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After Parity, No Upswing in Use of Mental Health Services

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(June 26, 2014) Six months after implementing the Affordable Care Act in Pennsylvania, mental health professionals say they have not seen greater use of mental health care in their region (“ACA hasn’t boosted use of mental-health care services in Philly region,” Kaiser Health News, June 24).

doctor patientPeople aren’t accessing treatment because “there is still a lot of stigma [attached to mental illness],” says Patricia Kleven, director of outpatient mental health services at the Belmont Center for Comprehensive Treatment.

Actually, “the main issue is the Medicaid gap,” said Joseph Rogers, chief advocacy officer for the Mental Health Association of Southeastern Pennsylvania. "If you don't have private insurance and you are not poor enough to be on Medicaid, it is very difficult to get behavioral-health services."

But perhaps it isn’t just stigma or the Medicaid gap that are preventing people from using services. Even though the Affordable Care Act has significantly increased insurance coverage for mental health care, it won’t help the people who need treatment the most.

These are the people who suffer from a condition called anosognosia, an anatomical brain condition that affects approximately 50% of individuals with schizophrenia and 40% of individuals with bipolar disorder. People with anosognosia are simply unable to recognize their own illness – no matter how painfully obvious it may be to everyone around them. They are the people sleeping on the front steps of a community clinic, but who will not walk inside to seek treatment.

If we really want to address the most vulnerable people we need to foster universal adoption of mental illness treatment laws based on a person’s need for treatment and provide sufficient public psychiatric beds to treat individuals in psychiatric crisis.

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Prevalence of Untreated Severe Mental Illness by State

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(June 25, 2014) To continue raising public awareness of mental illness treatment issues, the Treatment Advocacy Center has published a fact sheet providing state-by-state population numbers on the prevalence of schizophrenia and severe bipolar disorder, including the number of those people who are untreated during a 12-month period.

mental illness genericPrevalence of Untreated Serious Mental Illness by State” provides the public with a central source of state-by-state information about the following:

  1. Number of adults diagnosed with schizophrenia and severe bipolar disorder

  2. Total number of those diagnosed with untreated schizophrenia

  3. Total number of those diagnosed with untreated severe bipolar disorder


The numbers were calculated using 2014 U.S. Census Bureau population data and National Institute of Mental Health (NIMH) estimates of prevalence and treatment by diagnosis.

Individuals with untreated schizophrenia or severe bipolar disorder are the most at-risk populations for a host of poor outcomes that affect them and their communities. These consequences of non-treatment include arrest, incarceration, hospitalization, homelessness, victimization and violence, including suicide, homicide and other violent acts.  

“Prevalence of Untreated Serious Mental Illness by State” is published as a public service of the Treatment Advocacy Center to further evidence-based knowledge and understanding of mental illness treatment issues in America.

All of the Treatment Advocacy Center’s resources can be found at TACReports.org, including our studies on mental illness in jails and prisons, state civil commitment laws and law enforcement shootings involving people with untreated severe mental illness.

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We are Making a Mockery of Civil Rights – personally speaking

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(June 23, 2014) I was the probate judge in Contra Costa County for 11 years. I am here to support the implementation of Laura’s Law in our county.

gavelLaura's Law provides a very thorough protection of the civil rights of the persons with severe mental illness. But, you will hear claims that Laura's Law is an infringement of civil rights.

At the core of our civil rights is our ability to choose to do what we want. When a person is unable to understand the nature and consequences of their decisions because of their illness, that person is fundamentally deprived of the ability to exercise any civil rights.

When we consider civil rights in this context, we should consider the annihilation of the civil rights of victims of homicide by persons with untreated severe mental illness.

We should consider the civil rights of people who are severely injured, whose lives are changed forever.
We should consider the civil rights of the families of the victims of the violence by persons with mental illness.

We should consider the horror for someone who is treated successfully, then learns they have done terrible things while untreated. They will find no comfort in being told we only cared about their civil rights and not at all about giving them the treatment they needed.

