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A Year of Firsts for Mental Health

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(Dec. 16, 2013) In the year following the Dec. 14 mass killings at Sandy Hook Elementary School, reforms across the country show that public officials might just be getting serious about addressing the nation’s broken mental health system. 

funding_mapLast week, the White House announced that it will devote $100 million to increasing access to “mental health services.”

Later in the week Congressman Tim Murphy (R-PA) introduced the “Helping Families in Mental Health Crisis Act,” which aims to provide help to the most severely ill patients and their families. The proposed changes include exemptions to the HIPAA privacy rule, funding for mandatory outpatient treatment programs and clarification of standards that allow involuntary outpatient and treatment.

Earlier in November, the mental health community cheered when the Obama administration announced regulations that help make mental health parity a reality. Under the Affordable Care Act private insurers will now be required to provide coverage for mental illness equal to what they provide for physical illnesses.

At the state level, nearly a dozen state legislatures passed or improved their laws that determine who receives court-ordered treatment for symptoms of severe mental illness.  In the same period, thirty-six states and the District of Columbia increased funding for mental health.

We’ve seen a new and real public and political resolve to address the issues that involve people with serious mental illness, and the resulting breakthroughs will help lower barriers to treatment for severe mental illness, but many remain.

A half-century of abandonment and neglect will not be reversed by a single banner year (“USA has made slight progress on mental health since Newtown,” USA Today).  Help us keep the momentum going:

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My First Time in an Institution – personally speaking

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(Dec. 13, 2013) I vaguely remember lying awake that first night in a large room with maybe twenty beds occupied by other patients. Weird thoughts and fantasies raced through my brain as I tried to reconcile events and apparent reality with my recent grasp of what I had thought “real.” I don’t know how many days I stayed in this big room.

joseph_bowersOver the next two and a half months, my feelings about being in this place would evolve. Initially I felt trapped in a strange and sinister place. I would later come to enjoy fellow residents, both patients and staff, and the freedom from stress-causing responsibilities, tasks or expectations. I adjusted to this strange new environment quickly.

We would meet with our psychiatrists rarely--perhaps once a week.  I remember my psychiatrist as being quick to smile, soft-spoken and kindly. He would try very hard to get me to clearly explain what was going on in my mind, what I might have been thinking while doing the things that had gotten me there in the hospital and that sort of thing. It was initially very difficult to answer him.

There were many patients in the hospital near my age. Often when alone with other patients one would say to me, “I’d never tell my Doctor this but…” 

I would eventually realize and accept that one only gets out of therapy what one puts into it. If I wasn’t open and honest with my therapist, he couldn’t help. I’m thinking, though, that I only got good at committing to sessions as the people I was dealing with seemed to regard me more as a person to work with and with whom to engage in two-way communication rather than as a defective object.

When my planned series of treatments were over, they started making plans for my release. The prospect of returning to the world was scary. Were my mental problems over? How would I cope with everyday stress, schoolwork and such? How would my friends and schoolmates treat me after I had been in Middletown? On the other hand, I still had hopes of a decent future, though my prospects had been severely damaged and I wanted to get on with my life.

Joseph Bowers
Author of Life Under a Cloud: The Story of a Schizophrenic


Last  week we published Part 1, “My First Psychotic Episode.
Purchase a copy of the book here.

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Rep. Murphy Unleashes a Potential Treatment Game-Changer

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(Dec. 12, 2013) Rep. Tim Murphy (R-PA) is to be strongly commended for taking leadership on federal problems regarding the treatment of individuals with serious mental illnesses.

tim_murphy2This is an issue on which federal and state leadership has been in short supply. Rep. Murphy, a psychologist by training, has approached the issue in a systematic and thoughtful manner, focusing specifically on the parts of the problem which have federal origins.

Earlier in 2013, following the Newtown tragedy, the Subcommittee on Oversight and Investigation, of which he is the chairman, held hearings on these problems. On the role of the Substance Abuse and Mental Health Services Administration (SAMHSA), Rep. Murphy noted:

One lesson we must immediately draw from the Newtown tragedy is that we need to make it our priority to get those with serious mental illnesses, who are not presently being treated into sound, evidence-based treatments…[Such treatment] can reduce the risk of violent behavior fifteen-fold in persons with serious mental illness…SAMHSA has not made the treatment of the seriously mentally ill a priority, in fact, I’m afraid serious mental illness such as schizophrenia and bipolar disorder may not be a concern at all to SAMHSA…It’s as if SAMHSA doesn’t believe serious mental illness exists.

