Another tragic story in Kentucky and why HR 3717 is needed! ACT NOW to help families!

click here to read story:
Man arrested after attempting to murder uncle and Boyle sheriff with pickup truck - The Advocate Messenger: Boyle

Yet, another tragedy where an individual had a 10-year psychiatric history, but was released too soon after a brief 72-hour hold!

Review the list below and check off the many acts needed that could have prevented this tragedy.

Another reason to inform your Congressman of Rep. Murphy's HB 3717/Helping Families in Mental Health Crisis Act. 

This Act fixes the nation’s broken mental health system by focusing programs and resources on psychiatric care for patients & families most in need of services.

1.) Empowers Parents and Caregivers

2.) Breaks down barriers preventing doctors and mental health professionals from talking to parents about mentally ill loved ones who are in an acute mental health crisis

3.) Fixes Shortage of Inpatient Beds

4.) Increases access to acute care psychiatric beds for the most critical patients.

5.) Alternatives to Institutionalization

6.) Provides alternatives to inpatient care through court-ordered ‘Assisted Outpatient Treatment’ — reducing rates of imprisonment, homelessness, substance abuse, and costly ER visits for the chronically mentally ill.

7.) Reaching Undeserved and Rural Populations

8.) Advances tele-psychiatry to link pediatricians and primary care doctors with psychiatrists and psychologists in areas where patients don’t have access to mental health professionals

9.) Driving Evidence-Based Care

10.) Creates Assistant Secretary for Mental Health (HHS) to coordinate federal government programs and oversee evidence-based models of care developed by the National Institute of Mental Health at Community Mental Health Centers. Ensures federal programs are optimized for mental health and patient care rather than bureaucracy.

11.) Stabilizing Patients Beyond the ER

12.) Protects classes of drugs so physicians can prescribe the appropriate medications for mental health patients enrolled in Medicare and Medicaid (similar to epilepsy, cancer)

13.) Advances Critical Medical Research

14.) Authorizes the BRAIN research initiative at the Nat’l Institute of Mental Health

15.) Promotes High Quality Behavioral Health Clinics

16.) Improves quality and expands access to integrated medical and mental healthcare at community mental health providers

17.) Department Of Justice Reforms

18.) Reauthorizes mental health courts so patients are treated in the healthcare system and not warehoused in the criminal justice system

19.) Behavioral Health Awareness For Teens

Please contact your Rep in Congress and ask them to co-sponsor Rep. Murphy's HB 3717/Helping Families in Mental Health Crisis Act. 

The fastest way to find your Rep phone number is to enter your zip code at:  http://www.opencongress.org/people/zipcodelookup

SB 50 is a "life saving" AOT bill for Kentucky

AOT saves lives, helps families help their loved ones, and saves state funds. SB 50 is a comprehensive bill that can actually be implemented.

 

Please thank Senator Denton for sponsoring an “assisted outpatient treatment" (AOT) bill called SB 50. 

Phone: (502) 564-8100 Ext. 646 

Email: click here 

Click here to download a copy of HB 50.
SB 50 (BR 136) - J. Denton

   

Summary: This bill creates a new section in the KRS 202A, and makes it easier for District Courts to order outpatient community mental health treatment outside a hospital. This bill will allow individuals who are too ill to understand they need help (who have been diagnosed with a severe and persistent mental illness) the opportunity to receive treatment in a less-restrictive environment. 

Currently an individual can only qualify for court-ordered outpatient treatment if they are already in a hospital. Most who become a danger to self or others and meet inpatient criteria end up in jail or prison, long before they receive the help they so desperately need.  

In the past 31 years, the current community based outpatient agreed order under the KRS 202A.081 did not provide a safety net provision for those noncompliant with their treatment plan. This is one reason of many it has been woefully underutilized. 

Currently there are many treatments, programs and resources available for individuals with disabilities to regain their life — yet if an individual with a psychiatric disorder/brain disease does not believe they are sick and become incompetent (too sick to ask for help), there is no way they can access services. 

This in turn, sets the individual up for failure when they are released such as a criminal record that prohibits them from gaining employment, housing, shelters, etc.

Assertive Community Treatment (ACT) Teams or Intensive Case Management (ICM) are wonderful resources for these individuals, but without AOT first  — it is rare for this subset of individuals struggling with psychiatric disorders/brain diseases to sustain stability.

