Bills to Help People with Mental Illness in California Pass Mental Health Committee

(April 14, 2015) Several California bills proposed by Assemblymembers Eggman, Waldron and Brown passed the mental health committee today and go to other committees. The first two improve Laura's Law, California's Assisted Outpatient Treatment (AOT) program. It allows courts to order  noncompliant persons with mental illness who have already become violent or needlessly hospitalized as a result of going off treatment, to stay in six months of mandated and monitored treatment while they live in the community. It's been very successful in counties and states that use it. The following summaries are based on bills before they were amended by the committees, so this may not be entirely accurate. Check the actual bills.

• AB1193 (Eggman) eliminates the requirement that counties vote to implement Laura's Law and eliminates the requirement that counties certify that voluntary programs are not being cut. Counties that don’t want Laura’s Law have to vote not to have it, rather than to have it as before. It also allows superior court judges to request a Laura’s Law petition be filed for individuals who come before the court. It extends Laura's Law until 2022. 
• AB 59 (Waldron) supposedly complements AB 1193. I believe it removes the sunset (whereas AB 1193 moved it until 2022, but maybe that was one of the provisions removed during the meeting.) It also removes the requirement that counties certify that no voluntary programs are cut before implementing Laura's Law. That certification requirement basically required counties to maintain failed programs before they could implement Laura's Law. The bill originally would have authorized the court to order a person to obtain assisted outpatient treatment for up to 12 months, rather than 6 months as is now the case. But that provision was removed at last minute. It allows hospitals to petition for AOT for people who are involuntarily committed to inpatient care (5150) and who are being released. That is a good idea as there are people who are involuntarily committed who could leave the hospital if Laura's Law was available to them.

Two other bills, not related to Laura's Law, but that help the seriously ill also passed the mental health committee and move to other committees.

• AB1194 (Eggman) allows courts to consider past history when deciding when to 5150 (involuntarily commit) someone. Past history is best predictor of future behavior (l,e someone who went off meds in past, and became violent is more likely to become violent again if they again go off meds). AB1194 now goes to appropriations.  
• AB 1237 (Brown) passed mental health committee and goes to next committee. It requires state hospital system to create pool of psychiatrists to evaluate people who are found mentally incompetent to stand trial or who has been found to be insane at the time he or she committed the crime. 

Research Shows Assisted Outpatient Treatment (AOT) Works

AOT allows courts to order six months of mandated and monitored treatment in the community for a very small group of people with very serious mental illness who have previously become arrested, incarcerated, violent, homeless or hospitalized multiple times as a result of their failure to comply with treatment, often because they are so ill they don't know they are ill ("anosognosia").

More than two decades of research and practice show it works. AOT reduced hospitalizations[i], arrests[ii], incarcerations, crime[iii], victimization[iv] and violence[v] and improved treatment adherence[vi] The Department of Justice deemed AOT to be an effective evidence-based program for reducing crime and violence[vii]; AOT also produces significant taxpayer/system cost savings. New York’s program achieved savings of 50% in the first year and an additional 13% in the second year. A study in North Carolina reported similar cost savings of 40%[viii]. These savings free up mental health funds to treat more people or provide better treatment.

Research showing AOT (Kendra's Law) in New York works

Research showing AOT (Laura's Law) in California works is here

Footnotes 

Biggest Police Group Endorses Greater Use of Assisted Outpatient Treatment (AOT)

“AOT helps prevent mental health officials from offloading 
the most seriously mentally ill to jails, shelters, prisons and morgues.” 

(Oct. 29, 2014) The International Association of Chiefs of Police (IACP) took steps to improve care for people with serious mental illness and protect the safety of officers by endorsing greater use of Assisted Outpatient Treatment (AOT) at their 2014 annual meeting in Orlando, FL. Research collected by Mental Illness Policy Org shows AOT reduces arrest, suicide, hospitalization and violence by people with the most serious mental illnesses over 70% each. By replacing more expensive and liberty-depriving inpatient commitment and incarceration with less expensive outpatient treatment, AOT cut taxpayers’ costs in half. DJ Jaffe, Executive Director of Mental Illness Policy Org. said “Police step in when one condition has been met: the mental health system failed. This resolution will encourage mental health departments to do the right thing. If implemented it will save the lives of patients and police.”

AOT allows judges to order a small group of the most seriously ill to stay in six months of mandated and monitored treatment while they live in the community. It is limited to those who have already accumulated multiple episodes of homelessness, hospitalization, violence, arrest or incarceration associated with going off treatment. Representative Tim Murphy (R. PA) included funding for AOT in the Helping Families in Mental Health Crisis Act (HR 3717). AOT is known as “Kendra’s Law” in New York and “Laura’s Law” in California after two women who were killed by persons with untreated serious mental illness. Families of the seriously ill in those states had been arguing for AOT to help their ill family members get treatment, but could not get mental health departments to listen to them until after the tragedies.

