St. Dymphna, Patron Saint Of The Mentally Ill

Aspect of Need Addressed: Spiritual


Searching the Internet this evening to learn about other supports for families afflicted by mental illness, I discovered something that I as a Catholic should have sought out sooner. I found out about the patroness saint of the mentally ill, St. Dymphna of Gheel.

Born in Ireland in the 700s, Dymphna was the daughter of an pagan Irish chief named Damon and his Christian wife, who died when Dymphna was an adolescent girl. Overwhelming in his grief, Damon searched the world to find another woman as beautiful as Dymphna's departed mother. But he could find no other like her.

His mind now addled, Damon turned his sights to his own daughter, who resembled her mother in all her beauty. Immeasurably distressed by her now mentally ill father's incestuous entreaties, Dymphna confessed the matter to her priest, St. Gerebernus, and then with him fled Ireland for Belgium, settling in Gheel. Through spies, her father discovered her whereabouts and eventually found her and her confessor in Gheel. Damon beheaded the priest and then once more demanded that Dymphna surrender to him. She again refused, upon which her enraged father killed her.

The site in Gheel where she died is today known for miraculous healings of the mentally ill. In the 1300s, Gheel became the site of a gentle form of deinstitutionalized psychiatric care, whereby mentally ill individuals would be placed in home care with host families. It is also known for a well-known sanitarium for the mentally ill which apparently still stands today.

Lost... And How To Find: Two Good Products

Aspect of Need Addressed: Functional

If you are a reader of my tandem blog, PsychOdyssey, you'll remember the harrowing night when my schizophrenic son relapsed with substances, got behind the wheel on a cold winter's night, and then... got lost! (See "Lost... And Almost Not Found".) Although he was way high and drunk, and presumably nearing psychosis, thank God he had sense enough to call me on his cell phone ("Dad, I've relapsed, and I don't know where I am!").

He didn't know where he was, and we had to find him. But he only had 15 minutes of battery time left on his cell phone. We didn't have the GPS function active on his cell phone. And the police couldn't track him on their radio waves without a judge's consent, which would have taken three hours. In the end, I had to phone-coach my son, even though inebriated, to drive (carefully!) back to a place where we could pinpoint his location of a map. Thank God he was able to do that (without getting arrested), and thank God we were able to rescue him safe and unharmed.

But I resolved from that point that we must always know two things: where my son is and where his car is. I set out to find technology to do this.

Cell Phone Locator

Verizon Wireless, with which my family has a family plan, has a feature that can allow the account holder to track the location of any of the cell phones associated with it. The feature is called Family Locator, offered at $9.99 per month. Family Locator requires a recent-issue cell phone that has capacity to send and receive GPS signals. Since my son's phone was an older model, I had to replace it with a new phone. I procured the most basic phone, which didn't cost me anything except the requirement to extend my phone plan another two years. Family Locator works fine. Through Verizon Wireless's website, I can press a locator button, and after a few seconds a map appears with the exact location of the cell phone. This is a beautiful thing for reducing my worry about being able to find my son in case something has gone wrong.

But it is not a complete answer...

Car Locator

What is the phone runs out of juice? Or if the loved one forgets to take it? Or, most likely, if he or she turns it off? Then the Family Locator is of no use.

There is another solution, one that comes with a clever name: ZoomBak. Owned the Liberty Media (which is led by the well-known media mogul, John Malone), ZoomBak is a personal GPS locator service. ZoomBak makes a small device (as pictured above) which a kid can carry in his school bag, a dog owner can attach to his dog's collar... or a worried father of a relapse-prone loved one with schizophrenia can install in his car.

The ZoomBak service all-in is a little expensive. The device itself costs $149. The car installation kit costs another $49.99. And the monthly service runs $19.99 per month (or, "just" $0.60 a day!...), with a discount for signing up for a longer contract. As with Verizon's Family Locator service, a ZoomBak user can dial up through the ZoomBak website exactly where the device is. When installed in a car, the device is continually powered by the car battery, so will never run out of juice.

But I've decided this is worth the money. I may not be able to prevent my son from relapsing, but now I am assured that I can find him wherever he is, before his relapse might get him into more serious trouble.