SB 50 bill sets up a comprehensive system for Kentucky to implement court-ordered outpatient treatment including: 
  

1. The development of a treatment plan unique to each individual.
   
2. The process for hearings authorization of a 72-hour if failure to comply with orders.
   
3. It provides for the right to stay, vacate, or modify orders.
   
4. It provides for a process to change a treatment plan.
   
5. It authorizes extension of orders and repeals KRS 202A.081. 
   

SB 50 creates a new code that contains new criteria for court ordered outpatient treatment. Criterion for court ordered outpatient treatment:

(1) Based on clinical observation and a review of treatment history, a person suffering from severe mental illness if not treated is likely to:

(a) Cause the person to present a danger or threat of danger to self or others; (b) Cause the person severe mental, emotional or physical harm.; (c) Significantly impair the person’s judgment, reasoning, functioning or capacity to recognize reality. (d) Substantially diminish the person’s ability to make informed decisions regarding or his or her need for sustained medical treatment. 

(2) Unlikely to adequately adhere to outpatient treatment on a voluntary basis as demonstrated by the person’s prior history of treatment, non adherence or specific characteristics of the person’s clinical condition that prevent the person from making rational and informed decisions regarding mental health treatment; and

(3) In need of court ordered outpatient treatment as the least restrictive alternative mode of treatment presently available and appropriate. 

Behind the wall: I am the Mother of a gifted man who has many talents and abilities. My son has a brilliant IQ, excellent communication skills and unquenchable drive for success! Unfortunately, his untreated brain disease, holds him back! 

"Each time a mass shooting or a preventable tragedy appears in the media, everyone asks, “where are the parents?" Yet the family’s hands are tied — we have no rights to help protect ourselves or help our loved ones receive necessary treatment." 

A Few Facts: SB 50 is for families who have loved ones trapped in the revolving door – too compromised to utilize voluntary resources and medical services, yet not “dangerous enough” to meet the overly restrictive inpatient criteria! Even if an individual is hospitalized, 72 hours or a few days – is not long enough to find the road to recovery.

• To complicate matters, the first psychotic break usually appears in late teens or early adulthood, while the young brain is still developing. This is also the around the time many begin to experiment with illegal and dangerous substances, that can also bring on the early onset of psychiatric disorders such as Schizophrenia and Bipolar disorder.
• 1 in 4 individuals will develop a psychiatric disorder/mental illness in their lifetime, but only 1 in 17 — suffer from a "serious" mental illness or debilitating brain disease. 40-50% of this 1 in 17 group, do not recognize they are ill due to lack of insight or Anosognosia. Anosognosia, is an anatomical brain condition that makes a person unable to recognize their own illness – no matter how painfully obvious it may be to everyone around them.
• Without an AOT law there are no safety nets to help these individuals, (many under the age of 21) receive needed treatment and resources, which eliminates them from becoming disabled by irreversible brain damage!  
• Essentially, the current mental health law in KY lacks emergency programs, leaving the sickest and most vulnerable individuals accountable for their own disease, and then discriminates against these same individuals due to their symptoms.
• Civil rights attorneys fight to protect these individuals from being hospitalized against their will, (even when they are too ill to understand they are psychotic) ... which leads to the loss of their civil rights after they are dumped in overcrowded jails! 

Currently, if your family member becomes a danger in your home, both Kentucky mental health providers and law enforcement, encourages these families who are in crises, to file restraining orders against our own family members  — during an acute psychotic break! How would you like to force your sick loved one surviving his first serious bout with cancer — to live on the streets? 

If you compare the seriousness of this psychiatric disease to heart disease, then we would be forcing a person who is having a heart attack “to jail” with the hope that months later, they will eventually find needed treatment!

SB 50 will help Kentucky families, it will save lives, and it will save state funds. It will help STOP the revolving door.

Please help us pass SB 50! Call (502) 564-8100 Ext. 646 and state you support this bill!
    

How supporting the "Helping Families In Mental Health Crisis Act /(HR 3717)" can help the Homeless and their families!

By GG Burns

Over the weekend, I became involved with a Facebook post generated by Debra Hensley and many of her friends. Debra currently serves as Vice-Chair of the Mayor's Commission on Homelessness and is a long time public servant from Lexington.

Debra’s post began with her search for a well-known homeless woman who some refer to as “Dorothy” or even as an “iconic” Lexingtonian.

In a few hours, one post had generated over 184 likes, 166 comments and 32 shares. Since Lexington temps were predicated to plummet to 0 by Sunday evening, this created quite a frenzy of solutions among Debra’s friends. Some believed if Dorothy refused shelter she might meet inpatient criteria for hospitalization. (This was assuming that Dorothy has serious “untreated” mental illness.) Others believed that we should respect Dorothy’s rights – after all, she’s not hurting anyone by living on the streets, right?

According to the latest government data, more than 600,000 Americans are homeless on any given night. Each year, about 700 homeless people die from hypothermia, according to the National Coalition for the Homeless.

If the “Dorothys" living on our streets are not being arrested, refuse shelter and other community resources – they must not be costing tax payers anything, right? Think again!