As the result of the mental health system’s refusal to deliver services to the most seriously ill, and preferring to treat the highest functioning, there are now ten times as many mentally ill incarcerated as hospitalized according to the Treatment Advocacy Center. New Windsor, NY Police Chief Michael Biasotti conducted a survey of 2400 senior law enforcement officers and recently told Congress “We have two mental health systems today, serving two mutually exclusive populations: Community programs serve those who seek and accept treatment. Those who refuse, or are too sick to seek treatment voluntarily, become a law enforcement responsibility.” “AOT will help return care and treatment of the seriously mentally ill back to the mental health system where it belongs” said Jaffe. The National Sheriff’s Association and Department of Justice previously endorsed AOT as has almost every major organization concerned about care and treatment of the most seriously ill. Chief Michael Biasotti and outgoing IACP President Yost Zakhary were responsible for obtaining the IACP endorsement. Mental Illness Policy Org urges local chiefs to encourage their mental health departments and legislatures to make greater use of it.

A copy of the IACP Resolution follows or get PDF version to share with local law enforcement and mental health officials. Learn about AOT in New York (Kendra's Law) and about AOT in California (Laura's Law)

Mental Illness Policy Org. is an independent science based think tank on serious mental illness (not mental health) @MentalIllPolicy

IACP Endorses Assisted Outpatient Treatment 
Resolution adopted by IACP October 28, 2014
PDF VERSION

WHEREAS, law enforcement officers are often the first responders to individuals in mental health crisis; and

WHEREAS, law enforcement officers continue to experience an increase in interactions with people with severe mental illness[1]; and

WHEREAS, such interactions consume a disproportionate amount of limited law enforcement resources[2]; and

WHEREAS, approximately forty percent of individuals with severe mental illness are not receiving treatment, primarily because the illness affects their ability to voluntarily participate in needed care[3]; and

WHEREAS, noncompliance with treatment, specifically non-adherence to medication, is strongly associated with hospitalization,[4] suicide,[5] victimization,[6] violence[7] and relapse;[8] and

WHEREAS, noncompliance with treatment is also strongly associated with arrest and incarceration,[9] resulting in a disproportionate representation of individuals with severe mental illness in the criminal justice system; and

WHEREAS, a 2014 report found that 10 times more mentally ill persons are in prisons and jails than are receiving treatment in state psychiatric hospitals[10]; and

WHEREAS, Assisted Outpatient Treatment (AOT) provides court-ordered treatment in the community for high-risk individuals with severe mental illness and a history of treatment noncompliance, as a less restrictive alternative to inpatient hospitalization; and

WHEREAS, more than two decades of research and practice document AOT as an effective tool to improve outcomes for this focus population, including reduced hospitalizations[11], arrests[12], incarcerations, crime[13], victimization[14] and violence[15] while increasing treatment adherence[16] and substance abuse treatment outcomes; and

WHEREAS, numerous state and local law enforcement associations support and have championed the passage and implementation of AOT programs; and

WHEREAS, the Department of Justice deemed AOT to be an effective evidence-based program for reducing crime and violence[17]; and

WHEREAS, studies amply demonstrate AOT’s effectiveness in reducing arrests and incarcerations, e.g., a recent study of New York State’s signature AOT program (“Kendra’s Law”) concluded that the “odds of arrest in any given month for participants who were currently receiving AOT were nearly two-thirds lower” than those not receiving AOT[18]; and

WHEREAS, AOT also produces significant taxpayer/system cost savings, ultimately increasing overall service capacity and leading to greater access for both voluntary and involuntary recipients. A cost-impact study in New York City found net cost savings of 50% in the first year and an additional 13% in the second year; a study in North Carolina reported similar cost savings of 40%[19]; now, therefore be it

RESOLVED, that the International Association of Chiefs of Police (IACP) recommends the authorization, implementation, appropriate funding, and consistent use of Assisted Outpatient Treatment (AOT) laws to ensure treatment in the least restrictive setting possible for individuals whose illness prevents them from otherwise accessing such care voluntarily.

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[1] Biasotti, Michael C. Management of the severely mentally ill and its effects on homeland security. Naval Postgraduate School Monterey Ca. Dept. of National Security Affairs, 2011.

[2] Biasotti, Michael C. Management of the severely mentally ill and its effects on homeland security. Naval Postgraduate School Monterey Ca. Dept. of National Security Affairs, 2011.

[3] Substance Abuse and Mental Health Services Administration. (2013). Results from the 2012 National Survey on Drug Use and Health: Mental Health Findings. NSDUH Series H-47, HHS Publication No. (SMA) 13-4805.

[4] Valenstein, M., Copeland, L., Blow, F., et al. (2002). Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care 40:630–639.

Weiden, P., Kozma, C., Grogg, A., et al. (2004). Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatric Services 55:886–891.

