I urge all who honestly want to be informed about this issue to read the following from 1992. The article focuses on "warehousing" and the subsequent devastating effects on Ocean Grove and Asbury Park when the state stopped funding institutions in favor of "mainstreaming" their patients, which meant towns like ours where many unethical opportunists made big bucks at the expense of the poor and the residents. The article is an in-depth account of that awful episode during which AP suffered severely while the "white bread" towns prospered. Sorry if weird wingdings appear below but you can access the article here _Shore Towns Dread Release of Mentally Ill - New York Times_ (http://query.nytimes.com/gst/fullpage.html?res=9E0CE7DF113BF931A25754C0A964958260&sec=health&spo n=&pagewanted=print) or email me privately or tell me how to post some other way without the wingdings. New York Times, July 12, 1992 Shore Towns Dread Release of Mentally Ill By JON NORDHEIMER, Amid complaints that their towns have become warehouses for the mentally ill, residents of several communities along the Jersey Shore are worried about the possible arrival of hundreds of men and women previously considered unprepared for life outside of institutions. The plan is causing much anxiety in places like Ocean Grove, which has seen many of its aging bed-and-breakfast hotels and boarding houses converted into homes for thousands of mentally ill people who were removed from state hospitals during the last two decades. Such residents now make up 10 percent of the city's population. 'Mainstreaming' and the Reality "The state talks about 'mainstreaming' the mentally ill but the reality is these poor people are being put away and forgotten in 19th-century boarding houses used as the poorhouses of the 21st century," said Jennifer Boyd, a documentary film maker who is president of the Ocean Grove Homeowners Association. She is one of many who hope that the state will successfully relocate 450 patients scheduled for discharge next year and not dump them in Monmouth and Ocean County beachfront towns. Boarding houses along the northern Jersey Shore became convenient places to house the mentally ill removed from institutions beginning in the 1970's. The structures, used only in summer, had lost economic viability as vacation patterns changed. And the buildings were already zoned for high-density use, so protracted fights to place state-licensed beds in more dispersed settings could be avoided. Besides that, the communities did not have the political muscle or economic vitality to fight back. The year-round residents of these beach towns say the state says it has no control over where a mental patient chooses to settle after discharge. But they argue that in the past, that was all but decided by a little-known state agency that has been dispensing millions of dollars in grants since 1981 to operators who can turn tidy profits by converting old boarding houses into state-licensed homes for the disabled or aged. After a series of fires in the late 1970's killed residents of boarding houses in Asbury Park and Bradley Beach, the state began to underwrite operators who needed money to qualify for licensing. Gary Anastasia, director of the Housing and Mortgage Finance Agency set up to handle the financing, said the state has made 147 loan commitments valued at $24.5 million, the "great majority" to boarding house operators in Monmouth, Ocean and Essex Counties. The program, Ms. Boyd of the Ocean Grove Homeowners Association said, has hurt prospering communities like hers, a historic mile-square beachfront resort that has 5,000 year-round residents. Since the mid-1980's, 470 former mental patients have moved into town. Asbury Park, a financially troubled city of 18,000 directly north, has 700 licensed beds and is probably home to many more people who occupy unlicensed beds, local officials say. Ocean Grove, listed on the National Register of Historic Places, still has the look of a Victorian seaside resort and continues to draw tourists and beachgoers, just as it first attracted Methodists for summer camp meetings in the 1860's. Turreted roofs, cornices and railed porches on two or three levels stand shoulder to shoulder for blocks inland from the ocean, a virtual wood museum. Fears for Local Economy The local homeowners association, which was organized in the 1970's to fight for historic preservation, charges that the state is undermining the community's growing tourist economy and its irreplaceable architectural heritage by subsidizing operators who convert buildings into threadbare shelters for the mentally ill, discouraging individuals who are interested in restorations for personal use or investment. Two such residents are Polly and Alan Hewson, former New Yorkers who say they fell in love with Ocean Grove at first sight in 1989 and bought a gingerbread-trimmed cottage for $140,000 a block from the beach. "What we didn't realize because of the summer crowds was that there were two boarding houses on our street whose only clients were mental patients," said Mr. Hewson, a 39-year-old computer arts designer. "People wouldn't mind one or two such places in Ocean Grove, but the people who own the buildings have discovered a real opportunity in Federal funds to fill their rooms year-round," said Mrs. Hewson, an actress. "They're turning this community into a mental ward." Now that the state will purge an additional 450 patients and shut down one of the state's four adult psychiatric hospitals by 1997, people in shore towns like Ocean Grove dread that they