With its maze of agencies, multiple office visits and voluminous paperwork, signing up for public assistance is a daunting obstacle course for many New Yorkers. But for those suffering from mental illness, it can be a nightmare. Soon, a legal clinic that helps the mentally ill access their benefits could vanish, one of roughly 26 non-traditional mental health programs due to be hacked this year.
For much of fiscal year 2005, the Department of Health and Mental Hygiene has avoided $3.15 million in program cuts by scraping residual funds from city coffers, but the stopgap money is dwindling. Within months, the city could lose a counseling center for mentally ill lesbian, gay, bisexual and transgender people; an arts program for the mentally ill and disabled; and support services for immigrants.
The cuts also endanger a legal clinic run by the Mental Health Project of the Urban Justice Center, a nonprofit advocacy group [where this reporter once interned]. The clinic offers pro bono representation and advice for the mentally ill, serving roughly 1,000 clients per year. It stands to lose $124,000—nearly its entire budget.
Jorge Petit, associate commissioner for the Department of Health and Mental Hygiene, said his department had no choice but to select victims from a range of programs not specially earmarked for protection by the state. “We spared those that provided direct clinical and rehabilitation services to clients,” he said, and everything else was fair game.
But at a recent City Council hearing on the mental health budget, MHP attorney Craig Acorn argued that programs like his are essential. Often, he testified, legal advocacy “is all that stands between [a client] and the revolving door of homelessness, poverty, incarceration and mental health crisis.”
One 53-year-old MHP client with cognitive and neurological disabilities said his botched application for temporary income assistance ensnared him in red tape, until MHP advocates helped him obtain the benefits he needed to cover rent and medicine. “I couldn’t get help from anywhere else,” he said.
Marie Palladino, 54, who suffers from an anxiety disorder, had a similar experience. Eviction threats from her landlord and conflicts with neighbors would have left her homeless, she said, were it not for MHP lawyers who represented her in court. “If it wasn’t for Urban Justice,” she said. “I’d probably be in Bellevue by now.”
Programs that do not qualify as conventional treatment are more vulnerable to cuts than other services, said Michael Friedman, director of the Metropolitan Center for Mental Health Policy Development and Advocacy. “These cuts…are a terrible loss to the service array,” he said. Non-traditional care is often excluded from the scope of federal Medicaid funding as well.
Impacted service providers and clients have petitioned the state for budget restorations, but the prospects for a last-minute reversal of the reductions are dim: Governor Pataki vetoed an earlier attempt to restore statewide mental health cuts.
Vaguely hopeful that allocations for 2006 could repair some of the damage wrought by this year’s budget, agencies that go beyond mainstream clinical services want Albany to recognize the importance of their work. Bill Lienhard, director of the MHP, notes that by cutting these programs, the state saves only a miniscule amount compared to the long-term costs of homelessness and institutionalization of the mentally ill. “It’s expensive for government,” he said. “And it’s destructive for the individual.”