According to the Mayor Gray’s Commission on Homelessness Report published on Jan, 2013:  Homelessness can cost the community between $35,000 and $150,000 depending on the type of services needed. The cost to provide housing and services, however, is between $13,000 and $25,000 an individual. Therefore, a homeless person on the street or in the shelter system can cost up to five times as much as those who are permanently housed! Click here to review the report: http://www.lexingtonky.gov/Modules/ShowDocument.aspx?documentid=24190

In the Mayor's Homelessness’ Report recommendations for "outpatient treatment" are revealed on page 42. Some persons with severe mental illness do not accept that they are ill and will not take their medication or participate in treatment. Because the law protects individual civil liberties, it requires a court order to force people to do so. In Kentucky, court-ordered outpatient treatment is allowed under KRS 202A.081 in limited circumstances when symptoms are severe and long-term hospitalization appears to be the only option. Consequently, it is not used as often as it is needed.

"There is a ground swell of support for changing the civil commitment legislation to broaden the ability to order an individual into outpatient treatment. Changes in the legislation would allow treatment to be ordered any time there is evidence that an individual has a significant history of problems that are directly related to not following treatment recommendations. A change in legislation will have a positive impact on reducing an individual’s cycle from being on the street, to jail, to homelessness due to untreated mental illness."

On the Facebook thread about "Dorothy" some of us suggested if rescue measures did not occur, the police would sadly find her dead! The story written here by Lexington Herald Leader journalist, GREG KOCHER, reveals the entire story much better than I. Greg gives credit to individuals such as Debra Hensley, the Lexington Police and Connie Milligan at Bluegrass.org, for their heroic efforts, for which I am grateful. The entire article can be found here: http://www.kentucky.com/2014/01/06/3020794/lexingtonians-use-facebook-to.html

Dorothy’s rescue story explains the complexity of the community’s inability to provide needed mental “health” resources, because she doesn’t believe she needs them. I am not a doctor, but this is most likely due to Dorothy’s lack of insight or Anosognosia to her condition.

According to Treatment Advocacy Center: Anosognosia - "lack of insight" or "lack of awareness" - is believed to be the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications. A result of anatomical damage to the brain, it affects approximately 50% of individuals with schizophrenia and 40% of individuals with bipolar disorder. 

Next time you encounter a person like “Dorothy,” huddled in a dark alley, obviously mentally ill and suffering – please consider there are solutions and your call can make a life saving difference beyond a few nights. 

Not mentioned in the Lexington Herald Leader story are solutions like "AOT", a separate outpatient standard law, which would enable individuals to have options to live in a least restrictive alternative environment - and not wait until they deteriorate - reaching dangerous inpatient criteria. 

This story was later repblished on "SHINEYAHOO.COM" here:http://shine.yahoo.com/healthy-living/facebook-saved-one-homeless-woman-deep-freeze-201700405.html

As the Mother of a young man diagnosed with a serious brain disease and advocate for improving mental health laws, my recommendation is simple: Support HR 3717.

What can we do as a society to bring needed change for individuals and their families suffering with serious "untreated" mental illnesses (brain disorders)? 

1.) learn more about the mental health laws in Kentucky, or in your state.

2.)  Learn about needed solutions that will redirect funds and have a more humane impact for individuals and families like “Dorothy”.

3.) Call your Representative in Congress and ask them to co-sponsor Rep. Murphy’s HB 3717 Bill. View a list of numbers for Kentucky here.

 4.) Follow this Blog and help desperate families like mine to advocate to change state laws. GET INVOLVED!

Families of young adults in crises, have been pushed aside with “NO RIGHTS” due to civil liberties laws, HIPPA and government grants that sometimes leave out those too ill to ask for assistance.  

Millions are spent on anti-stigma campaigns instead of focusing on treatment that would help end stigma. The most stigmatizing barrier to treatment is how brain disease is managed under behavorial health but should be managed under physical health. We need to update our diagnostic categories to classifications that reflect the severity of brain illness (much like cancer-stages). 

The contents of Murphy's bill will help families in crisis and includes provisions for states to support AOT. By helping HR 3717 pass, we as a society can make an informed decision to not neglect the most vulnerable members of society, those with severe mental illness/brain disease who are suffering from homelessness and/or repeated and traumatic experiences with law enforcement. Instead, reach out and help those individuals seek treatment and experience life - instead of being forced to barely survive - and sometimes die - in the cold, alone and fearful.

Civil Liberties and Mental Illness: Best Article Ever Written

Click here to read the article:
Civil Liberties and Mental Illness: Best Article Ever Written

To quote the author of UNCIVIL LIBERTIES, Herschel Hardin

 "How can such degradation and death -- so much inhumanity -- be justified in the name of civil liberties? It cannot. The opposition to involuntary committal and treatment betrays profound misunderstanding of the principle of civil liberties. Medication can free victims from their illness -- free them from the Bastille of their psychosis -- and restore their dignity, their free will and the meaningful exercise of their liberties." 

