GUILDERLAND — “Hate is not a mental illness,” says Dr. Stephen Giordano.

He notes that there is no diagnostic category for hate, and it is wrong “to assume that hateful people, whatever their color, creed, or stripe, must be mentally ill.”

People suffering with mental illness are more often the victims rather than the perpetrators of crime, he says.

As violent crimes are increasing not just in Albany County but across the nation, Giordano says, “The solution is not just going to be a mental-health solution …. If we are alienating and isolating and stigmatizing and discriminating against portions of our community, that’s going to come with a cost … One of those costs may very well be violence.”

Giordano also says, “I think people who cause other people pain are very likely in pain themselves.”

For 11 years, Giordano has served as the mental health commissioner for Albany County. It’s not an easy job. The work took on new dimensions over the last two years as the pandemic, with isolation-inducing restrictions, caused more mental-health problems.

Giordano, who grew up in New York City, and says his heart is still there, majored in philosophy as an undergraduate at the State University of New York at Binghamton.

“Some of the questions that are dealt with historically in philosophy are about how to live, what’s right, what’s fair, what does suffering mean,” says Giordano in this week’s Enterprise podcast.

A licensed psychologist, Giordano was in private practice before he became commissioner and also taught courses at the University at Albany and Russell Sage, specializing in addiction.

His current work can be a daily struggle. “We’re up against it ….,” he says. “A lot of people in our community are suffering. And, at the end of the week, it’s not clear that everyone was helped in the way that they should have and could have been.”

Giordano worries: “Am I going to read about this in the paper tomorrow and what could we have done differently?”

He credits his staff for their skill and dedication. Among other services, his staff ran a helpline through the beginning years of the pandemic to help callers cope with the challenges of loss and isolation.

Many people struggling with addiction to alcohol and drugs got worse during the pandemic and some in recovery relapsed. “And many people who weren’t addicted maybe became addicted,” says Giordano.

“We have seen overdose fatalities rise precipitously in the last two years,” he says.

The county offers a “rich array” of addiction services. “That’s the good news,” says Giordano. “The bad news is: They’re all full.”

Currently, 2,500 county residents are in outpatient addiction treatment. Albany County has a population of about 315,000.

Two new programs have been started in the last two years. A mobile response team visits the homes of people who have survived a drug overdose. Local police are involved, including from Guilderland and Colonie.

“Sometimes they tell us to go away; sometimes they tell us to come back next week; sometimes they welcome us into their home,” says Giordano. “But we are trying to follow up in real time with people, to try to give them support, to make sure they have Narcan, to give them linkages to treatment.”

The second new program is being piloted in the Helderberg Hilltowns in partnership with the county’s sheriff, executive, and legislature.

Local discussions on police actions were spurred by then-Governor Andrew Cuomo’s directive, in the wake of George Floyd’s murder, for each municipality to come up with reform plans.

“The police are necessary often in crisis response — they’re not always essential,” said Giordano. “We’re trying to learn how to respond to psychiatric and mental-health emergencies with social workers.”

Giordano outlined three goals of the pilot program when it was presented last June. First, he said, “Mental-health crises deserve mental-health responses … That is the best way to serve people.”

Second, he said, the program will free up law enforcement to do public safety work since oftentimes, mental-health response is not integral to their work.

The third goal, Giordano said, is “to keep all parties safe, divert folks from hospitals which … are overwhelmed and from our jails … Our jails have become the defacto psych hospitals in this county, in this state, and in this nation.”

In the past six to eight months, Giordano says, the ACCORD (Albany County Crisis Officials Responding and Diverting) program has answered about 400 calls in the Hilltowns, and the hope is to expand the program elsewhere.

“You learn as you go,” says Giordano. The dispatchers, for example, have had to be trained to find out “what is really at play” and not not “feel like they have to send the police to everything.”

The program is being documented and researched by the School of Public Health and Social Welfare at UAlbany. 

“This is just an outgrowth of our mobile crisis team, which has been operating in the county for more than 30 years,” says Giordano. “We were the first in the state to develop a mobile crisis team 24/7 … We know how to do it, but we’re trying to learn how to do it without front-loading it with police.”

As Giordano writes in a letter to the Enterprise editor this week, he believes the pandemic has shown us that we are at once more vulnerable than we thought but also more resilient.

Since COVID-19 looks now like it won’t be a virus that is conquered, but rather something we will live with, Giordano warns against “the danger of complacency” and says, “Denial is always a danger.”

At the same time, though, he says, “Living in a heightened state of alert and feeling of danger is also unhealthy.”

He advises, “We have to attend on a daily basis to our mental and physical health and the mental and physical health of those in our sphere — our loved ones, our coworkers, our friends, our family.”

While it’s important to stay informed with the latest news, says Giordano, who says he’s been called a “news junkie,” we can only take so much of the “constant flooding of trauma.”

“Psychologists in Canada are actually prescribing walks in the national parks,” says Giordano.

Answering the question of how an individual can cope with the onslaught of never-ending bad news, he says, “I would say take a walk in the forest.”

With one in five people experiencing a diagnosed mental-health condition in any given year, Giordano believes it is essential to do away with the stigma.

“Most of the time we think it’s happening to ‘them’ …. Those poor people who have mental-health challenges,” he says, stressing, “We all have mental-health challenges.”

Giordano concludes, “The way you deal with stigma is to realize that we’re all in this together and to see in the other yourself. That is how you develop empathy and compassion. And that’s something we don’t have enough of.”