← Tony Mantor: Why Not Me ?
Tony Mantor: Why Not Me ?
Senator Christine Cohen and advocate Denise Paley Legislating Mental Health Care
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- [00:00]
A
Foreign. Welcome to why Not Me Embracing Autism and Mental Health Worldwide, hosted by Tony Mantour, broadcasting from the heart of Music City, usa, Nashville, Tennessee. Join us as our guests share their raw, powerful stories. Some will spark laughter, others will move you to tears. These real life journeys inspire, connect, and remind you that you're never alone. We're igniting a global movement to empower everyone to make a lasting difference by fostering deep awareness, unwavering acceptance, and profound understanding of autism and mental health. Tune in, be inspired, and join us in transforming the world one story at a time. Hi, I'm Tony Mantour. Welcome to why Not Me Embracing Autism and Mental Health Worldwide. This is our special event, Crafting Justice, Empowering Autism and Mental Health through Legislation. Joining us today is Senator Christine Cohen, who champions mental health in Connecticut through bipartisan laws, expanding crisis services and care access. Denise Paley also joins us who collaborates with Senator Cohen to advocate for mental health law reforms in Connecticut. They have a wealth of information to give us because of their passion for what they do. Thanks for coming on.
- [01:38]
B
Well, good to see you again.
- [01:39]
C
Yeah, absolutely. Thanks for doing this and raising awareness on all things mental health. I had a chance to look through your podcasts and listen a bit, so thank you for what you're doing.
- [01:50]
A
Oh, it's my pleasure. Thanks. My first question is, as a senator, what led you to get into the journey of helping the mental health community?
- [02:00]
C
Yeah, well, I mean, this is something I've always cared about a great deal about in my mother is a psychiatric social worker, so I grew up talking about mental health and knowing the importance of mental health care for folks, including myself. I've had my own struggle with mental health in terms of panic disorder and depression. And so I've been very open about that now that I've become a legislator and working on state policy. I've known Denise for a number of years. Actually, Ellis worked on my first campaign when he was in high school. And unfortunately, when tragedy struck, I was able to work with Denise on some matters where we saw some gaps in the system at that time, which was particular to crisis intervention training. Also, we share a mutual friend who produced an incredible documentary on crisis intervention training. And so that's what started us down this road. And as you know, Denise will share her story, I'm sure.
- [03:01]
A
Yes, she's been on this podcast and told the complete story of how it happened.
- [03:06]
C
You know, things progressed and was in the Department of Corrections system within the state of Connecticut. It was evident that mental health care was lacking due to resources and other issues. And so we really wanted to set out to see if we could improve upon that.
- [03:23]
A
So you're in the Senate now. With that said, you have passed a bill, then you have to deal with the House. Now, I was speaking with a representative from Iowa. They passed a bill unanimously. Then it went to the Senate and it got killed. Now, with that said, have you ever had any situations like that that you've had to deal with as well?
- [03:45]
C
Absolutely. I mean, this is something that I'm all too familiar with. It's, you know, a lot of times we set out at the beginning of session with high hopes that we'll be able to get a full proposal passed and over the finish line. And as we go through session, it becomes, you know, a time for negotia and seeing what we can, in fact, get over that proverbial finish line. Oftentimes, you know, we'll have to make some significant compromises or we don't have any luck. And we say, okay, we're going to come at this again. I think we've made incredible strides particular to crisis intervention training over the years that we've been working on it. I think we've also made some strides with respect to mental health in prisons and getting more folks staffed there. But we have a long way to go, and that's become quite evident. And so, you know, we set out for some policy this past session to improve upon that, and we didn't quite get everything we wanted over the finish line. While there is some funding pertaining to mental health care in our prison system, there's not nearly enough.