We should consider the civil rights of the vast majority of persons with mental illness who are shunned because of the public’s fear that all mentally ill people are violent, making it harder for consumers to find places to live and to get jobs.

We make a mockery of civil rights when we ignore people with severe mental illness, leaving them on the streets until they do something we characterize as a crime, then we lock them in our overcrowded jails and prisons.

Laura’s Law will fill a gap in our mental health system. We currently have no option treating people with severe and persistent mental illness who have demonstrated violent tendencies and do not accept treatment voluntarily.

Don Edward Green
Testimony from Contra Costa County, California

 

Victimization: A Tragic Consequence of Untreated Serious Mental Illness

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(June 20, 2014) Individuals with untreated serious mental illness, especially women, are extremely vulnerable to being victimized. A recently updated Treatment Advocacy Center backgrounder reviews existing studies on this association and offers summaries of them.

victimizationVictimization of persons with severe psychiatric disorders, the backgrounder says, “frequently involves acts such as theft of clothing or money but also includes assault, rape, or being killed.” These disturbing acts are unfortunately quite common, according to research on the subject. Some of the key research findings the background refers to are:

1. A 2014 analysis of five American studies of victimization among adults with mental illness that found that 31 percent of study participants had experienced at least one episode of physical violence;

 

2. A 2012 meta-analysis of victimization studies that found that 24 percent of mentally ill individuals had been victimized; and

 

3. A 2009 review of victimization studies that found victimization to occur more frequently among individuals who were also abusing drugs and/or alcohol and among those with the most severe symptoms.


Also of particular note is a 2002 North Carolina study that showed that individuals with severe psychiatric disorders were victimized only half as often when on outpatient commitment orders as compared to their peers who were not participating in outpatient commitment.

The victimization of individuals with serious mental illnesses is a disgraceful consequence of the failure to provide these individuals with timely treatment that could reduce their vulnerability. Our backgrounder, “How often are individuals with serious mental illness victimized?” can help advocates to educate stakeholders in their communities about one of the biggest reasons to support better treatment standards and assisted outpatient treatment laws.

For access to more of our backgrounders, which summarize information about severe mental illness, policies and programs related to its treatment, and the consequences of lack of treatment, visit the “Reports, Studies, Backgrounders” page on our website.

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California Reaches Tipping Point for Laura’s Law

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(June 18, 2014) San Francisco must move forward and adopt Laura’s Law to allow court-ordered outpatient treatment for people with serious mental illness, Fred Martin writes in the San Francisco Chronicle (“Mentally ill individuals need care and treatment not jail,” June 17).

mental illness jails“Adopting Laura's Law is about public safety. It is about whether we offer treatment for those with serious mental illness or abandon them to the streets or jail,” Martin says. “It is a means to help individuals avoid being forcibly hospitalized or jailed. It may help someone with severe psychosis avoid a violent confrontation."

As the chairman of the Committee on Mental Illness of the Episcopal Diocese of California, which works closely with homeless and incarcerated populations, Martin witnesses firsthand how America’s mental health system struggles to help the most severely ill among us.

With a shortage of public psychiatric beds and community-based treatment available only to those who seek it voluntarily, the consequences of untreated severe mental illness are apparent on the streets of San Francisco.

Bringing the law to the city will save taxpayers money. Laura’s Law can vastly reduce overall costs of tax-supported services associated with severe mental illness by reducing expensive hospitalizations, arrests and incarcerations. Nevada County, which implemented Laura’s Law in 2008, estimates it saves $1.81 for every $1 invested.

Last month, Orange County voted to bring this lifeline to treatment to its most vulnerable citizens and their families.

Next Monday morning, residents of San Francisco will have the opportunity to publicly voice their support for Laura’s Law to the Rules Committee in Room 263 at the San Francisco City Hall.

It’s time to bring Laura’s Law to San Francisco.

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