Public Policy Report
Board Meeting, Sept. 29, 2009
As the leaders of Congress are grappling with Health Care Reform, it is important that NAMI Texas and its affiliates officially support the position that NAMI National has developed on Health Care Reform:
http://www.nami.org/PrinterTemplate.cfm?Section=August8&Template=/ContentManagement/ContentDisplay.cfm&ContentID=84791
Section 3.1 of the NAMI Texas Board Operating Policies and Procedures states, “All projects, activities, and partnerships of NAMI, its state organizations, and local affiliates must conform to NAMI National Bylaws and policies.”
Individual members might have differing views on Health Care Reform, but they should only put forth those views as individual citizens and not speaking for NAMI Texas or for their individual affiliates. Articles in local affiliate newsletters and/or public statements made by affiliate or state leaders in their capacity as representatives of their organization shall not voice positions differing from NAMI national’s policies and positions.
Submitted by Jackie Shannon, Committee Chair
Sunday, October 4, 2009
Monday, September 21, 2009
Updated Mental Health Code
17th Edition
Texas Laws
Relating to Mental Health
Reflecting changes in law passed by the
81st Legislature, Regular Session – 2009*
Throughout this book will be various statutory references to the Texas Department of Mental Health and Mental Retardation, Texas Commission on Alcohol and Drug Abuse and the Texas Department of Health. On September 1, 2004 these three agencies were combined to form the Department of State Health Services. Any reference in statue to the legacy agencies should be read to mean the Department of State Health Services.
Disclaimer – The information contained in this book does not constitute the provision of legal advice. While every attempt has been made to ensure the accuracy of the information contained in this book, the Department of State Health Services, its officers and employees disclaim any responsibility for any errors in content or formatting that may be contained herein.
*Most changes in law reflected in this book become effective on 9/1/09.
Texas Laws
Relating to Mental Health
Reflecting changes in law passed by the
81st Legislature, Regular Session – 2009*
Throughout this book will be various statutory references to the Texas Department of Mental Health and Mental Retardation, Texas Commission on Alcohol and Drug Abuse and the Texas Department of Health. On September 1, 2004 these three agencies were combined to form the Department of State Health Services. Any reference in statue to the legacy agencies should be read to mean the Department of State Health Services.
Disclaimer – The information contained in this book does not constitute the provision of legal advice. While every attempt has been made to ensure the accuracy of the information contained in this book, the Department of State Health Services, its officers and employees disclaim any responsibility for any errors in content or formatting that may be contained herein.
*Most changes in law reflected in this book become effective on 9/1/09.
Monday, September 14, 2009
Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage
From David Evans, Executive Director
Austin Travis County Mental Health Mental Retardation Center:
Last week the Kaiser Family Foundation released an issue brief examining how individuals with complex health care needs might fare in a reformed health system. The report, Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage , analyzed healthcare coverage for three individuals and cost sharing requirements to the Blue Cross Blue Shield Standard Option plan offered to Members of Congress and federal workers under the Federal Employees Health Benefits Program (cited as benchmark under a reformed health care system), and also takes into consideration Medicaid coverage.
What this study shows is that coverage for persons with complex health needs may be significant and broad - still containing cost provisions that are beyond the financial reach of middle class workers. They offer examples of disabilities that require treatments which could range up to $12,000 annually and out of pocket expenses from $21,000 to $32,000 for long-term care costs under such plans.
This study adds an important dimension to policy issues for people who would have health insurance coverage extended to include them - what benefits does that coverage include? The question cannot be answered accurately without careful examination of cost sharing and out of pocket expenses. To view and download the report, go to: http://www.kff.org/healthreform/upload/7967.pdf .
Austin Travis County Mental Health Mental Retardation Center:
Last week the Kaiser Family Foundation released an issue brief examining how individuals with complex health care needs might fare in a reformed health system. The report, Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage , analyzed healthcare coverage for three individuals and cost sharing requirements to the Blue Cross Blue Shield Standard Option plan offered to Members of Congress and federal workers under the Federal Employees Health Benefits Program (cited as benchmark under a reformed health care system), and also takes into consideration Medicaid coverage.
What this study shows is that coverage for persons with complex health needs may be significant and broad - still containing cost provisions that are beyond the financial reach of middle class workers. They offer examples of disabilities that require treatments which could range up to $12,000 annually and out of pocket expenses from $21,000 to $32,000 for long-term care costs under such plans.