- [04:54]
A
I'm so glad you brought up that word compromise. I was speaking with a legislator, he brought a bill, and the first thing they said to him, you know, you're going to have to compromise. And they hadn't even read the bill yet. So how do you get around that kind of thought process? Compromise is understandable. Sometimes it can be a very big thing, unfortunately. Sometimes you wind up giving up some things that you shouldn't have. And then when you start looking at things five, 10 years later, you realize, wow, we compromised on something that we probably just should not have done.
- [05:30]
C
Yeah, I mean, I think it's a balance, right? I mean, some of these bills and policy changes were require, you know, a lot of money, quite frankly. And so you're also working as another added layer of complication because you're working on a state budget. Everybody thinks their cause is the cause that should be funded. And so you're fighting that battle as well. So saying, you know, we need X million dollars in order to employ 50 more mental health professionals across our prison system. And somebody else is saying, well, you know, we need these important social services for DSS or we need more addiction services. All of these things are really important. And I'm using examples that are closely interrelated because you can see, like we should all be working together and we all want these things which are so important when it comes to mental health and addiction services. But oftentimes it comes down to sharpening the pencil and really figuring out what we can actually provide. And that requires saying, okay, well, a little bit going to go to this, this year, and a little bit is going to go to that. And so those are some big comprom that we need to make policy wise. I think there's policies that don't involve funding. Those tend to be typically a little bit easier because there's not that added layer of complication, as I mentioned. However, depending on what the policy is, something that seems like a no brainer to you and I may be very difficult for somebody else to wrap their heads around. And particularly when you're talking about mental care in prison, there's still a lot of misunderstanding just around mental health in general. We know there's still a tremendous stigma associated with mental health. And when you add in incarcerated individuals, there's still a lack of compassion and lack of understanding, quite frankly, that these are human beings that really should receive the level of care that every human being deserves. And there's also tremendous amount of benefits to making sure that this population is getting the mental health care. There's an estimate in Connecticut that 80% of inmates need some type of mental health care. And we are far from providing that and we want to do what we can. There's tremendous benefits, including reducing recidivism and safety for our corrections officers. Safety for other inmates, of course. And this is something that is really has become very important to me. I know it's important to Denise as well.
- [07:58]
A
Yes, I think you're absolutely correct there. Now, are you like other states I've spoken with where your job is like a full time, part time?
- [08:06]
C
That's correct. We are not in session right now, but as you can see, I'm working and always thinking about what we can do moving forward. Your work changes when you're not in session, but you're still working. Always working.
- [08:18]
A
Yeah, I totally get that. Now as a senator, you have to work with people like Denise that will come to you and say, hey, we need these changes. Now, this question is actually a Good question for the both of you. How do you find it as a senator working with people like Denise that come to you and say, hey, look, we need some changes in our state. And then let's flip this around and put it in a perspective from Denise on working with a senator trying to get those changes. The good thing is that this particular senator has the knowledge of it. There's a lot of senators and legislators out there that don't. So my question is, how do you cross that bridge?
- [08:55]
C
I'll start out, and then I'll pass it to Denise. I'll say, in our situation, I think, is unique because Denise and I are friends, and so I can speak very frankly with her. These are oftentimes very emotional issues and can be difficult. So, like I said, everybody has their cause and they want to take up their cause, and they want people to hear them and understand them and understand the importance of what it is they're trying to get done. And so it can be really difficult if perhaps the person receiving that information isn't receiving it with the same passion or compassion that's necessary, or the person providing the information feels that. That it deserves. And similarly, you know, are we. Are they feeling like they're being heard and that they're going to see movement? And then once they are being heard and seeing movement, it can be very frustrating, as you've just alluded to. You know, lots of changes, lots of movement throughout the session and twists and turns. It's sort of like a roller coaster. And sometimes you have to strategize and tell the individual who's advocating that you need to dial it back strategically in order to move something forward. And that's a difficult discussion to have,
- [10:11]
A
especially telling them to dial it back, because a lot of people do not understand the legislative process.
- [10:17]
C
Yeah. And Denise does understand it very well, but not everybody does.
