Tuesday, December 13, 2016

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

    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:

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