NANCY CHIERO WAS as devoted as she was patient with her son Lee. The 35-year-old Uxbridge man had spent his life struggling with psychotic delusions, which would periodically send him to the emergency room for a prescription for medications. Those brought a brief respite, but Lee, who lived in his mother’s basement, would soon cycle off the meds and the visions would return. In 2007, caught in the grips of paranoia, he pushed her down the stairs and fatally stabbed her in the eyes — capturing the murder on videotape.
The story of the Uxbridge mother and son is emblematic of the state’s failed policies for treating those with serious mental illness. In a powerful series called “The Desperate and the Dead,” the Globe’s Spotlight team chronicled decades of tepid response, persistent underfunding, and governmental neglect that has thrown mentally ill patients into the streets and left families, police, and ER doctors with an enormous burden of care.
Since 2005, the series reported, more than 10 percent of all state homicides in which a suspect is known were allegedly committed by people with a history of mental illness or its clear symptoms. The Globe built a first-ever database of such cases; the numbers show that over the past 11 years at least 139 people in Massachusetts have died violently at the hands of a person with a diagnosed mental illness, or strong signs of one.
The arc of mental health care was supposed to be different, especially in the Bay State, where Frederick Wiseman’s shocking 1967 documentary, “Titicut Follies,” exposed humiliations inflicted on patients at Bridgewater State Hospital for the criminally insane and prompted pledges for change. State officials moved to shut down mental hospitals, with the aim of placing patients in more humane community clinics. The number of inpatient psychiatric beds in the state declined to 671 as of last year, from a peak of 23,560 in 1953, according to Spotlight.
But that robust system of community care never materialized. State officials slashed funding for inpatient mental health care by more than half from 1994 to 2013, at the same time that some treatment was being farmed out to private companies and nonprofits. But nearly a third of community mental health providers in Massachusetts reported closing clinics from 2013 to 2015, including the sort of intensive programs that could have benefited Nancy Chiero and her son.
Closing the gaps left by the legacy of deinstitutionalization is, front and center, an essential job of government. Cities like San Antonio provide a model, with aggressive funding of a system to handle psychiatric and substance abuse crises and move people from jails and ERs into treatment, Spotlight reports. There are other signs of progress in Massachusetts: In 2015, the state received nearly $1 million in federal seed money intended to establish pilot community clinics. And Governor Charlie Baker’s administration has put $41 million into MassHealth reimbursement rates — as private insurers seem to be fleeing in droves.
Finally, change is needed in state law in order to protect families, friends, and the public from mentally ill patients who pose a danger to others. Massachusetts, with its strong support for civil liberties, is one of only four states without a law that allows courts to compel patients with a history of noncompliance to undergo treatment. Such “assisted outpatient treatment” laws have led to better health outcomes in other states: patients are escorted to settings where they receive required medications. And while psychiatric medications can cause unwanted side effects — and research sometimes seems stuck in another era — they can also be effective in quelling symptoms.
It’s important to note that the vast number of those with mental illness are not violent, and feel stigmatized by any broad-brush approach. But legislators could couple the law with more funding for community clinics, as well as education and training. It could ultimately help patients like Lee Chiero and those who love them.
The personal stories of workers featured in the above video paint a clear picture of what’s at stake in House Bill 59 — Governor Deval Patrick’s proposed changes to retiree healthcare. Simply put, HB59 goes to far.
Under House Bill 59, workers just two or three years from retirement could see the rules changed so drastically they would have to work another 22 years to receive promised benefits. The legislation has its biggest impact on low-wage workers, and offers no real cost-saving measures other than spiking out-of-pocket expenses for seniors – meaning future retirees will bear 100% of the cost burden of these reforms. Even worse, HB59 penalizes workers who must take a leave of absence for the birth of a child or death of a loved one.
That’s why hundreds of workers across the commonwealth are taking action to educate their legislators about the negative impact of House Bill 59 — testifying at public hearings, sending letters to Representatives and Senators, and meeting face-to-face with key legislative leaders. You can take action today to protect retiree healthcare.
State contract negotiations are already in full swing, and Local 509 members are more prepared than ever for the potential fight ahead. Dozens of leaders prepped at Bargaining Team caucus meetings, and more than 1,700 members responded to our contract survey –- sharing their ideas, concerns and priorities for the upcoming negotiation sessions. This trove of information will serve as the foundation for many of the proposals we put forward in the coming weeks, and we are fired up and ready to go!
The first Alliance Contract negotiation session took place on July 31, and Local 509 members put their solidarity on full display. Thousands of state workers rocked their ‘Fair Contract NOW’ stickers to send management a clear message: let’s get this thing done! (Check out the Local 509 Facebook Page to see a few of the many photos members sent in throughout the day.)
With so much at stake in this contract — from wages to benefits to working conditions — it’s incredibly important that as many workers as possible get engaged in the negotiation process. A quick and easy way to get involved is to sign up for the Contract Action Team (CAT) for your chapter/worksite. As a CAT member, you’ll communicate important negotiation updates to co-workers at your worksite and help mobilize members for key contract actions as the process moves forward.
Workers have set a goal of building a 750-member CAT team in the coming weeks, so there’s no shortage of opportunities to make a difference. Together we can win a strong contract for all state workers!
Today, state workers voted overwhelmingly to ratify their contract!
3252 – YES
212 – NO
8 – blank
237 – YES
4 – NO
Thanks to all of the poll captains and volunteers who staffed the 26 balloting sites across the state. Your hard work was instrumental in making today’s vote a smooth process.
To see the details of the newly ratified settlement, click here to read the Memorandum of Understanding