The legislation proposed by Rep. Murphy deserves bipartisan support. The problems it addresses are not Democratic or Republican problems, but rather everybody’s problems. The proposed legislation accomplishes the following:

  • Requires states to authorize assisted outpatient treatment (AOT) in order to receive Community Mental Health Service Block Grant funds.
  • Allocates $5 million for a federal assisted outpatient treatment (AOT) block grant program funding up to 50 grants per year for new, local AOT programs.
  • Carves out an exemption in HIPAA that permits a “caregiver” to receive protected health information when a mental health care provider reasonably believes disclosure to the caregiver is necessary to protect the health, safety or welfare of the patient or the safety of another. (The definition of “caregiver” includes immediate family members.)
  • Establishes a new National Mental Health Policy Laboratory in the Department of Health and Human Services
  • Prevents federally funded “Protection and Advocacy” organizations from engaging in lobbying activities and counseling individuals on ““refusing medical treatment or acting against wishes of a caregiver.”
  • Requires the US comptroller general to submit a report to Congress detailing the costs to the federal and state government of imprisoning people with severe mental illness.
  • Increases Congressional oversight of SAMHSA programs and seeks improvements to the programs it supports.

The Treatment Advocacy Center (TAC) strongly supports these efforts of Rep. Murphy to improve the care of individuals with serious mental illnesses, and commends him for providing needed federal leadership in this area.

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A Widow's Story

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(Dec. 10, 2013) Joan Scott is a new widow who sent the following message to the Treatment Advocacy Center in June.

Our son, Douglas, in the spring voluntarily went to Ft. Lauderdale Hospital, where he had been admitted four times before. They sent him to Broward General Hospital in Ft. Lauderdale for evaluation, and he was sent home the same day.

A few weeks later, on April 15, the police took him to the same ER for an emergency psychiatric evaluation. He was sent home again.

On April 17, the police again took him to the ER. This time, he was sent home with a prescription.

Five days later, on April 22, he killed his father – my husband, Norman.

Do you have any suggestions? What can I do to help stop tragedy?

Joan is now working with us to raise awareness of the need for treatment before tragedy. She is advocating for public policies that provide timely and effective treatment for individuals with untreated severe mental illness. She has also has become a faithful Treatment Advocacy Center donor.

“It’s too late for us, but it’s not too late for other families living with a loved one’s untreated mental illness, and the Treatment Advocacy Center is the organization that’s there to help,” she says.

Please join Joan in helping us make treatment possible for more of the people with severe mental illness who are least able to help themselves.

Your gift of any size will help. Please give today by clicking here to make an online donation or to find mail-in instructions.

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Law and Order: Officers on the Front Lines of Mental Health

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(Dec. 9, 2013) Responding to a possible psychiatric crisis, police ended up shooting a Maryland woman last week, according to the Washington Post (“Hyattsville police officer shoots woman in the chest after a mental health call to her home,” Dec. 4).

police_carOfficers were trying to calm the woman when she produced a knife, the Post details. In light of the potential threat, an officer tried to subdue her with a Taser and then “fired one round from his weapon.”

Thankfully, the woman is recovering in a local hospital, but confrontations between police and individuals in psychiatric crisis often have even more tragic consequences. At the Treatment Advocacy Center we see stories like this all the time – one of the results of a system that diverts people with severe mental illness from receiving effective treatment and instead places them into the hands of law enforcement.

In Maryland, most of these officers are untrained to handle their roles as front-line mental health workers. Our study, “Prevalence of Mental Health Diversion Practices: A Survey of the States,“ found that only 31% of Maryland’s population is served by crisis intervention teams, units of police officers who are trained to respond more effectively to crises involving mental illness.  

And Maryland has a mental health system that reserves treatment for those who are able to seek it voluntarily. It is one of only five states without an assisted outpatient treatment (AOT) law . At the same time, the standard for court-ordered inpatient treatment in a hospital is exceedingly high.

While the woman’s psychiatric diagnosis is unknown, what is known is that Maryland is consistently failing its population with mental illness. Unless the state modernizes its mental health laws and better trains its police officers to respond to people in the midst of a psychiatric crisis, we will continue to see stories like this.

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