who testified noted that very few physicians and even fewer dentists in the county accept Medicaid, the insurance often carried by these consumers. Getting doctors to take medical complaints seriously is yet another problem, according to Laurie Fuller. Her doctor chalked up her complaints of nausea and vomiting to her “being a hypochondriac.” Even as the symptoms persisted, “the doctor was telling me that it was anxiety, or all in my head or that I was drinking too much diet soda.”

It turned out to be cancerous growths in her stomach.

The nine-month gap from Ms. Fuller’s surfacing her medical complaint to the emergency hospitalization where the extent of her condition was found may have contributed, she believes, to the cancer spreading to more of her stomach and to her gallbladder. She happily noted that she is now cancer free.

Ms. Marguerite Richmond, the parent of two adult sons facing serious mental illness, expressed frustration with the laws that affect communication between parents and their caregivers. Seeking to have one of her sons tested for a medical condition common in her family, she was unable to find out whether the test was performed or even arranged, because her son had yet to sign the needed consent.

“We need to increase the skill of caregivers to work with family members,” she said. 

Treating persons with intellectual/developmental disabilities, who often have significant medical conditions associated with their disability, requires more “time and patience” than doctors are able to provide, according to Dr. Silver, medical director of the Special Needs Program. He advocated that physicians receive special training as part of their continuing medical education.

A thorny problem in regard to persons facing chemical dependency is the prescription of narcotics to treat medical conditions, according to Beth Schuster, executive director of Twin County Recovery Services.  Estimating that 30% of the persons served by her program are dependent on prescribed medications, she advocated for “alternative to prescribed narcotics for this population.”

The Community Services Board-Department of Human Services panel will present its findings and recommendations at a follow-up public meeting Friday, October 23, from 2 to 4 p.m. at Columbia-Greene Community College. Federal, state and county legislators will be invited. Dr. Michael O’Leary, Columbia County director of Community Services expects this forum to be well very well attended. He cited a “confluence of issues” that have come together to galvanize providers, consumers and family members to seek ways to better address the physical health needs of the three disability groups. Primary among these is the national debate on healthcare reform, said Dr. O’Leary. 

One such recommendation for change was offered at Thursday’s forum by James Haskin, a consumer and mental health worker for the Center for Advocacy, Voice and Empowerment. In suggesting the development of medications that have less adverse effect on health and lifespan, Mr. Haskin noted his need to choose between “living two-thirds of the average lifespan or being psychotic six out of every 24 months.”  

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