This study adds an important dimension to policy issues for people who would have health insurance coverage extended to include them - what benefits does that coverage include? The question cannot be answered accurately without careful examination of cost sharing and out of pocket expenses. To view and download the report, go to: http://www.kff.org/healthreform/upload/7967.pdf .
Thursday, August 27, 2009
Senator Ted Kennedy: A Member of the NAMI Family
Statement of Michael J. Fitzpatrick
Executive Director, National Alliance on Mental Illness
NAMI mourns the passing of U.S. Senator Edward M. Kennedy, a true champion for individuals and families affected by serious mental illness. This is a profound loss for the NAMI family.
We do not have to struggle to remember what Senator Kennedy accomplished in seeking to improve the lives of millions of Americans. The real challenge would be to try to recall what he didn’t do. His idealism moved the country. His pragmatism and ability to work with liberals and conservatives alike enacted legislation.
Read the rest here.
Executive Director, National Alliance on Mental Illness
NAMI mourns the passing of U.S. Senator Edward M. Kennedy, a true champion for individuals and families affected by serious mental illness. This is a profound loss for the NAMI family.
We do not have to struggle to remember what Senator Kennedy accomplished in seeking to improve the lives of millions of Americans. The real challenge would be to try to recall what he didn’t do. His idealism moved the country. His pragmatism and ability to work with liberals and conservatives alike enacted legislation.
Read the rest here.
Wednesday, August 26, 2009
Lopez, the author and Los Angeles Times columnist who is portrayed by actor Robert Downey Jr. in the film "The Soloist," was the guest speaker at UTT
Lopez Details How One Man Helped Him Reconnect With His Work
By STEWART SMITH
Staff Writer
Steve Lopez encouraged several hundred incoming freshmen at the University of Texas at Tyler to develop a passion that would define their lives.
Lopez, the author and Los Angeles Times columnist who is portrayed by actor Robert Downey Jr. in the film "The Soloist," was the guest speaker at the freshmen convocation held in the R. Don Cowan Performing Arts Center on Tuesday morning.
Beginning in February 2005, Lopez began writing a series of columns about a homeless man he saw playing a two-stringed violin on Los Angeles' Skid Row. What was initially a piece about a "violin man," exploded into something much larger, igniting what Lopez describes as an unlikely friendship as well as a shifting his point of view regarding the city's homeless population.
While the columns, book and feature film have provided Lopez with national recognition, he considers the real gift to be the day he met Nathaniel Anthony Ayers. The meeting launched a friendship, and Ayers gave Lopez a new perspective.
Early on in his life, Ayers was a promising, naturally talented musician studying at The Juilliard School in New York City. However, a mental breakdown and schizophrenia left him reduced to living on the streets, crushing cockroaches and keeping sticks to ward off rats at night. His musical talent remains, however, despite often not being able to tell the difference between what is real and what is imagined.
Encountering Ayers, Lopez said his eyes were opened to the lack of attention society pays to those with mental illness.
"We wouldn't let 7,000 people crush cockroaches and go to sleep on the pavement of any city if they had cancer, if they had muscular dystrophy. It's OK because it's mental illness and we don't want to deal with it and we haven't through the decades and we've never come to grips with that. But that's not acceptable either, and Mr. Ayers has shown us why," Lopez said. "He's made it clear that those people are not strangers, they are our brothers and sisters, our sons and daughters, and that we can do better. I was never a giver. And I found so many rewards, probably in part because of the great challenges. It was a gift the day I met Mr. Ayers."
Lopez said Ayers has progressed. He no longer refuses assistance for housing and has begun to talk about his mental illness, thanks in part to watching the film, "The Soloist," Lopez said.
During his brief time at Juilliard, Ayers was a classmate of world renowned cellist Yo-Yo Ma. However, because of Ayers' perseverance, Lopez said he considers his friend to be more successful in life than Ma.
"They were launched from the same stage at the same time, which one though, really has been more successful? It's obvious Yo-Yo Ma became an international icon. Few people in the history of classical music have had commercial success like he has, but Nathaniel wakes up every day fighting demons, trying to distinguish between the real and the imagined," Lopez said.
"And each and every day he gets through that with his belief in music. And he clears a space and whether he plays the cello or the piano or the violin or the string bass or the flute, trumpet or French horn, he finds peace and it is because he has this passion that nothing can defeat. Few people in this world ever find this passion. I hope that you find it at UT Tyler. I hope you find something in your life that gives you purpose. Nathaniel's got it. And, to me in some ways, given his challenges, he is the more successful of the two when you look at Yo-Yo Ma and Nathaniel Ayers."
Lopez said his passion continues to be writing, thanks to Ayers.
