The Arizona Tragedy and Mental Health Care Statement by Michael J. Fitzpatrick, Executive Director, National Alliance on Mental Illness (NAMI)
When tragedies involving mental illness occur, it is essential to understand the nature of mental illness—and to find out what went wrong.
The U.S. Surgeon General has reported that the likelihood of violence from people with mental illness is low. In fact, “the overall contribution of mental disorders to the total level of violence in society is exceptionally small.” Acts of violence are exceptional. They are a sign that something has gone terribly wrong, usually in the mental healthcare system.
Nationwide, the mental health care system is broken. Arizona, like other states, has deeply cut mental health services. Arizona has a broad civil commitment law to require treatment if it is needed; however, the law cannot work if an evaluation is never conducted or mental health services are not available.
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NAMI list of articles
http://www.cbpp.org/cms/index.cfm?fa=view&id=1214
■ Arizona. Eliminated a host of behavioral health services for 4,000 children ineligible to receive such services through Medicaid, and has also cut case management, therapy, and transportation services for 14,500 individuals participating in a non-Medicaid program for the seriously mentally ill.
■ Colorado. Cut payment rates for mental health providers and eliminating funding for residential treatment for an estimated 626 patients each year in the state’s mental health institutes.
■ Illinois. Its FY2011 budget makes cuts in community mental health services for children that will limit access to services. Community mental health services for adults who are not eligible for Medicaid are reduced or eliminated.
■ Mississippi. The state’s mental health budget has been reduced 7 percent from FY10 budgeted levels and 22 percent from FY09 budgeted levels. Over time, these cuts have resulted in the reduction of 200 beds at the state mental health hospital, closure of 24 supervised apartments at a state residential center, closure of a state adolescent dorm, and elimination of some early intervention programs.
■ New Hampshire Reduced reimbursements to 10 mental health centers for children’s support services in FY11, likely resulting in longer waiting lists and more costly inpatient care as outpatient services become less available.
■ Ohio. Eliminated virtually all state funding for mental health treatment for individuals who are not eligible for the state’s Medicaid program.
It will likely take many days to understand the reasons and motivations behind this national tragedy. Many have pointed to mental health as an issue.
It must first be emphasized that people with mental health conditions are no more likely to be violent than the rest of the population. And we have science-based methods to successfully treat persons with even the most severe mental illnesses. A very small group of individuals with a specific type of mental health symptoms are at greater risk for violence if their symptoms are untreated.
At the same time, we must recognize that the nation’s mental health system is drastically under-funded and fails to provide Americans living with mental health conditions with the effective community-based mental health services they need. Sadly, in the current environment of strained state budgets, mental health services have been cut drastically just as demand for these critical services has risen dramatically.
Statement of Mental Health America on the tragedy in Arizona. MHA is the country’s oldest and largest nonprofit organization addressing all aspects of mental health and mental illness.
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Mental Health America: New National Survey Finds Jobless Individuals Four Times as Likely To Report Serious Problems
ALEXANDRIA, Va. (October 6, 2009)-A new national survey shows the economic downturn is taking a toll on the mental health of Americans. Individuals who are unemployed are four times as likely as those with jobs to report symptoms consistent with severe mental illness.
Americans who experienced involuntary changes in their employment status, such as pay cuts or reduced hours, also are twice as likely to have these symptoms, even though they are employed full time.
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N.J. to delay outpatient mental-treatment lawBy Adrienne Lu
Inquirer Trenton Bureau
The Christie administration will delay the implementation of a law that would allow a judge to require a person to undergo outpatient mental-health treatment, officials announced Tuesday, citing a lack of funding. Officials from the state Department of Human Services said that the law, which was prompted in part by several slayings committed by individuals with mental illnesses who had refused treatment, could not be implemented because the state “did not appropriate funds to the department to support its implementation.”
The current budget, Christie’s first since taking office, reduced appropriations for existing community mental-health programs by more than $11 million, according to a memo by DHS Deputy Commissioner Kevin Martone. That reduction followed previous years of cuts
. . .
Lawmakers who pushed for the law’s passage were disappointed with the delay and promised to fight the decision.
Assembly Human Services Committee Chairwoman Valerie Vainieri Huttle (D., Bergen) said the administration “does not have the authority to simply chose whether to implement laws. That arrogance is unacceptable in any situation, but it’s especially appalling when it threatens public safety and the health of those struggling with mental illness.”
This is not the first time the Christie administration has delayed the implementation of a law – officials recently requested a delay of the medical-marijuana law, but in that case, administration officials sought a formal delay by pleading their case to the bill’s sponsors, who agreed. The administration argued in that case that while it was making a good-faith effort to comply, officials needed more time to work out the details of the law’s implementation.
Huttle said that under the direction of Speaker Sheila Oliver, she intends to convene a hearing of the Assembly Human Services Committee to demand answers from the administration regarding the delay.
Politics aside, advocates say they hope those who need treatment will receive it before it is too late.
“The purpose of the whole piece of legislation was to be able to intervene in a timely manner before people became imminently dangerous to themselves or others,” Lubitz said.
Finding ways to help Minnesota’s poor get careWith a fraying health plan, some counties and hospitals are getting creative to help the poor get clinical care.
By WARREN WOLFE, Star Tribune
Last update: August 10, 2010 – 9:15 PM
As cracks emerge in Minnesota’s experimental new health care program for the poorest adults, about a dozen counties and hospitals have taken matters into their own hands — organizing charity care networks or, in some cases, paying insurance premiums so their patients can get better coverage.
