The PAIMI program is an outgrowth of the 1986 Federal Protection and Advocacy Act for Mentally Ill Individuals. The Act was the result of a nine month investigation of state operated mental health facilities. The investigative team found that individuals labeled mentally ill who resided in facilities were subject to abuse and neglect. Although advocacy existed, there was no authority behind advocates to investigate, monitor, or to administer disciplinary action for those who were found to be abusers of patients. There was also no federal money available for investigative or advocacy work.

The 1986 Act insured that the rights of individuals with mental illness are protected by establishing a Protection and Advocacy (P & A) system which has the right to investigate incidents of abuse and neglect and provide advocacy services.

The New York State Commission on Quality Care (CQC) receives federal funding to provide PAIMI services, and investigates incidents of abuse and neglect. CQC contracts with other agencies throughout New York State to provide legal and advocacy services. Neighborhood Legal Services, Inc. (NLS) is one of these agencies. NLS provides PAIMI services in fifteen counties of Western New York.

When someone requires PAIMI assistance, the consumer or sometimes a friend of the consumer places a call to NLS. All calls are screened through an intake paralegal who can sometimes answer questions to help a person resolve the problem on his or her own. If the help needed cannot be provided through a screening call, then the issue is taken to "case review." The disability unit talks to PAIMI advocates who decide who will handle the case. The unit is made up of attorneys and paralegals. A follow-up call will be made to the client and work will be started to resolve the issue.

Presently we are working on cases that deal with discrimination due to mental illness, fresh air and telephone access for patients in psychiatric institutions, and insurance denials to individuals due to a history of mental illness. We also assist students in their schools, people who disagree with treatment plans as an inpatient or outpatient, clients who are returning to work and want to preserve SSI/Medicaid eligibility, residents of adult homes who are unhappy with their living situations, individuals who want copies of their records from agencies, and others who have called NLS for brief assistance.

Many of the individuals who contact us need advocacy to obtain services from their mental health providers. For example, a client in a continuing day treatment program was basically denied one-on-one counseling. The client requested one-on-one counseling from the day treatment provider and was told group counseling was all that was available. Our client then attempted to access one-on one- counseling from another provider. He found a psychiatrist willing to provide treatment, but was told by the continuing day treatment program that he was not allowed to access therapy from two different providers, pursuant to applicable New York State Office of Mental Health (OMH) regulations. He then became at risk of losing the group therapy. With NLS’s assistance, we convinced the person in charge at the continuing day treatment program that it was possible to have dual providers. The continuing day treatment program allowed our client to obtain treatment from two different providers. This person now receives group and individual counseling.

In another case, a young man wanted to be weaned off medication. His treatment team did not recognize that he had the right to refuse medication. NLS took an active role in making known the client’s request to his treatment team and eventually he was allowed an opportunity to stop medication entirely.

A woman who resided in an adult care facility sought help from NLS when she was served an eviction notice from the facility. NLS was able to represent her in court and then investigate whether staff played a role in causing her to act out so that a basis for a second eviction could be established. Once rapport between NLS and the facility was established, the threat of eviction stopped. We continued to work with the client until another place of residence was found. This person is now happy in her new environment.

The laws allow and encourage consumers of mental health services to have an active role in their treatment and recovery process. The PAIMI unit offers assistance to carry out that responsibility. Please call Neighborhood Legal Services, Inc. at 716/ 847-0650 and ask for the PAIMI intake line if you need more information.