"I think he reconnected me with column writing. I had done it for so long. I thought maybe I should try something else with the last years of my working life," he said. "But I think Nathaniel reminded me how much I enjoy doing this. I feel privileged all over again to have a stage. And that's more precious to me now, having gotten the chance to write about Nathaniel and do so in ways that might be helpful to educate people on public policy issues. So it's as if that longtime passion had been rekindled by him."
By STEWART SMITH
Staff Writer
Steve Lopez encouraged several hundred incoming freshmen at the University of Texas at Tyler to develop a passion that would define their lives.
Lopez, the author and Los Angeles Times columnist who is portrayed by actor Robert Downey Jr. in the film "The Soloist," was the guest speaker at the freshmen convocation held in the R. Don Cowan Performing Arts Center on Tuesday morning.
Beginning in February 2005, Lopez began writing a series of columns about a homeless man he saw playing a two-stringed violin on Los Angeles' Skid Row. What was initially a piece about a "violin man," exploded into something much larger, igniting what Lopez describes as an unlikely friendship as well as a shifting his point of view regarding the city's homeless population.
While the columns, book and feature film have provided Lopez with national recognition, he considers the real gift to be the day he met Nathaniel Anthony Ayers. The meeting launched a friendship, and Ayers gave Lopez a new perspective.
Early on in his life, Ayers was a promising, naturally talented musician studying at The Juilliard School in New York City. However, a mental breakdown and schizophrenia left him reduced to living on the streets, crushing cockroaches and keeping sticks to ward off rats at night. His musical talent remains, however, despite often not being able to tell the difference between what is real and what is imagined.
Encountering Ayers, Lopez said his eyes were opened to the lack of attention society pays to those with mental illness.
"We wouldn't let 7,000 people crush cockroaches and go to sleep on the pavement of any city if they had cancer, if they had muscular dystrophy. It's OK because it's mental illness and we don't want to deal with it and we haven't through the decades and we've never come to grips with that. But that's not acceptable either, and Mr. Ayers has shown us why," Lopez said. "He's made it clear that those people are not strangers, they are our brothers and sisters, our sons and daughters, and that we can do better. I was never a giver. And I found so many rewards, probably in part because of the great challenges. It was a gift the day I met Mr. Ayers."
Lopez said Ayers has progressed. He no longer refuses assistance for housing and has begun to talk about his mental illness, thanks in part to watching the film, "The Soloist," Lopez said.
During his brief time at Juilliard, Ayers was a classmate of world renowned cellist Yo-Yo Ma. However, because of Ayers' perseverance, Lopez said he considers his friend to be more successful in life than Ma.
"They were launched from the same stage at the same time, which one though, really has been more successful? It's obvious Yo-Yo Ma became an international icon. Few people in the history of classical music have had commercial success like he has, but Nathaniel wakes up every day fighting demons, trying to distinguish between the real and the imagined," Lopez said.
"And each and every day he gets through that with his belief in music. And he clears a space and whether he plays the cello or the piano or the violin or the string bass or the flute, trumpet or French horn, he finds peace and it is because he has this passion that nothing can defeat. Few people in this world ever find this passion. I hope that you find it at UT Tyler. I hope you find something in your life that gives you purpose. Nathaniel's got it. And, to me in some ways, given his challenges, he is the more successful of the two when you look at Yo-Yo Ma and Nathaniel Ayers."
Lopez said his passion continues to be writing, thanks to Ayers.
"I think he reconnected me with column writing. I had done it for so long. I thought maybe I should try something else with the last years of my working life," he said. "But I think Nathaniel reminded me how much I enjoy doing this. I feel privileged all over again to have a stage. And that's more precious to me now, having gotten the chance to write about Nathaniel and do so in ways that might be helpful to educate people on public policy issues. So it's as if that longtime passion had been rekindled by him."
Monday, August 17, 2009
'Schizo' - The Movie Launched To Counter Negative Stereotypes
Time to Change, the mental health anti-stigma campaign, launches two provocative films aimed at challenging the stigma surrounding mental health head on. Both films are launched as an exclusive YouGov poll reveals that more than a third of the public believe people diagnosed with schizophrenia are likely to be violent. The reality is that people are as likely to be struck by lightning as to be harmed by a stranger with a mental illness. Research also shows that support from friends and family helps people with mental illness get better, faster and for longer. People going through it say that the stigma and shame can be worse than the illness itself.
