Thread: NJ-Undocumented trapped in state mental hospitals

Undocumented trapped in state mental hospitals


Wednesday, June 17, 2009
Last updated: Wednesday June 17, 2009, 9:14 AM
BY ELIZABETH LLORENTE


Undocumented immigrants are trapped in state psychiatric hospitals even after they are found ready to be released to less restrictive, residential settings, says the state's public advocate.


The immigrants, say officials, cannot be released to community facilities, such as group homes, because the federal funds and programs that cover services in those places are off-limits to those in the United States illegally.

What's more, some immigrants who end up in psychiatric limbo actually were in the country legally at one point. But because of their medical condition, they failed to keep up with renewal and expiration dates and lost their legal status, a report done earlier this year by the advocate found.

"These people who remain hospitalized may become acutely ill again," said the report's author, Ann Portas, who is deputy director of the Division of Mental Health Advocacy in the Public Advocate's Department. The deterioration, Portas said, happens fairly frequently. "People lose the skills they need to be a part of the community," she explained. "They lose touch with people they knew. They lose skills like taking transportation, doing laundry."

It is unclear exactly how many undocumented immigrants are in the state's four psychiatric hospitals, which are Greystone, Ancora, Trenton and Hagedorn.

The state Department of Human Services (DHS), which oversees the hospitals, says there are 29, of whom 14 are ready for a less restrictive setting; Greystone, in Morris County, has 12, including five ready to leave.

The Public Advocate's Department, however, said it found 61 "known undocumented immigrants" during its visits to the hospitals in the latter part of 2008, and that 55 of those patients were ready to be discharged. Greystone, the advocate said, had 26 undocumented patients who were ready to go.

Officials in neither agency could explain the discrepancy.

The undocumented are not the only ones stuck in hospitals after they're ready to leave. Because of a shortage of community-based housing for mental health patients, roughly half of the 2,000 people in state hospitals, though they qualify to leave, are on waiting lists. However, there are no waiting lists for the undocumented.

"The patients who are no longer committable are playing a waiting game," Portas explained. "But the undocumented immigrants aren't on any waiting list, they can't say, 'I know I'll leave when a slot opens.' "

Portas said she found one undocumented patient who remained hospitalized seven years after he'd been classified as ready for discharge. She found another who had sent away for a green card application in 1999, but the application was ignored when it arrived at the hospital. It wasn't until 2008 that a new social worker dealt with the matter, submitting a new application, which was still pending at the immigration office late last year.

Portas, as well as other mental health experts, said that keeping undocumented immigrants institutionalized beyond what is necessary is inhumane and expensive for taxpayers.

Portas said that it costs about $130,000 per year to keep a patient in a state hospital. So it cost $7 million, she noted, to keep 55 undocumented patients hospitalized who were deemed ready for discharge.

Community-based, 24-hour residential mental health care costs roughly half that, or about $65,000 per person a year, according to Henry Acosta, deputy director of the non-profit New Jersey Mental Health Institute, in Mercerville.

Officials of neither DHS nor the Public Advocate's Department could provide details on the cost of community mental health care programs.

DHS officials said they share the concerns raised by the public advocate's staff and added that the problem is "highly complex," given the legal and mental health issues.

In a statement in response to Portas' report, DHS Commissioner Jennifer Velez said that care for undocumented immigrants "is an ongoing issue at every acute-care hospital, for psychiatric or non-psychiatric patients."

The advocate says it is mindful that, particularly now, there are many needs competing for few dollars. But it says that the state's psychiatric hospitals must do more, for example, to make sure that legal immigrant patients remain legal and that a state as diverse as New Jersey needs staff who speak foreign languages and understand immigration issues.

Greystone, for example, has one staff member almost exclusively devoted to working with immigrants. Derwin Miranda, who speaks English and Spanish, does everything from trying to determine if someone has — or ever had — legal status, to working with foreign consulates to obtain information when a patient cannot provide it.

"I take them to the immigration office in Newark to talk to an official to see what year they came in, where they're from," Miranda said, adding that sometimes patients cannot provide, or recall, such basic information. "A handful don't have family members here. Every case is different."

For patients who have no hope of becoming legal, the advocate says, the state Department of Human Services should make a more concentrated effort to help them return to their countries, as long as they are willing.

DHS does not have a written policy that would make hospital staff aware of repatriation as an option and provide guidance on how to pursue it.

"Assisting them with being repatriated to their country of origin," said the advocate's report, "is far more humane than allowing them to remain hospitalized unnecessarily."

DHS spokeswoman Ellen Lovejoy said the agency "is examining the recommendation."

The problem has little public awareness, said Acosta, of the Mental Health Institute, who's a nationally recognized expert on immigrant mental health. Acosta, who serves on Governor Corzine's Council on Mental Health Stigma, said he had heard rumblings about the issue in past years and only in the last week learned that a state agency had studied the problem.

"There's really been nobody advocating for these people," Acosta said.

E-mail: llorente@northjersey.com




http://www.northjersey.com/news/immigra ... c=y&page=2

For patients who have no hope of becoming legal, the advocate says, the state Department of Human Services should make a more concentrated effort to help them return to their countries, as long as they are willing.

If they are willing? That should not even be a question.