Chairwoman Malia, Chairwoman Flanagan, and honorable members of the committee, my name is Cathy A. Levin. I am coordinator of the National Empowerment Center’s project to create Peer Run Crisis Services in Massachusetts. I was also the chairwoman of the Emergency Room Rights Campaign at MPOWER. These organizations are led and staffed by current and former users of mental health services.

As a leader in the consumer/survivor movement I urge you to support House Bills 3585 and 3584 and House Bill 1945/Senate Bill 743: ER Rights bill, Peer Run Respite bill, and Five Fundamental Rights/Fresh Air bills, respectively. I will address each of these bills in turn.

House Bill 3585 responds to reports of consumers about terrible experiences being restrained for hours in ERs. The department of public health corroborated these reports in their investigations. The Boston Globe wrote about them. The reason we are here is not only the death and broken bones investigated by DPH, but the far more common emotional damage being restrained causes to someone whose psychiatric troubles stems from childhood sexual abuse. It is common to be restrained in an ER by four or five security guards in uniform. I speak for young women, especially, because I was restrained several times in ERs when I was younger, and the pain and anger are still with me.

When we peers asked for regulatory reforms in our meetings with hospitals and doctors hosted by DPH, they insisted regulations were unnecessary. They said restraints in ERs were rare occurrences. We know differently. I have interviewed dozens of my peers about their experiences in ERs. Restraint numbers are all over the map. This bill provides for collection of data on restraints in emergency rooms. It may prove the hospitals are right-that restraints are an aberration-and then DPH can go after just those hospitals. But the same hospitals that fought us on regulations to protect us from restraints are now fighting us on this data collection bill.

House Bill No. 3585 also requires continuation of the meetings with hospitals and doctors that was called the consensus group process. These meetings have has been incredibly helpful, but are being shut down now that the pressure is off, since the ER Rights bill did not pass last session. Without these meetings, they never would have sat down with us to hear our concerns. We need these meetings to continue.

Through my emergency department work, I became interested in alternatives to busy, overcrowded ERs, ill-suited and unwilling to provide psychiatric treatment and where psychiatric patients are unwanted and called "clutter." House Bill No. 3584 provides an opportunity to introduce this committee and the department of mental health to Peer Run Crisis Services. This is a cost effective way to help people in emotional crisis avoid emergency departments and hospitalization and stay connected to their communities.

Generally, the costs per night for Peer Run Crisis Services are between 45-80% less than a psychiatric facility. The director of a program in New York state recently reported a one-night stay in his program costs $170 compared to $1,600 for a psychiatric bed. I have provided the committee with a study that includes estimated costs of Peer Run Crisis Services. The study estimates costs of serving hundreds of consumers for five years, including start up costs in the first two years like staff training, at a little over $1.5 million. People stay in five individual bedrooms and have one-to-five day stays. In contrast, a psychiatric facility bed, in a shared bedroom, resulted often in longer stays, and costs $14.6 million over five years.

Finally, I urge you to support House and Senate Bills 1945/743. The Five Fundamental Rights/Fresh Air bills add enforcement powers to a good existing law protecting psychiatric patients’ basic rights. While the law is good, it is routinely violated in psychiatric hospitals and residential facilities. The bills also make fresh air and daily access to the outdoors a sixth fundamental right. Having your rights protected as a citizen of the Commonwealth of Massachusetts is good for your self-esteem. It is also good policy as people get well faster, have greater satisfaction with their treatment, and recover more fully when these basic standards are met.

Thank you for listening to my testimony.

Cathy A. Levin

Somerville, MA

September 23, 2009