President Obama Addresses Mental Health Care at New Hampshire Town Hall Meeting
President Obama Addresses Mental Health Care at New Hampshire Town Hall Meeting
August 12, 2009
President Obama shared his vision for health care reform—and stressed his support of mental health parity—at a New Hampshire town hall meeting on Aug. 11.
Linda Becher, an audience member, specifically asked the president about access to mental health care and its impact on society. The president acknowledged the seriousness of mental illnesses and the reality that many existing insurance policies do not cover them on the same terms as physical illnesses. President Obama also expressed his desire to include mental health care as part of health care reform.
Watch President Obama speak about mental health care at 48:43 or read the transcript below.
Q Hello, Mr. President. My name is Linda Becher (ph). I'm from Portsmouth and I have proudly taught at this high school for 37 years…I've been lucky enough to have very good health care coverage and my concerns currently are for those who do not. And I guess my question is if every American who needed it has access to good mental health care, what do you think the impact would be on our society?
THE PRESIDENT: Well, you raise the -- (applause) -- you know, mental health has always been undervalued in the health insurance market. And what we now know is, is that somebody who has severe depression has a more debilitating and dangerous illness than somebody who's got a broken leg. But a broken leg, nobody argues that's covered. Severe depression, unfortunately, oftentimes isn't even under existing insurance policies.
So I think -- I've been a strong believer in mental health parity, recognizing that those are serious illnesses. (Applause.) And I would like to see a mental health component as part of a package that people are covered under, under our plan. Okay? (Applause.)
August 12, 2009
President Obama shared his vision for health care reform—and stressed his support of mental health parity—at a New Hampshire town hall meeting on Aug. 11.
Linda Becher, an audience member, specifically asked the president about access to mental health care and its impact on society. The president acknowledged the seriousness of mental illnesses and the reality that many existing insurance policies do not cover them on the same terms as physical illnesses. President Obama also expressed his desire to include mental health care as part of health care reform.
Watch President Obama speak about mental health care at 48:43 or read the transcript below.
Q Hello, Mr. President. My name is Linda Becher (ph). I'm from Portsmouth and I have proudly taught at this high school for 37 years…I've been lucky enough to have very good health care coverage and my concerns currently are for those who do not. And I guess my question is if every American who needed it has access to good mental health care, what do you think the impact would be on our society?
THE PRESIDENT: Well, you raise the -- (applause) -- you know, mental health has always been undervalued in the health insurance market. And what we now know is, is that somebody who has severe depression has a more debilitating and dangerous illness than somebody who's got a broken leg. But a broken leg, nobody argues that's covered. Severe depression, unfortunately, oftentimes isn't even under existing insurance policies.
So I think -- I've been a strong believer in mental health parity, recognizing that those are serious illnesses. (Applause.) And I would like to see a mental health component as part of a package that people are covered under, under our plan. Okay? (Applause.)
Sunday, August 16, 2009
MTV Network Opportunity
MTV Networks casting director is "currently working on a new documentary series about young people living with a mental illness.
They are specifically looking for 18-25 year-olds living in the continental U.S. who have been diagnosed with a mental illness, such as OCD, bi-polar disorder, depression or schizophrenia. They should be open and honest about sharing the ups and down of living with this disease, including the effect it has on their family and friendships, any side effects from medications, any therapies they're engaging in, any challenges they take on in their academic and/or professional lives, etc. They should have a willingness to share the daily battles they encounter and a desire to raise awareness and tolerance of their illness with their audience of peers.
If you know someone who may be a great candidate for this show, please have them contact me directly - and please forward this email along to anyone you feel may be helpful."
For Immediate Release
Contact:
Linda Whitten Stalters
240-423-9432
SARDAA
They are specifically looking for 18-25 year-olds living in the continental U.S. who have been diagnosed with a mental illness, such as OCD, bi-polar disorder, depression or schizophrenia. They should be open and honest about sharing the ups and down of living with this disease, including the effect it has on their family and friendships, any side effects from medications, any therapies they're engaging in, any challenges they take on in their academic and/or professional lives, etc. They should have a willingness to share the daily battles they encounter and a desire to raise awareness and tolerance of their illness with their audience of peers.
If you know someone who may be a great candidate for this show, please have them contact me directly - and please forward this email along to anyone you feel may be helpful."
For Immediate Release
Contact:
Linda Whitten Stalters
240-423-9432
SARDAA
Saturday, August 15, 2009
Video on Anosognosia (Lack of Insight) on Mental Illness
Scope of the Problem
Poor and partial-adherence to treatment presents staggering obstacles to recovery. It is associated with a poorer course of illness, increased involuntary hospitalizations, suicide, poorer subsequent response to treatment, estrangement and discord with caregivers and providers, criminal behavior, and failure to reach optimal levels of recovery. In light of the tremendous advances made in the treatment of schizophrenia and bipolar disorder, the tragedy of both untreated, and inadequately treated, mental illness is compounded. The urgency to implement strategies that optimize adherence and recovery has never been greater.