Rep. Murphy Responds to White House Proposal on Background Check Rules

Chairman Tim Murphy welcomes discussion on treatment side of mental illness!

For Immediate Release: Friday, January 3, 2014

(WASHINGTON, DC) — House Energy and Commerce Oversight Subcommittee Chairman Tim Murphy (PA-18) made the following statement today following the public release of a White House proposal for two new administrative rules on addressing barriers to uploading state records of the dangerously mentally ill into the National Instant Criminal Background Check System (NICS).

“I’m encouraged to see the assisted outpatient treatment (AOT) model of care being recognized as a legitimate and important way to help the mentally ill who are committed by a judge to treatment in the community. AOT saves lives, money, and makes sure treatment is accessed through the healthcare system rather than the criminal justice system, which is why my Helping Families in Mental Health Crisis Act (H.R. 3717) encourages states and counties to utilize AOT programs.”

“While this proposal targets the HIPAA barrier preventing hospitals from communicating with the justice system, we must fix the HIPAA barrier preventing physicians from communicating with the parents and caregivers of the severely mentally ill.”

“I will be examining the details of this proposal in the coming days but I remain singularly focused on advancing my Helping Families In Mental Health Crisis Act and getting the 11-plus million Americans with serious mental illness the treatment they desperately need. Ultimtely, the most needed reforms in mental health policy must be debated and enacted through Congress.”

Last month, Rep. Murphy unveiled landmark mental health reform legislation, the Helping Families In Mental Health Crisis Act (H.R. 3717), following a year-long investigation into the nation’s broken mental health system.

Praise and support for Murphy’s bill has come from parents’ groups, the nation’s leading mental health professionals, and newspaper editorial boards including the Wall Street Journal, which wrote that the legislation is “an informed attempt to overhaul a broken system” that “might even prevent the next Newtown.”

Dr Insel's (NIMH) video on how we should change "Mental" Illness to Brain Disease!

It's long overdue and time that "mental disorders or behavioral health problems" such as Bipolar and Schizophrenia, be reclassified as Brain disease! 

Thank you NIMH and Dr Insel. 

Click here for more info
:http://www.nimh.nih.gov/about/updates/2013/mental-disorders-as-brain-disorders-thomas-insel-at-tedxcaltech.shtml

A rethink is needed in terms of how we view mental illness, stated National Institute of Mental Health Director Thomas Insel, M.D., in a recent TEDx talk at the California Institute of Technology (Caltech) in Pasadena.

Deaths from medical causes such as leukemia and heart disease have decreased over the past 30 years. The same cannot be said of the suicide rate, which has remained the same. A vast majority of suicides—90 percent—are related to mental illnesses such as depression and schizophrenia.

Insel believes part of the problem is that mental illness is referred to either as a mental or behavioral disorder. “We need to think of these as brain disorders,” he said, adding that for these brain disorders, behavior is the last thing to change.

SAMHSA Webinar on AOT

If you missed it earlier this month, this Webinar on AOT is a MUST WATCH!

SAMHSA Starts a Conversation on AOT -- published by the Treatment Advocacy Center (Dec. 3, 2013) The Substance Abuse and Mental Health Services Administration (SAMHSA), a federal agency charged with improving the quality and availability of mental health services, presented a highly illuminating public seminar yesterday on assisted outpatient treatment (AOT). Held at SAMHSA headquarters in Rockville, Maryland with live webcasting to hundreds of registrants, the event included Treatment Advocacy Center Policy Director Brian Stettin as a panelist. In the first half of the program, Duke University professors Marvin Swartz and Jeffrey Swanson gave highlights of the many AOT studies that they have conducted in New York and North Carolina, dating back to the late 1990’s. Their findings made a persuasive case that if properly implemented, AOT is a cost effective means to improve outcomes for people with severe mental illness who struggle with treatment adherence. In the panel presentation that followed, Brian cautioned against misinterpreting Drs. Swartz and Swanson’s findings to mean that AOT was only useful in states with ideal availability of community-based services. The panel also featured Dr. Stephanie Le Melle, Co-Director of Public Psychiatry Education at Columbia University and the New York State Psychiatric Institute, who spoke of the positive results she has had in treating patients under AOT, and Chaku Mathai, a peer advocate and longtime AOT opponent. Archived video of the four-hour seminar can be viewed here: http://services.choruscall.com/links/samhsa131202.html While we have certainly taken our shots at SAMHSA over the years for inattention to the needs of people with severe mental illness, today we offer only praise for facilitating this critical discussion. In her remarks, SAMHSA Administrator Pamela Hyde promised that yesterday was “only the beginning” of the agency’s plans to keep AOT in the spotlight. Count us in for whatever’s next. To comment, visit our Facebook page. Visit our blog archive to read all our recent posts.