Senator Christine Cohen and advocate Denise Paley Legislating Mental Health Care

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one story at a time. Hi, I'm Tony Mintur. 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.
Well, good to see you again.
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.
Well, 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.
Yeah, well, I mean this is something I've always cared
about a great deal about and 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 that 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, yes, she's been on this podcast and told
the complete story of how it happened.
You know, things progressed and Ellis was in the Department
of Correction system within the state of Connecticut. It was
evident that mental health care was lacking due to resources
and or their issues, and so we really wanted to
set out to see if we could improve upon that.
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?
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 negotiating 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 staff 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.
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 ten years later,
you realize, while we compromised on something that we probably
just should not have done.
Yeah, I mean I think it's a balance, right.
I mean, some of these bills and policy changes 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 fifty 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 compromises 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 eighty percent 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 a 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.
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 That's correct.
We are not in session right now, but as you
can see, I'm working and are is thinking about what
we can do moving forward. Your work changes when you're
not in session, but you're still working, always working.
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 here that don't. So my question is how do
you cross that bridge.
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 is in receiving
it with the same passion or compassion that's necessary, or
the person providing the information feels that it deserves And similarly,
you know, 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, 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, especially telling them to dial it back, because
a lot of people do not understand the legislative process.
Yeah, and Denise does understand it very well, but not
everybody does.
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.
That's right.
Yeah, 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.
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's taking 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 SAT build, when
I went and testified in front of the Legislature, it
happened to be at a time when we were moving
through COVID, so most people testifying did not go in
for a lot of people had stayed home and done
it over video. I did go in person, which allowed
me and it afforded me the opportunity to get a
lot of the legislators in the room one on one,
and you 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 spill 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 and makes 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 worse 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 A Amendment and by not offering mental
health services that people need. And then from a financial standpoint,
from a socioeconomic stand way, people are not being prepared
for a re entry while they're living in incarceration.
I think that's an important subject you just brought up.
Can you expand on that for our listeners.
Most people who are incrucerated, about ninety seven percent are
going to be released into the community. We risk them
coming right back into the DC, and it's just kind
of like a self fulfilling prophecy. We're not moving forward,
or people come out and there prepared to be employed
or find homes, or you know, we matriculate back into
society because their needs have never been met while they
really in incarceration. Incarceration is designed 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 re enter society.
And if those preparations aren't in place, you know, we're
doing everybody to service. Running the Department of Corrections is
very expensive. We may as well get our money as work.
This is how we choose as a socility to treat people.
Can you expand on other issues that you think need
to be addressed within that correctional system?
Staffing Staffing is a you just show in the Department
of Cruestions, hiring, getting corrections officers to stay in 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 and
mental health care. Everybody's role would go a little bit
more slowly. It would be safe for her people living
in incorucetration, but also safer for the correction's officers who
are not always trained to me, people who are not
thinking clearly or having them as a health episode. You know,
it's a skilled don't 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
risks there.
Yeah, absolutely, I can certainly understand that. What's the AOT
law look like in Connecticut?
Later have one?
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?
So there are two caveats to this, So one is
an asignosia. An asignosia is the 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 an a signosia to help them
understand that they are sick. So it's my belief that anybody,
especially in our depermentive corrections working mental health, should have
that training because we could probably avoid 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 and get hurt
and worse as that escalation kind of gets out of control.
So there were in situations and as permitive corrections. Christina,
I actually and not talk to about this. I am
personally in fanut of AOT. I think we could reduce
our ways of homelessness. I think it has to be
strategicalty and carefully executed so that we can be sure
that somebody who truly has 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
ato service by not allowing them. We're never allowing them
that opportunity. MY son can be an example of that.
So he had a SIGNOSI when he was first incarcerated,
and he went for three and a half years unmedicated.
If somebody had the training in an asignosia, I think
he would have breached in medication much more quickly. His
dad and I actually did the training for leap therapy
and did it with him when we would go and
visit and on the phone. Doing that an environment through
visits that's as stressful as the primitive corrections. It took
us three years to get him to gree to take medication.
Once he finally did, it was the wrong medication. So
you won that risk with alt What if somebody's given
something that's toxic. So it's not as simple. It's not
just they're gray areas.
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 ten 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.
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 a
fact of 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 recidivism, 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,
I think crisis invention 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
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.
Yeah, I agree. You mentioned that prisons are the biggest institutions.
I heard from some source that LA Prison was the
largest one.
Yeah.
I think LA, Cooks County and rikers As were the
three largest mental health facilities in the country.
We hear different numbers all the time.
Like I said, we got one report that said in
Connecticut they estimate eighty percent of those who are incarcerated
require mental health care. And there's some numbers that are,
you know, around fifty percent. I've seen sixty percent, So
the numbers are all over the place. But I really
do believe that it's probably more like eighty percent.
And if we could, 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, forty two percent of people that are housed
there are unsentenced. And in the youth facility, which is
from fourteen to twenty one, sixty six percent of people
are unsentenced.
So if we know a lot of these people living
in incarceration have mental health issues while they are incentenced,
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.
We know that mental health were sentenced 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.
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.
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 or 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 raiming 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 their 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
they're opportunity more opportunities for me, And that's why I
think a legislator really needs to care about the ISDU.
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 buildings.
I recently spoke with a lady on serious mental illness.
She said, I don't get the cast role. 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 serious illness. The first thing that you
do is bring somebody a cast role, 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 cast role. I thought of you because
you did get the cast role. 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 the
senators and legislators to help make change for the whole state.
It's interesting you asked that question, Tony, because I just
had this conversation with Jim 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 were willing to speak up, you know, make more noise.
You know it's Guildford, you know it's Madison Brand, but
you know it's our closed towns. How do we get
more people in more communities to speak up. That's tricky.
I think it's so vital. So it just had a
meeting about this the other day. We were meeting with
a social justice group at a synagogue in 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, and we need more people to say, hey,
this is not okay. The services and are mag 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 NOMY 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, and 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.
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. There's still
in between medications, they haven't found the right one. There
can be so many different reasons why they're there. So
how do we tackle that situation so that we can
get more empathy towards what they're going through.
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. People are
ill and they're being villainized, being seminalized, but it's really
an 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.
So in closing, what do you think is the most
important one thing that our listeners here from the both
of you, that you're trying to do to make things better?
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 healthcare or mental illness, and really thinking about more
humane and effective ways we approach this across the spectrum,
whether it be in hospitals, 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 in advocacy work to help us pass
important policies around this.
I think people should reconsider when people have a gut
feeling or a gut saw it 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.
Yeah, because one thing that's never answered is the email
or letter that is never sent.
That's right. Yeah.
Well this has been great, great information, great conversation. I
really appreciate you taking the time to join us today.
How are you?
Thank you?
I yeah, thank you, Tony. I really appreciate you raising
awareness around us.
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
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