Gilmer, T., Dolder, C., Lacro, J., et al. (2004). Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. American Journal of Psychiatry 161:692–699.

Ascher-Svanum, H., Faries, D., Zhu, B., et al. (2006). Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. Journal of Clinical Psychiatry 67:453–460.

Velligan, D., Weiden, P., Sajatovic, M., Scott, J., Carpenter, D., Ross, R., Docherty, J., (2009). The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. Journal of Clinical Psychiatry. 70 Suppl 4:1-46; quiz 47-8.

[5] Muller-Oerlinghausen, B., Muser-Causemann, B. & Volk, J. (1992). Suicides and parasuicides in a high-risk patient group on and off lithium long-term medication. Journal of Affective Disorders, 25(4),261-269.

Leucht S., Heres S. (2006). Epidemiology, clinical consequences, and psychosocial treatment of nonadherence in schizophrenia. Journal of  Clinical Psychiatry, 67(Suppl. 5), 3–8.

Nordentoft, M. (2007). Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Danish Medical Bulletin, 54(4),306-69.

Chapman, S.C., Horne, R. (2013). Medication nonadherence and psychiatry. Current Opinion in Psychiatry, 26(5),446-552.

[6] Hiday, V., et al. (1999). Criminal Victimization of Persons with Severe Mental Illness. Psychiatric Services, 50, 62-68.*

*Individuals with severe psychiatric disorders who were not taking medication were found to be 2.7 times more likely to be the victim of a violent crime (assault, rape, or mugging) than the general population.

[7] Swartz, M., Swanson, J., Hiday, V., Borum, R., Wagner, H., Burns, B. (1998). Violence and severe mental illness: The effects of substance abuse and nonadherence to medication. American Journal of Psychiatry, 155, 226-31.

Substance abuse, medication non-compliance and low insight into illness operate together to increase violence risk. Van Dorn, R., Volavka, J., Johnson, N. (2011). Mental disorder and violence: is there a relationship beyond substance use? Social Psychiatry and  Psychiatric Epidemiology.

Witt, K., Van Dorn, R., Fazel, S. (2013). Risk factors for violence in psychosis: Systematic review and metaregression analysis of 110 studies. PLOS  ONE, 8, e55942.

Belli, H., Ozcetin, A., Erteum, U., et al. (2010). Perpetrators of homicide with schizophrenia: sociodemographic characteristics and clinical factors in the eastern region of Turkey. Comprehensive Psychiatry, 51,135-41.

Alia-Klein, N., O’Rourke, T., Goldstein, R., et al. (2007). Insight into illness and adherence to psychotropic medications are separately associated with violence severity in a forensic sample. Aggressive Behavior, 33, 86–96.

Elbogen, E., Van Dorn, A., Swanson JW, et al. (2006). Treatment engagement and violence risk in mental disorders. British Journal of Psychiatry, 189,354–360.

Swanson, J., Swartz, M., Essock, S., et al. (2002). The social-environmental context of violent behavior in persons treated for severe mental illness. American Journal of Public Health, 92, 1523–1531.

Bartels, J., Drake, R., Wallach, M., et al. (1991). Characteristic hostility in schizophrenic outpatients.  Schizophrenia Bulletin, 17, 163–171.

[8] Robinson, D. (2010). First-episode schizophrenia. CNS Spectrum, 15 (Supplement 6), 4-7.

Ayuso-Gutierrez, J., Del Rio, V. (1997). Factors influencing relapse in the long-term course of schizophrenia. Schizophrenic Research, 28, 199-206.

Morken, G., Widen, J., Grawe, R. (2008). Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia. BMC Psychiatry, 8,32-8.

Suppes, T., Baldessarini, R., Faedda, G., Tohen, M. (1991). Risk of recurrence following discontinuation of lithium treatment in bipolar disorder.  Archives of General Psychology, 48(12),1082-1088.

Franks, M., Macritchie, K., Mahmood, T., Young, A. (2008) Bouncing back: is the bipolar rebound phenomenon peculiar to lithium? A retrospective naturalistic study. Journal of Psychopharmacology, 22(4), 452-456.

[9] Munetz, M.R., Grande, T.P., & Chambers, M.R. (2001). The incarceration of individuals with severe mental disorders. Community Mental Health, 34:361-71.* * Nearly 90 percent of a sample of individuals with severe mental illness in a local jail were partially or completely non-complaint with medication in the year before they were incarcerated.

Lattimore, P. K., Broner, N., Sherman, R., Frisman, L., & Shafer, M. S. (2003). A comparison of prebooking and postbooking diversion programs for mentally ill substance-using individuals with justice involvement. Journal of Contemporary Criminal Justice, 19(1), 30-64.* *Individuals with co-occurring mental illness and substance abuse who are noncompliant with medication have a threefold increase in risk for arrest and are significantly more likely to be at risk for violent behavior.

