Despite threatening skies on a Sunday afternoon in late May, about 2,000 people gathered in New York City's Bryant Park for the fourth annual picnic given by National Picnic for Parity, a broad-based coalition of mental health providers, consumer groups, legislators and other advocates interested in achieving parity for mental illness.
There, the picnickers visited the more than 60 information booths set up around the park's perimeter, watched dance, magic and poetry-reading performances by mental health consumers, and listened to 10 speakers, including Neal L. Cohen, M.D., commissioner of the New York City Department of Mental Health, Mental Retardation and Alcoholism Services (DMH).
This was just one of nine such picnics that took place concurrently across the states of New York and Pennsylvania, said Molly Finnerty, M.D., a fellow in public psychiatry at Columbia University's College of Physicians and Surgeons and president and co-founder of National Picnic for Parity.
"We hope that by next year, there will be picnics like this all across the nation," Finnerty told Psychiatric Times. "To make that happen, the most important thing for us to do right now is reach out to other psychiatrists."
Finnerty, who is also a consultant on the American Psychiatric Association's Joint Commission of Public Affairs and an APA assembly delegate, said the picnic was originally the brainchild of the residents committee of APA's New York County district branch, of which she was a member while doing her residency at Columbia in 1995.
"At that time, [Gov. George] Pataki had just slashed the state's mental health budget and the mental health community was in a panic," she said. "We residents on the committee wanted to do something."
One of those committee members, Wilfred Noel Raby, M.D., told the group about a small picnic he had hosted for some patients in Toronto. He suggested that such a picnic be held in New York, with the goal of decreasing isolation and educating mental health patients and their families.
"When [Raby] brought this up to the committee, we said, 'This is no time for a picnic! Our house is burning down!'" recalled Finnerty, laughing. "But as we talked about it and mulled it over, we thought well, what if it's a picnic for parity? What if the whole point of it is not just to decrease isolation and educate about mental illness, but also to do some political advocacy and bring attention to what Pataki was doing?
"But then we thought that what we really wanted to do is work with [patients] to make this happen, to build a coalition of people coming together to work collaboratively on a project," she said. "We felt it was important for psychiatrists to work side-by-side with patients and families, away from that formal professional setting where people get these ingrained and sometimes adversarial positions. We envisioned an event that would do several things at one time: educate the public about mental illness, build a coalition of all facets of the mental health community, and at the same time bring attention to what was happening politically and get people involved."
From the beginning, the residents committee envisioned the picnic as an annual event that would grow and spread throughout the nation. "We knew that what was happening politically would change over time, and that different states might have different political issues," Finnerty said. "But since this whole society discriminates against people with mental illness, we knew there would always be some political issue to address, whether it be housing, voting, jobs or health care. We saw our efforts as a model that could be applied anywhere, even internationally.
"Actually, the World Health Organization is very interested now in building common cause between providers, patients and families, decreasing stigma, and advocating for better treatment for mental illnesses. The Picnic for Parity does that and is a model that could be applied around the world."
Finnerty, who was head of the organizing committee for the first picnic, said that building the coalition that first year was difficult.
"The entire mental health community was literally panicked," she said. "All of the community clinics and the advocacy groups were just completely busy and consumed with trying to fight these budget cuts. But even so, that first year we were able to get 40 different organizations signing on as participants, including local and state affiliates of national advocacy groups like the National Alliance for the Mentally Ill and the Mental Health Association, various local agencies, provider groups, people from the National Stigma Clearinghouse and many more."
Held in Central Park, the first picnic drew 300 people. Mental health consumer-run businesses provided the food, hats and other picnic products and services. Twenty mental health organizations set up booths to disseminate information packets on mental illnesses and the services they offered, and picnic attendees were given the opportunity to register to vote. Speakers included Luis Marcos, M.D., who was then commissioner of DMH, in addition to legislators, mental health providers and consumers.
