Proposed Kentucky bill could help keep mentally ill out of hospitals while receiving assisted outpatient treatment

• Deborah Highland
 
• Dec 3, 2016
  

A Louisville lawmaker is, for the fourth time, attempting to address mental health care in Kentucky with proposed legislation that would help keep the state's mentally ill out of hospitals by establishing court-ordered outpatient mental health treatment.


"We have not really dealt with mental health in Kentucky," said Rep. Tom Burch, D-Louisville. "I have a compassion for that. If I do anything in my life, I hope that I will be able to pass this legislation. I don't care who gets credit for the bill, I just want the bill to pass."


Burch is referring to his bill, BR 87, filed Nov. 23, that would allow a mentally ill person who is already involuntarily hospitalized to be discharged from the hospital if the person agrees to court-ordered outpatient mental health treatment. The second part of the bill addresses mentally ill people who have been involuntarily committed to a hospital twice within a 12-month period, creating a new method for these people who meet certain criteria to access court-ordered outpatient treatment without having to be committed again.


The hope behind the proposed legislation is that once the people who are served by court-ordered outpatient mental health treatment have had a longer period of stabilization, they will be more likely to be fully compliant in their mental health care and better able to recover in their own homes and communities without repeat hospitalizations.


"I support anything to try to assist those with mental illness," Warren County Attorney Amy Milliken said. In some cases, "they don't recognize that they have a mental illness until it's too late. We've seen families try to help them and try to support them. The families are truly powerless to get them the treatment they need because we can only hold them so long."


Milliken's office oversees involuntary commitment court proceedings. In most cases, people are involuntarily committed for 72 hours and once they are medicated and deemed stable, they are released from the hospital. What sometimes happens is because they have been stable for such a short period of time, they will decide to stop taking the medication that stabilized them and will return to the mental state that landed them in involuntary hospitalization.


The second portion of the proposed legislation referred to as "Tim's Law" is named for a man who was repeatedly hospitalized due to schizophrenia.


"It's named for a man, Tim Morton, from Lexington who had a serious mental illness and had a condition called anosognosia," said Dr. Sheila Schuster, a licensed psychologist and executive director of the Kentucky Mental Health Coalition, which supports the proposed legislation. "That means you are so ill you don't recognize that you have an illness. He had both physical illnesses and mental illnesses. His mom, trying to keep him alive, could not talk him into taking his medication.
"The only thing she could do was take out a mental inquest warrant to Eastern State Hospital and they would admit him for a 72-hour hold and get him on his medications. He would do that for a while then he would quit taking them. ... He was hospitalized 37 times over a 15-year period. He passed away from physical illnesses that were never treated."


People like Morton with serious mental illness such as schizophrenia die, on average, 25 years before their peers who do not have serious mental illnesses. They often have other illnesses, but because of their mental illness don't know that they are sick and need treatment.


"What we're trying to do is get people treatment without having to go through the mental inquest warrant and have people hospitalized," Schuster said. "So we're focusing on a very narrow group of people – people who have a serious mental illness, people who have been involuntarily committed at least twice in the previous 12 months and people that have symptoms of anosognosia."


Milliken is familiar with a similar story in Bowling Green in which a severely mentally ill person committed suicide after the person's family tried to save that person through several involuntary hospitalizations.
"We tried and tried to help," she said.


The proposed bill, as it is currently written, would:


 Read more here: http://www.bgdailynews.com/news/proposed-bill-could-help-keep-mentally-ill-out-of-hospitals/article_d2cf2998-108b-5439-afa1-81eb93062281.html?utm_medium=social&utm_source=facebook&utm_campaign=user-share

Congress finally passed legislation to overhaul the broken mental health system!

(Dec. 7, 2016, by Treatment Advocacy Center)

Long overdue and years in the making, an overwhelming bi-partisan majority of Congress finally passed monumental legislation, known as the 21st Century Cures Act which includes the much needed "Helping Families In Mental Health Crisis Act" ... to overhaul the country’s fractured mental health system.

The legislation will address several significant areas of mental health treatment that have long eluded advocates and families struggling with mental illness and substance use disorders, such as increasing the number of psychiatric beds nationwide, elevating the topic of mental health by creating a federal position of assistant secretary for mental health and substance use disorders — that will require its chief have a clinical background — and requiring private insurers cover mental health care on an equal footing with physical health.

The Act will also fundamentally change the foundation for how the federal government prioritizes severe mental illness by:

Reforming SAMHSA:

* Creates a new Assistant Secretary for Mental Health and Substance Use Disorders to be presidentially appointed with Senate confirmation, who will oversee SAMHSA and coordinate related programs and research across the federal government, with emphasis on science and evidence based programs, and with the aid of a newly established Chief Medical Officer.

* Establishes a new federal policy laboratory for mental health and substance use, to elevate and disseminate policy changes and service models that work based on evidence, research, and science. 