- [10:21]
A
Right. The average person out there that just happens to find themselves thrust into a situation that they weren't even prepared for, they are just living their days, actually living the normal, average American life. They don't follow legislation that closely other than what they hear on TV or on the news. So they do not understand the process and how involved that it can get to.
- [10:48]
C
That's right. Yeah.
- [10:50]
A
Okay, Denise, now, what's it like from your perspective? How is it to work with these senators and try and get the laws changed to help?
- [11:02]
B
So. Well, there's a lot to say here. First of all, I am very lucky to have Christine as my senator. So I just want to point out that neither Judiciary Public health. These committees that she's been advocating with to push these laws forward are the committees that she is technically assigned to. In addition to all of the work that she does, she has taken all of this on and has really just been a voice for marginalized groups of people to get laws pushed through. So I don't know that that would happen if my senator or somebody else. I'm so grateful for that, her willingness to listen and to talk it through. One of the things I've noticed is I can use the CAT bill as an example. So when we were working on the CAT bill, when I went and testified in front of the legislature, it happened to be at a time when, when we were moving through Covid. So most people testifying did not go in person. A lot of people had stayed home and done it over video. I did go in person, which allowed me. It afforded me the opportunity to get a lot of the legislators in the room one on one and really listen to their side and their perspective. The idea of making crisis intervention team training a lot and mandatory was something that was really not endorsed before bringing this bill forward and having the opportunity to talk to people about the consequences down the road without that, you know, on the side, helping them understand and just, you know, and listening to where they were coming from, making the whole equation make sense. You know, when you talk about DSS and mental health and homelessness and unemployment, there is a thread that runs through all of it. So a lot of these laws take money to enforce them. But if you were to do the math at the cost to society, they are well worth it. There is a cost to not treating mental illness for those who are living in incarceration from a human level of allowing people to suffer. And the state of Connecticut has actually been called out multiple times for allowing people to suffer for violating the 8th amendment and by not offering mental health services that people need. And then from a financial standpoint, from a socioeconomic standpoint, people are not being prepared for reentry while they're living in incarceration.
- [13:30]
A
I think that's an important subject you just brought up. Can you expand on that for our listeners?
- [13:35]
B
Most people who are incarcerated, about 97% are going to be released into the community. We risk them coming right back into the doc and it's just kind of like a self fulfilling prophecy. We're not moving forward or people come out and they're unprepared to be employed or find homes or you know, re matriculate back into society because their needs have never been met while they were living in incarceration. Incarceration is designed to. For rehabilitation. Now, because there are. So there's such a strong need for mental health services. It requires a sense of recovery for people to come back and be productive when they reenter society. And if those preparations aren't in place, you know, we're doing everybody a disservice. Running the Department of Corrections is very expensive. We may as well get our money's worth. This is how we choose. This is how we treat people.
- [14:27]
A
Can you expand on other issues that you think need to be addressed within that correctional system?
- [14:33]
B
Staffing. Staffing is a huge issue in the Department of Corrections. Hiring, getting corrections officers to stay and work and getting qualified mental health providers to stay and do the work, because they often feel like they're always pushing against the tide. You know, they're always going upstream. So to get anything accomplished, if we could invest a little bit more into these services and get more quality mental health care, everybody's role would go a little bit more smoothly. It would be safer for people living in incarceration, but also safer for the corrections officers who are not always trained to meet people who are not thinking clearly or having a mental health episode. You know, it's a skill to know how to deal with somebody like that, and the training doesn't provide for that. There's a lot of turnover and there's, you know, there's. There's risk there.
- [15:21]
A
Yeah, absolutely. I can certainly understand that. What's the AOT law look like in Connecticut?
- [15:27]
B
We don't have one.
- [15:29]
A
Okay. Is that something that the two of you are trying to work on? Because it seems like every single state that I speak with has an AOT or an MOT or nothing. From what I see on the ones that are addressing it, they've got different terms for it. And it seems like no one is really happy with the way that they are addressing it. So how do we get that across? How do we cross that bridge? It seems like everyone wants change, yet the ones that want change are unwilling to go against a person's rights. Yet the person that needs the help, if they don't have something happen, they could become dangerous, either to themselves or other people. So how do we change this?
