By Alice Waugh
In an August 2 interview with the Lincoln Squirrel, a senior medical executive at McLean Hospital refuted the notion that the occupants of a proposed residential facility on Bypass Road would be violent or pose a risk to neighbors, contrary to fears of neighbors who have spoken out against the plan in a controversy that has spilled onto the pages of the Boston Globe.
McLean is proposing a 12-bed facility in a former private home at 22 Bypass Rd. that will offer dialectical behavioral therapy as part of a psychoeducational program to young men aged 15-21, who will live there for periods of weeks to months.
In a July 8 letter, Building Inspector Daniel Walsh acknowledged that “the issue is murky,” noting that both sides cited the same court case to support their arguments. However, McLean’s proposed use has “multiple objectives which include residential along with therapeutic and educational functions,” he noted. Case law as well as federal and state anti-discrimination laws indicate that McLean’s proposal qualifies for the Dover Amendment zoning exemption for religious and educational uses of a residential property, he concluded.
Walsh’s opinion concurs with an earlier statement by Town Counsel Joel Bard. However, neighbors disagree and are expected to file an appeal with the Zoning Board of Appeals and perhaps a court challenge if necessary.
On July 26, the Planning Board closed the public hearing on the site plan review, which is looking only at parking, traffic and visual screening and cannot pass judgment on the use of the property. The board will vote at its September 13 meeting.
Also at issue is the allowable number of beds, which is limited by the capacity of the property’s septic system. At the moment it is rated for seven beds plus staff. To accommodate 12 live-in residents plus staff, McLean would have to apply to the town’s Board of Health and/or the state Department of Environmental Protection to enlarge the septic system.
Boston Globe face-off
The battle made its way into the Boston Globe last week in a feature called “The Argument” that presents both sides of a current controversy. Lincoln residents Jennifer Morris, who favors the Lincoln proposal, and Dr. Steven Kanner, an abutter and Lincoln Board of Health member who opposes it, made their cases for and against the facility in the July 29 article.
“I’m quite certain the program will serve an educational purpose. As a parent, I felt highly unqualified to teach a disturbed adolescent how to cope, how to interact, how to study and progress,” Morris said. For his part, Kanner argued that a diagnosis of borderline personality disorder or BPD, which many residents of the proposed facility will have, is “a medical treatment unit reimbursable by medical insurance,” and that what McLean wants to offer is “patently a medical program and no more uniquely educational than other psychiatric treatment.”
A poll at the end of the Globe article asks readers which side they’re on. As of the evening of August 2, the votes in favor of the proposal were ahead by an almost two-to-one margin (62% to 38%).
Levandusky explains BPD and DBT
The Bypass Road facility will house “young men with a variety of issues that could be partially related to BPD, or less BPD and more mood or anxiety disorders. It’s not a one-diagnosis program,” said Dr. Philip Levandusky, senior vice president for business development and communications and director of McLean’s Psychology Department.
People with BPD have problems regulating emotions and thoughts; they exhibit impulsive and reckless behavior and have unstable relationships with other people, according to the National Institutes of Mental Health. Many also have co-occurring disorders such as depression, anxiety, substance abuse and eating disorders, along with self-harm and suicidal behaviors.
Those with BPD are “much more likely to have co-occurring depressions and anxieties and are not overtly assaultive or aggressive, “ Levandusky said. Violent behavior “is not a hallmark characteristic of people with BPD; if anything, self-harm may be more of a risk.”
Residents will be housed at the Bypass Road facility on a voluntary basis. While they will face locked doors and be forbidden from leaving the building without supervision, “it is not a secure setting in terms of having bars on the windows,” Levandusky said. However, McLean Hospital has more than 100 voluntary beds of this type, and it is “extraordinarily rare that we have people leave the program against our expectations,” he added.
McLean also operates another residential facility on Old Cambridge Turnpike in Lincoln for adult men and women, some of whom “have been stepped down from McLean Hospital” and periodically return there as part of their treatment, though no problems in Lincoln have ever been reported, Levandusky said. It was “within the realm of possibility” that the Bypass Road facility could include McLean Hospital “step-down” residents at times, he added.
Dialectical behavioral therapy (DBT) “is very clearly an educational experience,” Levandusky said. “It is teaching skills and doing homework assignments, and there is an expectation that the skills will be practiced.” Medical insurance will pay for a limited amount of outpatient DBT, but the Lincoln facility and others like it are for “a person likely to have had other types of experiences that were not as effective as hoped, and this can offer a more intensive kind of setting to engage in the psychoeducational process.”
“Fear of the unknown”
Is Levandusky surprised at the negative reaction to the Bypass Road proposal? “No,” he said. “It’s human nature; people don’t understand psychiatric conditions and psychological problems, or don’t necessarily understand the nature of psychoeducational programs in this day and age.” People are also subject to “fear of the unknown and [making] catastrophizing assumptions,” he added.
Asked specifically about the concerns expressed by Kanner, a primary care physician and a former chief of medical services for the state Department of Mental Health, Levandusky said, “We all have our things… obviously Dr. Kanner has certain perceptions of what we’re going to be doing there that are radically different from what we are going to be doing there.”