Wrestling With The Long Arm Of The Law

Aspect of Need Addressed: Legal

Families with mentally ill loved ones are no strangers to the legal system. Whether through abuse of substances or acting out in the midst of relapses or just accidentally, too often our mentally ill loved ones run afoul of the law. This can be one of the most harrowing experiences a family can experience.

The National Alliance on Mental Illness, New Jersey State chapter, has published a helpful pamphlet to help families navigate the legal system after, and before, problems occur.

See it here.

Housing... Another Waiting List Update Demand

Aspect of Need Addressed: Residential

Housing. Specifically, affordable housing. More specifically, subsidized housing, at a rental rate that a mentally ill loved one on SSI and SSD (receiving about $700 per month) might be able to afford. It's one of the toughest nuts to crack for a disabled loved one who may wish to live independently.

After my son became disabled, I searched the State of New Jersey to find whatever of this scarce resource I could find. I did not find much.

One of the sectors of housing I searched was the Public Housing Authorities. There are about 35 of them in the State of New Jersey. These PHAs originate from legislation during The New Deal under Franklin Roosevelt. They supervise publicly financed government housing that can offer residences to qualified applications at rents totalling 30% of an applicant's income, whatever that is. Theoretically this is attractive to those on SSI and SSD. If one is receiving only $700 per month, then one's monthly rent, at 30% of income, would be $210. That would be an incredible deal in New Jersey, where a market rate studio apartment might run $800 or $900 per month.

But! Local PHAs give preferences to their own local citizens. The available slots are rare, rare, rare. All one can do is apply to get on innumerable wait lists, keep a watch on them, and be ready to respond immediately when notices come your way. Most of such notices are merely waiting list updates. Failure to respond to these may result in being dropped altogether.

Trenton Housing Authority's Notice

Now that my son on innumerable waiting lists, one of the agencies has just sent a letter: The Trenton Housing Authority. This communication can give a sense of the challenge housing poses.

[Note: As you read this, keep in mind how, or whether, a mentally disabled citizen would manage this process... Ed.]

Letter from THA

Dear [ ],

We are presently conducting interviews for applicants on our waiting list. This is a preliminary interview to update your information only; it DOES NOT MEAN that you are going to be housed at this time.

Please contact the Admissions and Occupancy Department at [ ] to make an appointment with [ ]. If you do not respond within five [5] days from receipt of this letter, we will assume that you are no longer interested and your name will be removed from the waiting list.

At your scheduled appointment, please bring in the following documents (if you have not already supplied us with this information):

1. Social Security Cards and Birth Certificates for yourself and each person listed on your application.


2. Verification of any and all income such as Employment, TANF, Child Support, SSI/SSD, VA Benefits, Unemployment and any other form of income that is received which may not be listed.


3. For Employment, your employer must mail or fax all wage information. It should state your rate per hour and the hours you work per week and /or your annual salary.


4. If homeless, a third-party verification from a public or private facility that provides shelter for homeless individuals, the local police department, or a social service agency, certifying the family's homeless status.


5. If substandard, provide a third-party verification from a government agency or present landlord indicating substandard conditions existing at home (such as no lights, no running water, etc.). If required, you must provide entrance to your home by one of the Admissions and Occupancy staff to investigate the substandard conditions.

Sincerely,

[ ]

Manager, Admissions and Occupancy

THA History

[Note: To put this letter into context, here's a little history on the THA, lifted from its website... Ed.]

The Trenton Housing Authority began like other public housing agencies in the United States, with the federal government's creation and funding of nationwide public housing. The Housing Act of 1937, however, drastically changed the federal government’s role in public housing by placing ownership and production under local control. This important change allowed Trenton to create its own housing authority on December 18, 1938 by City Ordinance, in accordance with New Jersey enabling legislation.

Today, the Trenton Housing Authority is an autonomous body that is charted by the State of New Jersey, partially funded by the federal government, and governed by a seven member Board of Commissioners. Five of the Commissioners are selected by the City Council, one is chosen by the Mayor and one is chosen by the Government. The Organization is like a hybrid with each entity having a stake in the authority.

The very first public housing complex in Trenton—Lincoln Homes—was built in 1941. The second development—Donnelly Homes—was built the following year. Both sites were constructed to accommodate the housing needs of immigrants from southern states, most of which were African Americans coming to the city to take advantage of job opportunities in the industrial sector.