- [16:17]
B
So there are two caveats to this. So one is anosognosia. Anosognosia is that biological condition that people have that often is what's standing in the way of somebody agreeing to take medication because they do not recognize that they are ill. There's therapy that can be used to support somebody with anosognosia to help them understand that they are sick. So it's my belief that anybody, especially in our Department of Corrections working in mental health should have that training because we could probably avoid, you know, the Department of Corrections runs into these situations where people refuse their medication once they've already been medicated, but then they stop taking it. And situations can escalate and people can get hurt and worse as that escalation kind of gets out of control. So there have been situations in this primitive corrections. Kristen and I actually have not talked about this. I am personally a fan of aot. I think we could reduce our weights of homelessness. I think it has to be strategically and carefully executed so that we can be sure that somebody who truly has a human beings, the person's best interests at heart is involved in the decision. But there are illnesses where forcing medication could be the only way to help somebody see reality. I think we're doing people a disservice by not allowing them. We're never allowing them that opportunity. My son can be an example of that. So he had anosognosia when he was first incarcerated and he went for three and a half years unmedicated. If somebody had the training in anosognosia, I think he would have agreed to medication much more quickly. His dad and I actually did the training for LEEP therapy and did it with him when we would go and visit and on the phone. Doing that in an environment through visits that's as stressful as the primary corrections. It took us, you know, three years to get him to agree to take medication. Once he finally did, it was the wrong medication. So you won that race with alt. What if somebody's given something that's toxic? So it's not as simple. It's not just. There are gray areas.
- [18:27]
A
No doubt. There's always a gray area in anything you choose to look at. I spoke with one gentleman that had serious mental illness. It took him 10 years to get the right medication to get himself on the path for recovery. He was constantly going back and forth on medications until he found the right one that work. So, Christine, what are your thoughts on this subject?
- [18:52]
C
Yeah, I mean, it maybe should be part of the solution. I think there's more information that's needed. I think right now we're relying very heavily in the state of Connecticut on outside organizations to provide care that's needed when people are released from the prison system. As I mentioned, you know, our prisons have become these de facto mental health institutions. We are not providing the Care for those who are incarcerated. And so we really are falling short and denying effective mental health care in prison, which is obviously. Well, it should be ethically unacceptable. It's ethically unacceptable to me and really contrary to the therapeutic goals that are really underpinning treatment. So is AOT something that we should be incorporating to further prevent recidiv. Making sure that those who have been identified as cycling through, you know, the prison system or our hospital system are properly connected with care and properly connected with trained individuals who know the medications that need to be administered, the number of therapy appointments and individual needs, how intensive that therapy should be given, the diagnoses. And so I think it's something that should absolutely be part of the discussion. But we have a lot of work to do in Connecticut, a lot of work to do nationwide, really, on this issue. You know, I was talking about competing interests in terms of funding priorities. I mean, how do we prevent this from happening in the first place? Right. Crisis intervention training is one way, but how do we get mental health care, a proper mental health care into our school systems from an early age? That's something where we're lacking funding. Assigning one counselor to each school and then one school psychologist to a district. District is problematic. But that in a lot of cases, what the districts have across the state of Connecticut, we're just falling short all over the place. We need to be doing a better job at preventing folks with mental health illness from becoming incarcerated individuals. And then once they are incarcerated, what are the tools that we have to ensure that they are getting the proper treatment that's required?
- [21:20]
A
Yeah, I agree. You mentioned that prisons are the biggest institutions. I heard from some source that LA prison was the largest one.
- [21:29]
C
Yeah, yeah.
- [21:30]
B
I think la Cooks county and Rikers, those are the three largest mental health facilities in the country.