Ascher-Svanum, H., Nyhuis, A.W., Faries, D.E., Ball D.E., & Kinon B.J. (2010). Involvement in the US criminal justice system and cost implications for persons treated for schizophrenia. BMC Psychiatry, 10:11.

Shelton, D., Ehret, M. J., Wakai, S., Kapetanovic, T., & Moran, M. (2010). Psychotropic medication adherence in correctional facilities: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 17(7), 603-613.

[10] Torrey, EF, Zdanowicz, MT, Kennard, AD, et al. The treatment of persons with mental illness in prisons and jails: a state survey. Treatment  Advocacy Center and National Sheriff’s Association, April 8, 2014.

[11] Swartz, M., Swanson, J., Wagner, H., Burns, B., Hiday, V., & Borum, R. (1999). Can involuntary outpatient commitment reduce hospital recidivism: Findings from a randomized trial with severely mentally ill individuals. American Journal of Psychiatry 156: 1968-1975.

Swartz, M., Swanson, J., Steadman, H., Robbins, P., & Monahan J. (2009).  New York state assisted outpatient treatment program evaluation. Duke University School of Medicine.

[12]Gilbert, A., Moser, L., Van Dorn, R., Swanson, J., Wilder, C., Robbins, P., Keator, K., Steadman, H., & Swartz, M. (2010). Reductions in arrest under assisted outpatient treatment in New York. Psychiatric Services 61: 996-999.

[13] New York State Office of Mental Health. 2005. Kendra’s Law: Final Report on the Status of Assisted Outpatient Treatment.

[14] Hiday, V., Swartz, M., Swanson, J., Borum, R., & Wagner, R. (2002). Impact of outpatient commitment on victimization of people with severe mental illness.  American Journal of Psychiatry, 159: 1403-1411.

[15] Phelan, J., Sinkewicz, M., Castille, D., Huz, St., & Link, B. (2010). Effectiveness and outcome of assisted outpatient treatment in New York state. Psychiatric Services 61: 137-143.

[16] New York State Office of Mental Health. 2005. Kendra’s Law: Final Report on the Status of Assisted Outpatient Treatment.

[17] National Institute of Justice, Program Profile Assisted Outpatient Treatment (AOT). Retrieved August 27, 2014, from  http://www.crimesolutions.gov/ProgramDetails.aspx?ID=228

[18] Gilbert, A., Moser, L., Van Dorn, R., Swanson, J., Wilder, C., Robbins, P., Keator, K., Steadman, H., & Swartz, M. (2010). Reductions in arrest under assisted outpatient treatment in New York. Psychiatric Services 61: 996-999.

[19] Swanson, J., Van Dorn, R.,  Swartz, M., Robbins, P., Steadman, H., McGuire, T., & Monahan, J. (2013). The cost of assisted outpatient treatment: Can it save states money? American Journal of Psychiatry 170:1423-1432.

About Assisted Outpatient Treatment (AOT)

Assisted Outpatient Treatment (AOT) is for a very small group of the most seriously mentally ill who already accumulated multiple incidents of hospitalization arrest or incarceration associated with their failing to stay in voluntary treatment. AOT allows judges, after full due process to require certain mentally ill to accept six months of mandated and monitored treatment as a condition for living in the community. It provides an off ramp before incarceration. As Linda Dunn said, Assisted Outpatient Treatment is like putting a fence by the edge of the cliff rather than an ambulance at the bottom. (Barnidge 2014)

The research on AOT is extensive and positive. (Mental Illness Policy Org 2013). Six months of mandated and monitored treatment has been shown to reduce homelessness 74%; hospitalization 77%; arrest 83%; incarceration 87%, physical harm to others 47%; property destruction 46%; suicide attempts 55%; and substance abuse (48%). By replacing expensive incarceration and hospitalization with less expensive community care Assisted Outpatient Treatment cuts costs to taxpayers in half. (Swanson, et al. 2013). AOT also reduces victimization. (V.A. Hiday 2002). These results are particularly outstanding because AOT is limited to the most seriously ill, often a very hard to treat population.

Statement/Facts on Laura's Law vote in Los Angeles, CA

Tell Governor Brown to Sign SB 585 to allow MHSA Funds for Laura's Law

(Updated 9/3/13)

Urgent: Contact Governor Jerry Brown immediately (Sept. 2013) and URGE HIM TO SIGN SB 585 which will help clarify that Mental Health Services Act (Prop 63) funds may be used to fund Laura's Law.  Phone: (916) 445-2841.  Fax: (916) 558-3160 and use his online contact form.

Background:

Laura's Law allows courts to order a small group of people who have serious mental illness and a history of dangerousness to stay in treatment as a condition of living in the community. It has reduced arrest, incarceration, hospitalization and length of hospitalization in the two counties that use Laura's Law.