will have to shoulder the brunt of the policy. Alan G. Kaufman, director of the state division of Mental Health and Hospitals, said the alarm is misplaced. While conceding that shore communities were hit hard in the past when patients were released from state mental hospitals, he said the new round of releases was designed to avoid past mistakes by more carefully distributing the patients to their hometowns around the state and more closely managing their lives once they leave the hospitals. "This time we are going to do it right," Mr. Kaufman said. "Each one of the 450 patients who will be discharged by the end of 1993 will have a case manager and a built-in plan for community-based care and a residential program." Critics of the new plan scoff at claims that New Jersey, during a time of deep budget cuts, will come up with the money to sustain long-term suitable treatment and housing for discharged patients in the communities where they eventually settle. "What the state has done is warehouse the mentally ill in boarding houses and place the burden on the local community to service them," said Jerena B. Rezvan, director of the special services bureau of Asbury Park. "Saving money is the bottom line in this and anyone who says it isn't is full of beans." Emptying asylums sounds good, she said, but New Jersey's investment in community-based mental health services to assist discharged patients was the lowest among the Northeastern states for years. In 1990, the average per-capita expenditure in the Northeast for such care was $19.27 a year. In New Jersey it was $9.66. It costs the state $70,000 to $80,000 a year to care for a patient at one of the four adult psychiatric hospitals now equipped to treat 2,400 patients, all of whom are involuntarily committed after exhibiting some danger to themselves or others. When a patient is discharged, the financial burden passes to the Federal government, which pays most of the $5,500 to $6,874 annually in Supplemental Security Income or other disability payments that a chronically ill person living alone in New Jersey is eligible to receive. Reducing the Population In 1975, when the population of New Jersey was 7.3 million, 9,100 mentally ill people lived in state and county institutions. The four state adult psychiatric hospitals now have a daily population of 3,400. The goal is to bring that number to 1,800 by 1997. The population would be housed in three hospitals, each with 600 beds. Since 65 percent of the patients are discharged within two months, it is expected that the caseload would be manageable, supplemented by new local centers to handle acute short-term cases. To eliminate one of the present four state psychiatric hospitals, the state will close Marlboro in Monmouth County or Greystone Park in Morris County within five years. There is speculation that the state has already earmarked Marlboro for closing because Greystone is the only state adult psychiatric hospital in northern New Jersey, where most of the state population resides. The two other hospitals are in Trenton and south of Camden. Few of those scheduled for release can count on families to care for them, because relationships have been severed by time or the ravages of illness, hospital social workers say. Nearly all are poor. At the old Carlton Hotel, now the Carlton Residential Health Care Center, a weather-stained seven-story structure on the boulevard facing the beach in Asbury Park, the warehousing is palpable. "We try not to take young people because they tend to make trouble," said Dorothy Lutz, the owner, as she surveyed a second-floor lounge filled with men and women, most older than 50, seated on misshapen pieces of furniture arranged in rows before a steadily droning television set. Food smells clotted the air. Here was Louie, "who has no mind of his own," Mrs. Lutz said, introducing a man who grinned wildly at her description. And blank-eyed Carmine, whose brain was lacerated in an auto accident, and Rich, who has a nasty habit of digging through the garbage. By the window was Jacob, a problem case because he was always out on the street cadging money for drinks and smokes. "Jacob needs to be in a place where they lock the doors and he can't get out," Mrs. Lutz said wearily. "But there is no place like that any more." Plenty of Red Cards In the old lobby, behind a time-worn desk, was a battered metal cabinet taller than a man. Inside were shelves of plastic trays containing medication for each of the 163 residents. The trays of residents who have been forced to return to Marlboro for stabilization are marked by red cards. There are plenty of red cards. The state plans to spend $13 million in reimbursed Medicaid payments from the Federal Government to create community-based services operated by local nonprofit agencies to handle the release of the 450 patients next year. But it comes too late for the residents of the Carlton and the thousands of others in similar accommodations around the state. In future years, the costs of maintaining the community services are expected to come from savings brought about by decline in the permanent hospital population and the consolidation of staffs and programs. Yet late last month, in the search for ways to balance the state budget, the Legislature cut $5 million from the mental health appropriation, citing the savings expected from the discharge of the 550, a move that stunned mental health advocates already guarded about promises that fully financed community-based care will become a reality.
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