- [21:37]
C
We hear different numbers all the time. Like I said, we got one report that said in Connecticut, they estimate 80% of those who are incarcerated require mental health care. And there's some numbers that are, you know, around 50%. I've seen 60. So the numbers are all over the place. But I really do believe that it's probably more like 80%.
- [21:58]
B
And if we can. I mean, right now there are a lot of people in Connecticut who are held incarcerated, who are unsentenced. Ellis was at a mental, you know, what they consider a mental health prison in Connecticut. In that facility, 42% of the people that are housed there are unsentenced. And in the youth facility, which is from 14 to 21, 66% of the people are unsentenced. So if we know a lot of these people living in incarceration have mental health issues while they are unsentanced, perhaps there could be another avenue for them to be receiving more aggressive treatment until their cases are adjudicated. Time is brain. Your brain is on fire, and nobody's addressing it. And you're just waiting. What's the point of that?
- [22:45]
C
We know that mental health worsens behind bars. So regardless of whether getting proper treatment or not, so how can we ensure that we're doing as much as possible to maintain baseline at the very least?
- [22:59]
A
Unfortunately, as a society, we have this mindset of it's not a problem unless it affects our family. There's a lot of people out there that have no knowledge of serious mental illness, including our representatives. How can you get it across to them that if you can create legislation that will keep these people out of the judicial system and out of the prison system, it can save taxpayers millions and millions of dollars?
- [23:28]
C
Yeah, I mean, I don't need to convince everybody, but I do need to convince the right people. You know, as a public servant, I think that really requires some strategy. I think it requires some authenticity. Like, I need to authentically care about the issue. Whether I cared about it before somebody presented me with it, I didn't. I really need to have some level of passion about that because of everything we've talked about, how difficult it is to get things over the finish line, how you have competing interests. You know, Denise mentioned I'm on several other committees, but I'm not on these particular committees of cognizance. And so I think I need those components to effectively rally the right people. And I think it's really important that as we go through this process, that we're really framing whatever issue it is around shared values. And I think most people can understand mental illness, regardless of the fact that there still seems to be a stigma around it. And some people don't like to talk about it. I think most people have been impacted one way or another by mental illness. And to say they haven't, whether they know somebody or a friend, is just, I think, living under a rock, you know. So I think sharing those personal stories, and there's a lot of opportunity for that throughout the legislative process. It probably doesn't seem like it from a constituent standpoint. Right. When Denise has one shot to go in front of a committee and sort of lead her case, that feels like, you know, you're under pressure and who's actually listening. There are legislators coming in and out of the room, you could be waiting hours to testify. And then you just hope and pray that there's a couple of the right people that are really hearing you. So I think there are opportunities, more opportunities for me, and that's why I think a legislator really needs to care about the issue. So the best thing an advocate can do is to find somebody to care about and take up their cause, because they are the ones behind the scenes that are establishing those connections and getting the right people to care about what it is you're talking about and advocating for coalition building.
- [25:47]
A
I recently spoke with a lady on serious mental illness. She said, I don't get the casserole. That was the first time I'd heard that. After she explained it, the first person that came to my mind was you, Denise. She explained it like this. When you have someone that has cancer or a serious illness, the first thing that you do is bring somebody a casserole, a cake, a cookie, whatever you can to help them make it easier. But when you have someone that has serious mental illness, you don't get the casserole. I thought of you because you did get the casserole. Your neighbors were very supportive of you and did everything they could do to help you through this. Many do not get that. So how do you expand this to other communities so that they can do the same thing in getting to their senators and legislators to help make change for the whole state?