Two Reasons Counties Haven't Implemented Laura's Law:

There are two reasons more counties don't implement Laura's Law. Three million dollars in Mental Health Services Act (MHSA) funds are going to Disability Rights California and they are using those funds to threaten to sue counties that use any MHSA funds to implement Laura's Law even though such expenditure is clearly allowed. Laura's Law requires county boards of supervisors to vote to implement Laura's Law and simultaneously certify that no voluntary programs will be cut to do it.

Steinberg initially promised to help:

 In reaction to widespread outrage that people were being denied access to MHSA funded programs merely because they were so sick they were eligible for Laura's Law, Senator Steinberg introduced SB 585 in early April. The ostensible purpose was to clarify that MHSA funds could be used for people in Laura's Law.  But Steinberg  weakened his own bill. He added back a requirement that other bills by other legislators would have removed. Specifically, he added back a requirement that boards of supervisors vote (directly or through the budget process) to implement Laura's Law. And he added back a requirement that counties certify no voluntary programs will get cut to implement Laura's Law.

Unfortunately, SB 585 is the only bill Steinberg would let pass. And since it does somewhat clarify that MHSA funds can be used for Laura's Law, we are supporting it. Contact Governor Jerry Brown immediately (Sept. 2013) and urge him to sign SB 585 which will help clarify that Mental Health Services Act (Prop 63) funds may be used to fund Laura's Law. Phone: (916) 445-2841 Fax: (916) 558-3160 and use his  online contact form. 

Two new studies should lead to widespread use of Laura’s Law in California

Two new studies (including one reported in the New York Times) should lead to widespread adoption of Laura’s Law in California as a way to help some people with the most serious mental illnesses. Laura’s Law allows courts to order a narrowly defined group of individuals who have a history of violence to stay in treatment while living in the community. It has reduced violence, incarceration, hospitalization and homelessness wherever it has been used.

The first study was conducted in Australia and found 25% of individuals with schizophrenia were charged with a criminal offense during their lifetime. 6.4% of those with schizophrenia and 22.8% of those with schizophrenia plus substance abuse were charged with violent crimes compared to only 2.4% in the control group.

Unfortunately, California’s non-profit mental health industry continues to deny a relationship between violence and untreated serious mental illness and therefore oppose programs like Laura’s Law that can reduce the violence. They also claim it is too expensive.

A second study from Duke University studied New York’s version of Laura’s Law and found any increase in cost is dramatically offset by reduced hospitalization and incarceration costs.

Two Studies Should Lead to Radical Change in Mental Illness Treatment

The first study was conducted in Australia and found  individuals with schizophrenia – even those who do not have substance abuse problems – are significantly more violent than the general population.  The study found

·      25% of individuals with schizophrenia were charged with a criminal offense during their lifetime, compared with 10% of community controls.

·      6.4% of those with schizophrenia were found guilty of a violent offense, and 22.8% of those with schizophrenia plus substance abuse were found guilty of a violent offense compared to 2.4% of the general population

Assisted Outpatient Treatment for Seriously Mentally Ill Cuts Costs in Half

According to a just released study in the July 30, 2013, American Journal of Psychiatry, mandating Assisted Outpatient Treatment (AOT) for a narrowly defined group of persons with serious mental illness results in substantial savings. AOT allows courts to order individuals with serious mental illness and a history of treatment noncompliance to stay in treatment as a condition of staying in the community. It is only available for those who are so ill, they have a past history of going off the treatments that prevented them from becoming hospitalized, arrested, homeless or incarcerated. For this small group of the most seriously ill, AOT is a less expensive, less restrictive, more humane alternative to involuntary inpatient commitment and incarceration.

Researchers at Duke found that treatment costs declined 50 percent in New York City after the first year of AOT, and another 13 percent the second year. Even larger cost savings were reported in five other New York counties. Previous studies have proven AOT dramatically improves care for people with serious mental illness who have trouble staying in treatment voluntarily.

Darrel Steinberg pseudo-support for Laura's Law

(Updated 9/3/13)

Urgent: Contact Governor Jerry Brown immediately (Sept. 2013) and urge him to sign SB 585 which will help clarify that Mental Health Services Act (Prop 63) funds may be used to fund Laura's Law.Phone: (916) 445-2841 Fax: (916) 558-3160 and use online contact form.

Background:

Laura's Law allows courts to order a small group of people who have serious mental illness and a history of dangerousness to stay in treatment as a condition of living in the community. It has reduced arrest, incarceration, hospitalization and length of hospitalization in the two counties that use Laura's Law.

Two Reasons Counties Haven't Implemented Laura's Law:

There are two reasons more counties don't implement Laura's Law. Three million dollars in Mental Health Services Act (MHSA) funds are going to Disability Rights California and they are using those funds to threaten to sue counties that use any MHSA funds to implement Laura's Law even though such expenditure is clearly allowed. Laura's Law requires county boards of supervisors to vote to implement Laura's Law and simultaneously certify that no voluntary programs will be cut to do it.