* Funding and Strengthening Evidence Based Treatment Programs for SMI:

* Strengthens and expand critical Assisted Outpatient Treatment (AOT) programs to help break the revolving-door cycle through a grant reauthorization and funding increase for states to implement AOT, and permit states to use grant funding for AOT in civil courts as an alternative to incarceration.


* Establishes, hand in hand with AOT, a grant program for Assertive Community Treatment (ACT) teams to provide critical wrap around services in the community to people with SMI. 

* Provides states with new innovative opportunities to deliver much-needed care in IMDs to adult Medicaid patients with SMI.

* Strengthens community response systems with a grant program to create databases on psychiatric beds, crisis stabilization units, and residential treatment facilities.

* Directs CMS to outline for states innovative opportunities to use Medicaid 1115 waivers to provide care for adults with serious mental illness

Decriminalizing mental illness

* Allows DOJ funding to be used for civil AOT programs to provide treatment opportunities before incarceration.

* Allows DOJ funding to be used for Forensic Assertive Community Treatment Programs (FACT) for individuals with severe psychiatric disorders in the criminal justice system.

*  Creates federal mental health courts, and provides avenues for better screening and assessment of people with mental illness in the criminal justice system.

*  Provides law enforcement and the court system with Crisis Intervention Team (CIT) training and programs to divert people with SMI from the criminal justice system.

Mandating data collection on the role of SMI in public issues

*  Requires federal databases on psychiatric beds, crisis stabilization units, and residential treatment facilities.

*  Requires government reporting on federal, state, and local costs of imprisonment for individuals with serious mental illness, including the number and types of crimes committed by mentally ill individuals

*  Requires Attorney General data collection and dissemination regarding the involvement of mental illness in all homicides, as well as deaths or serious bodily injuries involving law enforcement officers

*  Clarifying the HIPAA quagmire and train health care providers so providers and families understand the circumstances under which they can share and provide protected information about a loved one with SMI.

*  Establishing a federal adult suicide prevention program.

The Treatment Advocacy Center will continue to work with its partners and advocates to ensure that people with serious mental illness and their families get the best care and support they need to avoid repeated incarcerations, hospitalizations and putting an end to stigma.

John Snook, executive director of the Treatment Advocacy Center, said, “It has been a long fight, and we are thrilled to see the Senate join their colleagues in the House today to pass reforms and send this bill to President Obama for his signature.”

http://www.treatmentadvocacycenter.org/fixing-the-system/features-and-news/3706-monumental-what-the-cures-act-means-for-severe-mental-illness

I wrote this in September 2016, as a response to a friend's blog post. It is a harsh reflection into my soul, after experiencing Kentucky’s mental health system failures for the 20th time in less than 10 years.

ANOSOGNOSIA -- #1 ENEMY   by GG Burns

I echo every word you wrote, Dede. It seems that I have more friends of children who have suffered with a brain disease and are now free, (passed), than I do with those who have figured out a way to recover. 

My son has "suffered" for most of his life. Nothing was easy for him (or us — his family), even though he was bright and full of life and joy until his brain illness took over. We tried everything. Twelve long years of IEP special accommodations in the school system; special diets, special vacations; (with as little stimuli as possible); special cocktails of meds; (some worked, some made him worse while others were like a miracle cure). For a while, in his late teens, the future looked good. He was adjusting and transforming into a responsible young man with enormous dreams.

Yet, as my son grew older, his desire to be normal, to be free of the labels and the "special world" we'd built for him became the enemy. He broke away from his life of special accommodations like an animal in chains. Once he was free of his chemical straight jacket, he refused to return. He was higher than a man on cocaine. The mania and impulsive reckless life was what he wanted. In his world, he was king! He could now do anything and there were no rules or consequences. And even when his recklessness and abandonment met handcuffs, locked doors and bars, he didn't seem to notice because it forced him to sink deeper into a total psychotic break from reality. 

Overtime, as my son's illness rapidly progressed, my own health declined. For almost 11 years I have battled PTSD, anxiety, and painful autoimmune diseases. My son is trapped in a place that is worse than death -- the carousel of insanity, the revolving door that leads nowhere. It just keeps him from killing someone and then spits him back out to the streets ... untreated! 

We’d never treat a human being with Alzheimer’s this way, but yet, the USA abandons the sickest people in their country everyday to live in homeless shelters. The senseless system of “self-directed care” --  a recovery bullshit model developed for addicts not for people with serious brain damage -- forces people who are at their worst to hate their own parents! It keeps us from communicating with their medical providers even when they are hospitalized! Their medical providers are trained to tell our sons/daughters that we were the ones who made them sick! It’s worse than death for many of us. 

Read the rest of my post here:

 http://www.soonerthantomorrow.com/blog/2016/9/8/le9qs631xr06q46y371z9skgyu95m9