The original housing complexes were predominately three-story walk-up and town house configurations. In 1945, near the end of World War II, Prospect Village was built offering more housing opportunities to families in need. In 1952, three additional developments were created—Kearney Homes, Campbell Homes and Wilson Homes.

Over the past 30 years, the THA has served nearly 2,000 households. Several new housing sites have been added to meet the growing needs of families in Trenton. The biggest challenge facing the Authority is the increased demands for housing with limited resources and support. Even with this challenge though, the THA is committed to providing the best possible service to our clients. Nothing is more important.

THA and HUD Eligibility Requirements

[Note: And here are the requirements, also from the website... Ed.]

An applicant must be 18 years of age or older to be designated the head of the household and qualify for public housing assistance. THA defines heads of household as an adult member of the family that has agreed to be wholly or partly responsible for paying the rent and has the legal capacity to enter into a Lease under state and local law. Emancipated minors that have court orders and qualify under state law can also be recognized as heads of household and are eligible to apply for housing.

At least one member of the household must be a US citizen or eligible non-citizen.
The applicant must have an annual income that does not exceed the low-income limits established by HUD. These income limits are posted in all THA offices and below:

The income limits for families with more than eight persons are determined by adding to the eight-person income eight percent of the four-person base. (Example: The nine-person limit equals 140 percent 132 of the relevant four-person income limit). All income limits are rounded to the nearest $50 to reduce administrative burden.

The applicant must provide a Social Security number for all family members, age six or older, that will be living in the housing—or they must provide written certification that they do have Social Security numbers. The applicant must meet or exceed THA’s "Selection and Suitability Criteria" including attendance and successful completion of the THA’s pre-occupancy class. Applicants with any outstanding debts to the THA (or any other public housing authority) from previous tenancy in a public housing program must be paid in FULL prior to admission. Applicants must pay any previous debts before they are eligible to apply for new housing—No Payment Agreement Will Be Accepted.

Tax Time... Even For The Disabled

Aspects of Need Addressed: Financial

The last thing I thought my son would need to do is file a tax return. He is on SSI and SSD, on Medicare and Medicaid, all due to his disability. He held a part time job for a few months which earned in total about $4100. As is so for most psychiatrically impaired loved ones on disability, my son's economic station compared to the rest of the country is on the lowest rung of the economic ladder. But, it turns out, there is a benefit to filing a tax return even for, indeed especially for, those like him.

Money Back From EIC: Who Knew?

The major benefit is the Earned Income Credit. This is a tax provision which provides cash refunds to certain low and middle income filers even if they don't actually pay any tax. The minimum age to file for an EIC is 25; the maximum is 65. The maximum earned income limit varies depending on marital status and number of children. SSI and SSD are not counted as earned income. Full details about EIC appear in a special IRS Publication, No. 596, "Earned Income Credit." (Of course it is... 68 pages long! How does the IRS expect the mentally disabled to navigate such a long document, and that just for one aspect of the tax code!)

There are 7 basic rules for EIC:

1. A filer's Adjusted Gross Income must be below a certain level.

2. A filer must have a Social Security Number.

3. A filer must not file "Married, Filing Separately". (A filer can be single.)

4. A filer must have been a US citizen or Resident Alien for at least a year.

5. A filer cannot file a Form 2555 (for Foreign Earned Income).

6. A filer's unearned investment income cannot be more than $3100.

7. A filer must have at least some earned income.

There are other rules for those filers who have "qualified children". Since my son is single, this does not apply to him.

There are other rules for those filers without children, like my son. These are:

8. A filer must be between the ages of 25 and 65.

9. A filer cannot be claimed as a dependent by another filer. (This can create an issue for parents of mentally ill loved ones who still live at home, but cannot be claimed as dependents.)

The EIC accrues immediately upon the receipt of even only $1 of earned income, which would create an EIC of $2. The EIC rises to a maximum of $457 for earned income between $6000 and $7500, after which it reduces again to zero when earned income is $13,300. Thus the maximum possible EIC benefit accrues to the filer who has earned income of between $6000 and $7500--which is exactly the kind of filer most psychiatrically afflicted loved ones on disability earning part-time wages tend to be.

