We hope this message finds you safe and well as we work our way through the COVID-19 pandemic together. We encourage everyone to take this crisis seriously, to follow CDC recommendations for infection prevention and control, and to keep in mind that those living with severe mental illness may be disproportionately impacted. Our national partner, the Treatment Advocacy Center, highlights some of those vulnerabilities in this special edition of “Research Weekly”.
Meanwhile, for most people, stress and anxiety is best managed through maintaining structured days and a normal routine. With that in mind, while you may be stuck at home, the following virtual conference might be of interest.
———————
Healing Minds NOLA is honored to have been asked by the Schizophrenia and Related Disorders Alliance of America (SARDAA) to participate in an interactive, virtual conference this Saturday, March 21st that will focus on reclassifying schizophrenia as a neurological brain disease. Janet Hays will join Judge Steven Leifman; William Lawson, MD, PhD; and David Geiger, MEE on a criminal justice panel to discuss the impacts reclassification would have on the criminal justice system.
Do you think reclassification would reduce incarceration and homelessness for the 25 million Americans, and over 1 billion people worldwide, who are living with neurological brain disorders? Tune in to find out the latest from advocates, researchers, and policy experts who are working on solutions.
Here’s the full list of this year’s incredible speakers
———————
Our 2019 Conference Videos Are Now Available for Viewing!
Speaking of conferences, If you were unable to attend last year’s “Implementing a Full Continuum of Psychiatric Care” event co-hosted by Healing Minds NOLA, the Louisiana Supreme Court and the Louisiana District Judges Association, all of the conference materials and videos are up on our website. We hope you’ll take the time to watch! Here’s the link:
Implementing a Full Continuum of Psychiatric Care: Focus on SMI
——————–
Legislative Priorities
While the Louisiana state legislature has temporarily adjourned due to COVID-19, we are poised and ready to resume advocating once the suspension is lifted.
If you or someone you know has been impacted by the lack of programs, facilities and services for a loved one living with serious mental illness, we want to hear from you! Send an email to HealingMindsNOLA@gmail.com – Subject Line: “I WANT TO ADVOCATE” – if you would like to participate in our efforts.
Below is the communication with our recommendations that we sent to all state legislators on March 10, 2020.
Dear Legislator,
Healing Minds NOLA is an organization that advocates for alternatives to homelessness, incarceration and death for people living with serious mental illnesses and/or co-occurring substance use disorders. Below are our policy recommendations for a full continuum of coordinated psychiatric treatment and care. We would like to work with you on any or all of the following:
- Form an Interdepartmental Serious Mental Illness Coordinating Committee that is chaired by a psychiatrist.
- Urge the Governor to add serious mental illness (SMI) in the Federal Medicaid Institutions for Mental Diseases (IMD) Exclusion Waiver for Substance Use Disorders (SUD).
Background:
- In the fall of 2018, Secretary Azar announced a waiver to the federal Institutions for Mental Diseases (IMD) Exclusion rule for SMI (passed in 1965) that provides financial incentives for states to address community psychiatric and residential treatment bed shortages.
- “Institutions for Mental Diseases” (IMDs), are psychiatric hospitals or other residential treatment facilities that have more than 16 beds that mainly provide services to people with mental illness.https://www.nami.org/Learn-More/Mental-Health-Public-Policy/Medicaid-IMD-Exclusion
The IMD exclusion is an outdated, discriminatory federal rule that creates significant barriers to treatment for adults with severe mental illness. Louisiana applied for, and was awarded, a similar waiver but only to increase beds for people with substance use disorders, often a co-occurring condition associated with serious mental illness. - The lack of capacity in the community to care for this vulnerable population, and civil commitment laws that require the high bar of dangerousness and/or grave disability, has resulted in the over-use of forensic hospitals. It is simply cruel to wait until dangerousness, often involving the loss of life, in order to provide therapeutic interventions for people suffering with no-fault brain diseases. Forensic hospitals as a first stop for decent treatment and care are unnecessarily expensive for taxpayers and unsustainable over the long term.