“I’m not getting into the politics or whether the state made a bad decision,” said Jay Kieft, social services director for Kandiyohi County, struggling to keep the irritation out of his voice. “It’s just that we’ve got people who really need medical and mental health care, and the only way they can get it is show up at the hospital ER or drive 100 miles from Willmar to the Cities.”
General Assistance Medical Care (GAMC), which became the subject of a fierce fight between Gov. Tim Pawlenty and DFL legislators last spring, serves about 30,000 childless adults who earn no more than 75 percent of the federal poverty guideline. Most have chronic illnesses, half are mentally ill and 25 percent are homeless.
After much wrangling at the Legislature, a change in state law June 1 slashed the program’s funding by two-thirds and transformed GAMC from a statewide managed care system into a hospital-based system — with participating hospitals bearing much of the risk.
State officials had hoped many hospitals would choose to join the new GAMC, offering local residents coordinated care, even though each would receive a fixed pot of funding and would lose money. . .
More than a dozen people testified yesterday against changes limiting eligibility for state mental health services — changes that some critics say contributed to a 36 percent rise in deaths among mental patients in 2009 from the year before.
“This deplorable statistic is evidence of our dire situation,” said Eileen Uchima, executive director of the National Alliance on Mental Illness’ Hawaii office. “We understand that the state budget is dire, and tough decisions must be made, but we urge you not to make these changes on the backs of extremely vulnerable people.”
Uchima as well as several other people criticized the state Department of Health’s budget-cutting decision in July 2009 to halt treatment of new patients for several mental health problems, including post-traumatic stress disorder, personality disorder and major depression. . . .
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New York. Democrats on the Westchester County Board of Legislators have come up with a plan that they say will eliminate proposed cuts to services and still maintain a 1% tax decrease for residents. [Ed. note: Westchester County is among the wealthiest counties in the U.S., according to Census data.]
Last month, Westchester County Executive Rob Astorino [GOP] presented the proposed spending plan that included cuts to numerous social service programs.
Yesterday, the Westchester County Board of Legislators Committee on Budget and Appropriations unveiled its suggestions, announcing its proposed additions and changes to the spending plan before the December 6 required deadline.
The Committee’s plan includes $43 million in new spending and restores child care services, mental health services and the Section 8 Program.
. . .
And, The Budget Committee is also proposing the restoration of funding to four community mental health clinics in Peekskill, Mount Kisco, Yonkers and Mount Vernon that had been slated for closure.
. . .
Meanwhile, Republican members on the County Board of Legislators branded yesterday’s budget maneuvers by Democratic lawmakers as “fiscally irresponsible” and called the addition of $43 million in spending “a total disregard for the taxpayers of Westchester.” [Italics added]
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State Cuts Put Officers on Front Lines of Mental Care
By KATIE ZEZIMA
Published: December 4, 2010
Maine. — As community mental health systems fray under the strain of state budget cuts and a weak economy, law enforcement officers across the nation are increasingly having to step in to provide the emergency services that clinics have typically offered the mentally ill.
Police and sheriff’s departments that are already grappling with budget and manpower cuts say the situation is further straining their resources and forcing them to divert officers from their regular duties. It has also stoked fears among law enforcement officers of dangerous encounters between the police and people with severe mental illness.
“I worry that there’s going to be a tragedy,” said James Craig, chief of the Police Department here, where calls involving the mentally ill increased to 1,645 in 2009 from 1,424 in 2007. “I’m worried that an officer might lose his life dealing with a dangerous person, a person who really needs treatment.”
. . .
Despite increased awareness, many officers, mental health workers and advocates for the mentally ill say that with fewer hospital beds and reduced outpatient services — especially at centers that treat the uninsured — many patients’ family members and friends, and even bystanders, are turning to the police as the first choice for help when a crisis occurs. Many states are feeling the brunt of cuts that started years ago but have gotten worse because of the economy.
“A lot of people view calling the police as the only way to get loved ones any kind of treatment, because when the police come they have to do something,” said Laura Usher, the national Crisis Intervention Team coordinator for the National Alliance on Mental Illness. “But unfortunately that doesn’t necessarily always lead to appropriate treatment.”
“States across the country are cutting their mental health budgets, and people who are serviced by state mental health programs are the poorest, and they’re unable to get services any other way,” she added. “The community mental health system is broken.”
In Illinois, where mental health services were cut by $35 million this year — a $90 million cut was proposed — the state’s police departments are “essentially a 24-hour free service,” said Chief Robert T. Finney of the Champaign Police Department.
“We’re the people who get taxed with dealing with these people,” said Chief Finney, who is also vice president of the Illinois Association of Chiefs of Police. “Even if you arrest them and they’re released from your jail within hours, they’re back on your street doing the same thing.”
In Oklahoma, calls to the police involving mental illness have increased by 50 percent in the past year, said Stacey Puckett, executive director of the Oklahoma Association of Chiefs of Police. The state has cut about $17 million in mental health financing this year.
Ms. Puckett said officers were “traveling from one end of the state to the other and are out of their departments for 6, 8, 10 hours at a time.”
“It’s the bed shortage,” she said. “We just do not have enough beds for the numbers.”
Danny Ray of Ardmore, Okla., had to call the police in August after his 30-year-old son, who had been unable to get treatment, threatened him with a loaded gun.
“The police, if I had a problem right now, they are my only source of help,” said Mr. Ray, 57, whose son’s psychiatrist comes to town only once a month. Mr. Ray says he also finds it difficult to secure a bed for his son at the local hospital.