Steinberg initially promised to help:

 In reaction to widespread outrage that people were being denied access to MHSA funded programs

4 New Laura's Law/MHSA Bills Could Help Mentally Ill in California

Bills Clarify MHSA Funds Can Be Used For Laura's Law and Make Other Improvements

Following is our preliminary analysis of the four California bills introduced 2/22/13

SB 585 (Steinberg/Correa) clarifies Mental Health Services Act (MHSA/ Prop 63) funds may be used by counties to implement Laura's Law. 

SB 664 (Yee/ Wolk) states counties may implement Laura's Law without first forcing County Boards of Supervisors to undertake a special vote or represent that they they will treat everyone else in the county before they treat those who need Laura's Law. (Unfortunately it allows counties to limit the number of individuals in Laura's Law.) 

AB1265 (Conway along with Achadjian/Beth Gaines/Gorel/ Hagman/Harkey/ Morrell) allows individuals under Laura's Law to receive treatment for up to one year (instead of the six month max previously allowed). It would also, smartly, require facilities discharging involuntarily committed patients first evaluate them to see if they could benefit from Laura's Law. They would then notify county officials so they can file a Laura's Law petition. 

AB 1367 (Mansoor along with Achadjian/ Alle/ Conway/Beth Gaines/Gorel/ Hagma/ Harkey/ Morrell). Like SB 585 (but using different language ) it clarifies that MHSA funds may be used to implement Laura's Law. It also makes changes (not necessarily improvements) to Prevention and Early Intervention (PEI) funds.

Numerous setbacks in care for seriously mentally ill

Sorry for not sending summer Mental Illness News. Here are recent developments in serious mental illness (not mental “health”).

 

Announcement: VIDEO FOOTAGE WANTED

We would like video of people with serious mental illness who are off medications and psychotic. If you have, please send. Try to get permission to use, but if you can't, we can blank out faces if needed. We want to educate the public about what serious untreated mental illness looks like. Footage may come from police interrogations, home video, trials, whatever. Most advocacy groups won’t allow public to see untreated serious mental illness. We want to change that because we believe a better understanding will lead to better laws and treatment.

 

LIBERTARIAN Thomas Szasz, progenitor of the ‘mental illness is a myth’ myth died. Szasz’s ideology that mental illness is a myth has permeated parts of government and prevented millions from receiving treatment. The NY Times obit revealed his prior connection to Scientology. Relatedly, we prepared a fact sheet comparing and contrasting Scientology (CCHR) and Mindfreedom. To their credit, the Libertarian Cato Institute ran our piece on How involuntary commitment & Treatment can increase civil liberties of mentally ill. Dr. Ronald Pies highlighted the pathology of schizophrenia and Rael Jean Issac, author of the most brilliant book on subject, Madness in the Streets took on Szasz directly.

 

CONSUMER NEWS

 

• In MICHIGAN, video emerged of Milton Hall, a man known to have mental illness and going untreated being shot and killed by police who felt threatened.
• FLORIDA police felt threatened by and killed mentally ill Ghulam Yahya Mujtaba.
• IN TEXAS, Thomas Cafall, a man with mental illness killed two at TEXAS A&M before being shot by police.
• IN COLORADO Mentally ill Kyle Miller, was shot by police after pointing a gun at officers.
• In ARIZONA Jared Loughner shot Gabrielle Giffords he is being given the involuntary treatment he needed, but could not receive before the shootings.

 

 

In light of the above, advocates argue for more police training. We believe if the mental health system were trained not to abandon people with serious mental illness and hide behind civil commitment laws the police would not need to be called.

 

It is nice to see consumer leaders emerging willing to stand up to the anti-treatment Szasian wing of the movement:

• Consumer blogger Natasha Tracy wrote on antipsychiatry consumers attacking those who disagree.
• Linda Saslow wrote a beautiful op-ed on being involuntarily committed.
• Erin Hawkes wrote “Forced Medication Saved My Life”.

 

 

FAMILY NEWS

 

Families are between a rock and a hard place: if they call the mental health system, they won’t help unless their child is well enough to accept help. When they deteriorate and the family is forced to call police, police can feel threatened and shoot. as two cases in CALIFORNIA demonstrated.

• Julian Kurita in NY received the minimum sentence, after his mom pleaded for the court for leniency when he was convicted of killing her husband, his father due to his schizophrenia.
• Jeneen Interlandi wrote a moving and highly visible piece in Sunday NY Times Magazine about civil commitment laws creating an inability to get her father treatment for his mental illness and the needless pain and suffering that caused. Hundreds of families commented.