- “Institutions for Mental Diseases” (IMDs), are psychiatric hospitals or other residential treatment facilities that have more than 16 beds that mainly provide services to people with mental illness.https://www.nami.org/Learn-More/Mental-Health-Public-Policy/Medicaid-IMD-Exclusion
- Support the rights of caregivers to participate in admissions and discharge planning from all inpatient and outpatient programs for loved ones with a serious mental illness. Ex: “A Concurrent Resolution Recognizing The Rights Of Family Members, Caregivers And Guardians Of Individuals With A Serious Mental Illness.”(azleg.gov/legtext/52leg/2r/bills/scr1005p.pdf)
- Increase funding for Assisted Outpatient Treatment (AOT). Louisiana passed a law in 2008 under Governor Jindal that allows parishes to create programs to address treatment non-adherence. Yet it was, and still remains, an unfunded mandate. AOT has been proven to reduce hospitalization, arrest and incarceration, homelessness, victimization, and also to prevent violent acts associated with mental illness, including suicide and violence against others. Read More: Treatment Advocacy Center
- Increase funding for Assertive Community Treatment (ACT and Forensic Assertive Community Treatment (FACT). ACT and FACT are medicaid reimbursable wrap around services for mentally ill people with or without charges.
- Reform civil commitment laws. Civil commitment laws should PREVENT dangerousness, not REQUIRE it. In addition to dangerousness and gravely disabled, psychiatric deterioration should be included as a 4th criteria for involuntary commitment. 22 states currently have psychiatric deterioration as a criteria for civil commitment. (http://www.treatmentadvocacycenter.org/grading-the-states)
- Open and expand clubhouse programs (http://clubhouse-intl.org) Clubhouses offer ongoing social supports and enhance mental and physical health by reducing disconnectedness and are proven to result in positive outcomes.
- Red flag law: Confiscating firearms from at risk individuals with a serious mental illness should trigger treatment. More information here.
- Fund group homes and congregate housing (including secured residential treatment housing) in addition to independent living options. Arizona legislation S.B. 1098 establishes the Housing Assistance Advisory Board (Board) to administer the Housing Assistance Pilot Program (Program). S.B. 1098 directs the Board to administer the Program for the purpose of providing grants to assist individuals who are transitioning from public assistance to secure housing. (https://www.azleg.gov/legtext/54leg/1R/summary/S.1098HHS-APPROP_ASPASSEDCOW.pdf)
- Increase funding for alternatives to incarceration.
Examples of where funding for deflection and diversion programs and services include:- Screening and assessment to identify individual risk factors/needs.
- Day treatment and day activity programs.
- Crisis respite services.
- Outpatient competency services
- Employment/vocational training services.
- Expedited access to state and federal entitlement benefits.
- Treatment for co-occurring substance use and trauma-related disorders.
- Community re-entry support services to assist individuals with linkages to basic needs after discharge, including ongoing treatment, housing, medications, clothing, and food.
Serious mental illnesses, like schizophrenia, bipolar disease and serious clinical depression are brain diseases that cannot be prevented, nor cured.
This document illustrates what schizophrenia looks like for a person that lacks insight that they have schizophrenia. A condition known as anosognosia. Because people with anosognosia do not know they are ill, they will not voluntarily seek treatment. Symptoms are not unlike dementia and Alzheimer’s Disease. However there are psychiatric treatments for people with serious mental illnesses, (with or without anosognosia), that can assist with successful disease management.
Untreated serious mental illness is a national disaster from which the state of Louisiana is not immune. The elimination of long-term inpatient psychiatric beds, lack of outpatient mental health resources and appropriate housing modalities for people suffering with long-term chronic diseases, has thrown the state of Louisiana into a mental health crisis. While only 4% of people in America have a serious mental illness, at minimum, 25 percent of America’s homeless suffer with SMI, and approximately 20 percent are in jails, and 15 percent are in state prisons – a huge over-representation!
As expected, the burden of care has largely fallen on the shoulders of ill equipped caregivers as well as law enforcement and the courts. Yet the criminal justice system lacks the facility and expertise to care for people with psychiatric diseases in correctional institutions.
Serious mental illness does not discriminate based on race, nationality, political affiliation, etc. For too long, people with the most severe mental illnesses have been excluded from systems of mental health care. Recently, as documented in a 3 part White House Summit and in the media, President Trump has taken steps to fund and support programs and services to mitigate the insane consequences of neglecting people with serious mental illnesses.
It is our hope that the Governor and Legislature will take full advantage of the incentives offered. It is incumbent upon citizens of Louisiana and policy makers to correct the ship, and we are more than willing to assist.
Thanks to all for your continued support! Stay safe!