My son, being 24, cannot qualify this year. But had he qualified, his Federal EIC for the income he earned from his part-time work, being $4100, would have been $310. The maximum EIC that he could have received as a single filer would have resulted from earned income between $6000 and $7500. That EIC would have been $457 for 2009.

Then there is also State Earned Income Credits, which can increase the amounts of cash returned. Had he been of sufficient age this year, he would have received $80 of EIC from the State of New Jersey.

Unfortunately my son, at 24, just missed the cut-0ff age. But it was good for him to file anyway to get himself recognized in The System of the IRS, so that next year he will be able to establish more easily his bona fides.

Worth The Effort: Other Money Back

Even though he is not old enough for EIC, there are other benefits to him filing his return. As it happens, his disability enables him to claim back moneys deducted at the State level. While the refund of $10 is not so much, it establishes something to which in his disabled status he is entitled. And he was pleased to be able to take advantage of such refunds.

Free Help With Tax Prep

There is another benefit out there of which too many mentally ill loved ones may not know. The AARP (and others) offer volunteer tax filing help. It was a delightful experience. At the Princeton Library today an AARP tax filing volunteer (Mr. Chris Eggert, formerly a banker at Citibank in New York before retirement), worked with my son to file his return. Within 30 minutes all the questions had been asked and answered, and with my son's permission Mr. Eggert pushed the button on his computer to "e-file" my son's return. Done! Now my son has a tax file with his first filed return, which will set him up nicely for next year when, hopefully, he will be back to work, earn a reasonable amount of extra money (without overly burdening his SSI requirements), for which then he might be eligible to receive back, say, about $450 of additional support. With SSI and SSD currently maxed at $695 per month, a "refund" of $450 would be no small matter.

Double Trouble: A Good Presentation On Co-Occuring Disorders

Aspects of Need Addressed: Medical, Psychiatric

Many of our loved ones who struggle with mental illness also suffer from a co-occuring substance abuse disorder. This can be "double trouble". It has been for my son. But now he's been clean for about a month now. He's making progress.

I am always interested in seeing new information on this terribly vexing problem. Here's a good presentation by Hazeldon and WestBridge Community Services. I am particularly fond of WestBridge, which my son attended for a while. It does a very good job in treating dual diagnosis cases.

Here's the presentation, a slide show. (Be patient. It's a big file and will take a little while to load.)

SHIP 3: Got The Appointment... For 7 Days From Now

Aspect of Need Addressed: Medical, Financial

Still working on my son's Medicare Part D prescription drug insurance...

Background: My son's previous insurer, Fox Insurance, was kicked out of the Part D program by CMS, the Medicare administrators. So he has to find a new plan. Before he can determine which is the best option, he must determine how any of the prospective plans interface with NJ Medicaid, under which he is also covered. My research determined that there is a State Health Insurance Counseling Program, called SHIP, funded by Medicare, that can help him with that. Earlier this week I had spoken to the SHIP Coordinator for Mercer County, who was to help me get an appointment with a SHIP Counselor.

Today I spoke with The counselor she had in mind for my son isn't available. So we've scheduled for my son to visit with another counselor, on March 31.

I'm looking forward to the appointment. I am observing, however, (and not yet judging) how long it is taking to get from the decision to get help with the Medicare-Medicaid interface to the time it actually will be offered. From the time we began seeking a change in his plan to time we discovered through research of SHIP's existence: 2 days. From the time we were offered an appointment with a counselor until the time one was available to see us: 7 days. This is itself perhaps is not so extraordinary, especially when working with agencies in which the workers are certified volunteers. There must be a relative scarcity of such qualified counselors. Hence the time it takes to get an appointment. Kind of like a doctor... I am keeping track of this initiative and all my son's other various initiatives on a master to-do list, managing from it every day like a regular job. One has to keep on top of such things.

But can a mentally ill loved one with a thought disorder manage this process on his own? The complexities of Medicare and Medicaid? Finding out that there is a SHIP and what it does? Finding the right person to call? Learning the process of getting an appointment with a counselor. Getting that appointment seven days later? There's a lot to keep track of. Can this system be made more simple or direct? How will this be after ObamaCare is implemented to include 30 million more people on the Medicare/Medicaid roles? I don' t think our waiting times for appointments will be reduced...