"The structure of that first picnic was to have a wide distribution of speakers so that all voices...patients, their families, providers and legislators...could be heard," said Finnerty. "It was an incredible experience in which people really did hear each other, and some amazing things happened through that. For instance, we had some particularly bright and articulate consumers with schizophrenia whose talks so impressed Bill Tucker, director of New York State's Bureau of Psychiatric Services who came from Albany to attend the picnic, that he invited them to come speak at the annual research conference of the New York State Office of Mental Health. So professionals got a new vision of what it really means to be a person with this illness, and of what remarkable and rich lives are led by such people. And consumers and their families gained new understanding of physicians as people as well."
As time went on, the coalition grew to include more than 200 participating organizations, and various awards were developed for consumers, advocates, family members, public officials, providers, the media and others who have advanced parity for people with mental illness.
"We shifted from just hearing people sharing their stories and accomplishments to acknowledging them with formal awards for those stories and accomplishments," said Finnerty, noting that there were nine awards presented at this year's Manhattan picnic.
Those prizes included an outstanding legislator award which went to Assemblyman Steven Sanders for his 1997 New York State mental health parity legislation.
Finnerty said, "By bringing together elected officials, providers and consumers in this way, we can educate ourselves about what the current issues are and what's being argued right now in the Legislature. We can learn what we, as individual patients, families and providers, can do to impact the political process, and show legislators how to best represent us. The message is that we are one, that we are all citizens, and our voice needs to be heard."
Last year, the coalition developed a 15-page booklet called The Picnic for Parity: Creating a National Movement, and began distributing it as a free guide to help others start their own local picnics. This year, public service announcements were created by a consumer-run business and aired over New York City's television and radio stations, and the coalition itself incorporated as the National Picnic for Parity.
"This is our first year with multiple picnics," said Finnerty. "It's so wonderful to see this not only growing every year, but also spreading into other areas."
Finnerty said the meaning of parity has grown significantly since the Manhattan picnics started four years ago.
"At first it was directed primarily at advocating for national and state legislative action to require insurance companies to set the same annual and lifetime limits for mental illnesses as they do for physical illnesses," she explained. "But today, our coalition's definition of parity encompasses equality for mental health recipients in all aspects of mental health services and treatment along its entire continuum of care, including housing and employment."
A large part of today's parity message, added Finnerty, is about empowering people with mental illnesses as voters and active members of their communities.
"With that in mind, the New York City Mental Health Voter Empowerment Project is an important part of the picnics, and has registered more than 27,000 consumers to vote in New York City alone...most of them for the first time in their lives," Finnerty said.
Finnerty said the coalition receives funding from more than 17 sources, including several district branches of the APA, the New York State Psychiatric Association and the New York City DMH. In a report she prepared for the New York State Psychiatric Association, she listed next year's coalition goals as including expansion of the picnics into more areas, the creation of a Web page, increased voter registration at all picnics, increased media exposure and more psychiatric involvement, which Finnerty stressed is crucial.
"What's interesting is that psychiatrists really believe in and want parity, but many have never seen themselves as political advocates," she said, adding that the National Picnic for Parity board includes four psychiatrists and that "countless" others have participated in organizing and supporting picnic activities. "I think it's incredibly important that we psychiatrists across the nation join forces in sympathy with patients and families to support them in their efforts to advocate for parity, lending our resources and expertise to this work."
And the rewards for a psychiatrist who participates are great, she added.
"Yes, it takes an extraordinary amount of time but it's well worth it," she said. "You get the opportunity to work with some incredibly amazing people in the mental health community and really get to know them personally."
Finnerty, who specializes in schizophrenia, said her involvement in the coalition has also changed her understanding of the illnesses she treats.
"Throughout your training, you really only meet people who are in a crisis and you rarely see them in the context of their normal lives," she said.
"But when you get to know these people and talk to them about what they care about, when you learn about their love for the ballet or their hobby of doing magic or art or writing poetry, you begin to perceive them in a way you hadn't before. Even people who we consider extremely disabled have very rich personal lives."
For more information or to order the free guide on how to start a picnic, call Ken Steele, secretary of the New York City organizing committee, at (212)757-1350, or e-mail Finnerty at finnerty@picnicfor parity.com.