- [26:38]
B
It's interesting you ask that question, Tony, because I just had this conversation with Jen McShane, who Christine referenced two days ago. We were talking about just that. Two things. One is my family has been very blessed to have such strong support within our community, and that has really helped in terms of moving forward when we're being knocked down in other ways, because, you know, Ellis is still incarcerated, There's a lot of knockdowns. So it's been tremendously helpful. I think that is the key. So I have, I mean, mostly moms, you know, many women within my community who are willing to speak up, you know, make more noise. You know, it's Guilford, it's Matt, you know, it's Madison, Branford, you know, it's our close towns. How do we get more people in more communities to speak up? That's tricky. I think it's so vital. So I just had a meeting about this the other day. We were meeting with a social justice group at a synagogue the next town over and talking about just this one matter, because I think people who are living in incarceration or People who just have serious mental illness in general, wherever they are, become invisible, and they become marginalized, and there's so much stigma around it. We need more people to say, hey, this is not okay. The services are not okay. This matters. We're actually thinking about ways that we can reach out to other people we know and get them to make more noise through nami. I can reach out to other leaders within NAMI and other affiliates across the state, and that is something that I've done. Who care about social justice. Not every NAMI affiliate has a social justice component, but many do. But that's something that I've been doing, just reaching out to other people, asking them to try and gain more voice, you know, where they are. But it's a challenge, especially when we're talking about an incarcerated community, because so many people living in incarceration come from certain pockets of the state. The strategies we're talking about is getting people from other areas of the state to say, it matters to us as a society, as human beings. You know, we've got to change this.
- [28:44]
A
Yes. And not only that, we have those that are incarcerated. We also have the homeless that live on the streets. Lots of times they'll bounce back and forth between homeless shelters and the streets because they don't fit the criteria to stay. So many people think they just want to be there, and that's just not the case. They're still in between medications. They haven't found the right one. There can be so many different reasons why they're there there. So how do we tackle that situation so that we can get more empathy towards what they're going through?
- [29:15]
B
It's really tough. I mean, that you're kind of circling back to aot. I've had. I've had family members of people reach out to me. You know, I've been very vocal about Ellis, and people have reached out to me privately to tell me that their sister is living in a different state on the street, or their brother has been on the street, and their families have sort of given up, and they don't know what to do. We run into this situation with addiction as well. Like, people are ill and they're being villainized, being criminalized, but it's wearying illness. I find it very hard to believe that there is a human being who wants to live on the street. I don't think that's a thing. I think somebody is voicing that they want to be left alone. That's what they're doing. It's because they need help.
- [29:56]
A
So in closing, what do you think is the most important thing that our listeners hear from the both of you that you're trying to do to make things better?
- [30:08]
C
Yeah, I think that's right. I think we need to keep talking about this. You know, do everything we can to reduce stigma around mental illness, do everything we can to increase parity when it comes to health care for mental illness and really thinking about more humane and effective ways we approach this across the spectrum, whether it be in hospital, whether it be in prisons, whether it be in our school systems. And so really thinking about that. And also as I mentioned and as we've talked about, all three of us have talked about today, you know, really coalition building around that. So if this is something that you're interested in, please get involved and we can always use your help as legislators and advocacy work to help us pass important policies around this.
- [31:01]
B
I think people should reconsider when people have a gut feeling or a gut thought when they hear something that is mental health related, that they should try and think a little bit more deeply and think about the trade off we are making as a society by not adequately treating people with serious mental illness, what it says about us as a society and what we're doing, what the impact is downstream.
- [31:26]
A
Yeah. Because one thing that's never answered is the email or letter that is never sent.
- [31:31]
C
That's right. Yeah.
- [31:33]
A
Well, this has been great, great information, great conversation. I really appreciate you taking the time to join us today.
- [31:39]
C
How are you?
- [31:40]
B
Thank you. Hi.
- [31:41]
C
Yeah, thank you, Tony. Really appreciate you raising awareness around us.
- [31:44]
A
It's been my pleasure. Thanks again. Thanks for taking time out of your busy schedule to listen to our show today. We hope you enjoyed it as much as we enjoyed bringing it to you. If you know someone who has a story to share, tell them to contact us at WhyNotMe World. One last thing, spread the word about why not me. Our conversations are inspiring guests that show you are not alone in this world. World.