 

POLITICS OF SERIOUS MENTAL ILLNESS:

 

• New stats show state psych bed shortage is getting even worse.
• New Pew Center report shows states are making it harder for people with mental illness to get meds.
• The Supreme Court upheld the Affordable Care Act (ACA), but as we wrote it really doesn’t help seriously mentally ill who need hospital care.
• Sadly, Paolo del Vecchio, a non-MD, and a leader of the anti-treatment movement was made Director of SAMHSA. (On the plus side legislators discussed cutting SAMHSA’s budget as we have suggested).
• Marvin Ross wrote on transplant committees denying organ transplants to people with schizophrenia.
• When James Holmes killied 12 in a COLORADO movie theater we wrote on the inadequacy of legal system to handle persons with mental illness for National Review as did Dr. E. Fuller Torrey. Like most, James Holmes was known to the mental health system but was exercising his right to not accept treatment. Perhaps Pete Early said it best, in USA Today:

 

“The suspect's parents will be blamed, though our civil rights laws make it extremely difficult for family members to force anyone to see a doctor or seek medical treatment if he or she has a mental disorder and is acting oddly. By law, we protect the right of an individual to be "crazy." Yet, we become outraged when a Cho or a Loughner kill and maim.” Huffington Post blogger made a full-throated case for better assisted treatment laws.

 

 

CIVIL COMMITMENT NEWS:

 

• Thanks to our efforts the Department of Justice certified Assisted Outpatient Treatment as an “effective crime prevention strategy.”

• GEORGIA Legislators are looking into reforming their civil commitment laws.
• WEST VIRGINIA is contemplating reform of civil commitment laws and MIPO’s testimony was covered by the Charleston Gazette.
• TEXAS is starting to see the benefits of implementing Assisted Outpatient Treatment (a court order to stay in treatment while in the community).
• Thanks to advocates in TENNESSEE, Knoxville started a pilot AOT program in Knoxville.
• OHIO is giving discharged prisoners more medicines.
• The DELAWARE legislature started a group to evaluate civil commitment laws (although it is dominated by ‘mental health’ interests rather than those who have experience with people with serious mental illness (ex. corrections).
• In Arizona, Deborah Fabos started a FB group for and blog for AOT reform. Mary Lou Brncik criticized AZ’s policy of incarcerating mentally ill.

 

BAD STATE NEWS:

 

• ILLINOIS received a court go-ahead to close Tinley Park Mental Health Center which (gasp!) provides inpatient psychiatric services to severely mentally ill.
• Pierce County WASHINGTON jail saw OT costs soar because of incarcerating mentally ill.

 

MEDICAL BRIEFS:

 

New fact sheet shows ANOSOGNOSIA (lack of awareness that you are ill) prevents many seriously mentally ill from getting treatment. There was a tempest in a teapot when pop-media reporting spanking is associated with mental illness. Not true.

 

BEST QUOTES

 

”A mentally ill person in US can get a gun easier than healthcare for their illness.”

 

"With respect to severe mental illness, our county has a “can't do, can’t change, cant fund and can’t help attitude”

said Jim Bassler, who’s son Aron killed two and was hunted down by police and killed after the mental health system used civil commitment laws to deny him care.

PSYCHIATRISTS:

 

• Dr. George Dawson (a/k/a “Real Psychiatry”) and James Coyne (a/k/a “Skeptical Sleuth”) regularly tackle the internet memes, myths, pop-psychology and nonsense surrounding serious mental illness. Coyne wrote how the race towards early identification of ‘at-risk’ individuals (as opposed to treating those who are already ill) may be leading to oncologists being bribed by pharma to find 'mental illness' in Psychology Today.
• Dr. Sally Satel, Dr. Steve Sharfstein, and Dr. E. Fuller Torrey did a brilliant serious mental illness roundtable discussion that focused on Dr. Torrey’s succinct analysis of the failure of federal mental ‘health’ system. The roundtable focused on SAMHSA encouraging states to move away from medical treatment; the failure to use Assisted Outpatient Treatment; the lack of psychiatric hospital beds and many of the other issues important to Mental Illness Policy Org but ignored by mental ‘health’ community (NAMI, MHA, consumertocracy, etc.)

 

JUDGES, POLICE & CORRECTIONS

 

• Judge Leifman says, ““We never deinstitutionalized; we just transferred responsibility from a hospital system to the prison system,”
• GEORGIA prison chief wrote on why we should “Decriminalize Mental Illness”
• Michael Biasotti, President of NYS Association of Chiefs of Police encouraged NY legislators to close the cracks in Kendra’s Law.

 

NEW YORK

 

Mental Illness Policy Org was very active in NYS this summer and started a NY Specific site. We wrote too many op-eds and testimonies to present them all here.

