Unworkable Guidelines

To the Editor: The New York State Commission on Quality of Care for the Mentally Disabled has issued guidelines that tell patients and family members how to complain about the quality of mental health care and treatment. Family members wishing to complain on behalf of their relatives perhaps could follow the complicated procedure, but I doubt that many patients could do so. Simply doing what we must for survival causes enough stress. As a patient, I know I am too disabled to comply.

I have been diagnosed with obsessive-compulsive disorder, social phobia, and social anxiety. Even though I take fluoxetine and clonazepam, which help me substantially, in certain situations I can reach intolerable levels of anxiety, and trying to follow the guidelines would be one of them.

After reading an article about the guidelines in Quality of Care, the commission's newsletter, I wrote to the author, Paul F. Stavis, the commission counsel. I told him that as a patient I would not be able to follow the guidelines and that I thought most other patients would not be able to either. He replied that the commission had discussed whether patients could follow the procedure and decided that they could.

What I found was that the commission didn't ask patients themselves. I believe a survey of patients' opinions would have resulted in a more workable set of guidelines that most patients would be able to use.

Mr. Francisco, an artist and writer, is a member of the Alliance for the Mentally Ill in New York City,