 

NY FAILURE TO CLOSE CRACKS IN KENDRAS LAW:

 

In spite of our efforts the legislature did not close the cracks in Kendra’s Law as proposed by NYS Senator Catherine Young and Assembly Member Ailleen Gunther. Mentally ill individuals discharged from prisons, jails, and involuntary commitment will continue to go to the community without first determining if they could benefit from enrollment in Kendra’s Law. This was a victory for NY’s mental ‘health’ community and a defeat for those who care about people with serious mental illness. See numerous editorials and op-eds in NY Daily News, and op-eds in NY Post. We thank them for their support (although don’t agree with periodic use of juvenile and offensive language). Highlights include our own op-ed blaming NYS OMH Commissioner Michael Hogan and this by Michael Benjamin. The Daily News blamed NYS Assembly MH Committee Chair Felix Ortiz for acknowledging the dangers and Felix Ortiz for doing nothing, and Felix Ortiz for promising hearings he never even held. Other papers around the state (that no longer make the articles available online) also supported reform. Thanks to our efforts the Department of Justice certified Assisted Outpatient Treatment as an “effective crime prevention strategy.”

 

PATIENT’S RIGHTS IN NY

 

NYS is holding hearings on how to comply with Olmstead v. L.C. which held that services for persons with mental illness be provided in the “most integrated setting ". We testified greater use of Kendra’s Law can prevent people from going to incarceration. The commission did not hold any hearings in jails or prisons where those who live in the least integrated setting are.

 

NY MENTALLY ORDERED OUT OF GROUP HOMES

 

NYS OMH Commissioner Michael Hogan also issued instructions to kick seriously mentally ill people out of adult homes.

 

REPORT ON NYS MENTAL HEALTH COURTS issued

 

LYNN SHUSTER one of the best advocates for improved care for seriously mentally ill in NYS stepped down as leader of NAMI Buffalo. Her parting words,

 

“Never trust a bureaucrat. It's THEIR money (and power and prestige, it's just our loved one's lives. And we know which comes out on top. "Making nice" makes you feel good, but doesn't result in success. News reporters are our friends. Tell the truth, the REAL truth.... Maintain a sense of humor even in dark days--we all need to laugh. Persevere. Persevere some more.... “

 

 

CALIFORNIA

 

Mental Illness Policy Org was very active in California and started a site on Laura’s Law and a site on Problems with Proposition 63/Mental Health Services Act. We had numerous op-eds and letters published including this by Mary Ann Bernard

 

INSIDER DEALING IN CALIFORNIA MHSA/PROP 63:

 

Mental Ilness Policy Org researched and issued a report finding over $16 million of Prop 63 funds going to oversight committee commissioners own organizations and a salary of $681,758 for Rusty Selix.

 

CA MHSA FUNDS NOT REACHING MENTALLY ILL

 

Due to voters altruistically passing Prop 63, a 1% tax on millionaires to fund services (Mental Health Services Act) for people with “serious mental illness”, California is the only state with plenty of money to provide care for people with serious mental illness. But it is being diverted elsewhere. Taking off on the work of Carla Jacobs, Rose King, Teresa Pasquini, and many others in CA, Hannah Dreier at AP reported Calif mental health dollars bypassing mentally ill . This led to editorials, calls for an investigation, the consideration of an investigation, our criticism, and a coverup by those who approved the spending. (They failed to disclose that the programs do not serve people with mental illness as the legislation requires.)

 

How can you help in California?

 

Be a Whistle Blower. The auditor wants to hear about problems with MHSA. She needs your help. If you know MHSA Programs that do not serve people with serious mental illness, especially in Los Angeles, please send them to the auditor. Make them as specific as possible and include links, details that will allow verification. You know the California mental illness system better than the auditor, so send Ms. Howle the tips she needs:

Elaine M. Howle

California State Auditor

555 Capitol Mall

Suite 300

Sacramento, California 95814

Phone Number: (916) 445-0255

General Fax: (916) 327-0019

Executive Office Fax: (916) 323-0913

 

Email a copy of your information about programs that do not focus on serious mental illness to those trying to stop the diversion of MHSA funds.

 

 

LAURA’S LAW

 

CalMHSA gave (and MHSAOC approved) a $2,917,092 grant to Disability Rights California and $1,539,225 to California Network of Mental Health Clients which will be used to prevent counties from providing Laura’s Law to patients who could benefit from it. This supplements SAMHSA money flowing into CA also being used to prevent those who don’t know they are ill from receiving treatment.

 

• SACRAMENTO County Mental Health Board subcommittee supports implementing Laura's Law, but the full committee found an excuse not to pass this on to board of supervisors.
• MENDOCINO health director made false claims about Laura’s Law which led the Board of Supervisors to punt, which we answered.
• SAN FRANCISCO’s health director tried to position a voluntary program as a substitute for Laura’s Law. We answered. As did SF Chronicle which has done a tremendous job covering Laura’s Law. Also the Examiner.

 

Thank you for your financial support which makes our work possible. Together we will get more mental ‘health’ money going to people with ‘serious mental illness’.