Non-adherence rates in schizophrenia and bipolar disorder continue to hover around 50% while partial adherence rates are even higher (75%). Considering that millions of people either flat out refuse to participate in treatment, or if they do, practice only partial-adherence, the "real-world" effectiveness of both the older, and more promising newer treatments, is abysmal.
Deficits in insight (a.k.a. "anosognosia" see DSM IV-TR, American Psychiatric Association Press, 2000, page 304) are very common. Not surprisingly, anosognosia predicts poor and partial-adherence. After all, who would want to take medication for an illness they did not believe they had? Research shows that poor insight is among the top predictors of poor adherence, far more predictive than the person's experience of side effects. Although recent innovations in drugs used to treat these disorders have addressed many of the limitations of traditional antipsychotic medications (e.g., severity of side effects, aspects of cognitive dysfunction), they still do not deal with the problem of poor adherence to treatment.
For more, click here.
For slide show, click here.
Friday, August 14, 2009
Local support available for families, friends affected by mental illness (Longview)
From the Longview News Journal
East Texas families that include members with brain disorders or mental illness may all too often feel they are alone in their quest to understand and deal with the challenges.
But Paula Hendrix says support, educational opportunities and information are available locally.
"There is help out there for people with mental illness and their families," said Hendrix, president of the National Alliance on Mental Health, Greater Longview chapter. The group is a nonprofit volunteer network of families and providers working to improve the quality of life for people affected by severe disorders, she said.
Friday, August 7, 2009
Minds On The Edge
MINDS ON THE EDGE: Facing Mental Illness is a multi-platform media project that explores severe mental illness in America.
The centerpiece of the project is a television program that will air on PBS stations in October 2009. This video component is part of a national initiative that includes an extensive web site and an ambitious strategy to engage citizens, professionals in many fields, and policy makers at all levels of government. The goal is to advance consensus about how to improve the kinds of support and treatment available for people with mental illness.
MIAW Teleconference: Tuesday, August 18, 2:00 PM ET
MIAW Teleconference: Tuesday, August 18, 2:00 PM ET
On Tuesday, August 18, the Center for Leadership Development and NAMI Communications team will hold a teleconference on Mental Illness Awareness Week (October 4-10), focusing on opportunities for community events around Minds on the Edge Facing Mental Illness, the PBS program that premieres in October 2009.
MIAW is the launch pad for Minds on the Edge events extending into 2010. More than 50 interviews with NAMI members from last month's national convention currently can be viewed on the Minds on the Edge Web site. Teleconference presenters:
Liz Smith, CLD director
Kristin Fellows, Minds on the Edge national outreach coordinator
Leah Matteson, NAMI Vermont president
Call-in information: 1-888-858-6021 access code: 861117#.
Please contact Christine Armstrong with any questions: via e-mail or 703-312-7893. Those who RSVP by email in advance will receive background materials shortly before the conference.
On Tuesday, August 18, the Center for Leadership Development and NAMI Communications team will hold a teleconference on Mental Illness Awareness Week (October 4-10), focusing on opportunities for community events around Minds on the Edge Facing Mental Illness, the PBS program that premieres in October 2009.
MIAW is the launch pad for Minds on the Edge events extending into 2010. More than 50 interviews with NAMI members from last month's national convention currently can be viewed on the Minds on the Edge Web site. Teleconference presenters:
Liz Smith, CLD director
Kristin Fellows, Minds on the Edge national outreach coordinator
Leah Matteson, NAMI Vermont president
Call-in information: 1-888-858-6021 access code: 861117#.
Please contact Christine Armstrong with any questions: via e-mail or 703-312-7893. Those who RSVP by email in advance will receive background materials shortly before the conference.
Tuesday, August 4, 2009
Depression Stigmatized on Local Radio Station - Update
From: Valerie Holcomb [mailto:vholcomb@andrewscenter.com]
Sent: Tuesday, August 04, 2009 10:41 AM
To: garthmaier@ktbb.com
Subject: Talkback question regarding the rise in the use of antidepressants - Action Requested
To: Garth Maier, KTBB Program Director, garthmaier@ktbb.com
CC: NAMI members and other mental health advocates
Mr. Maier,
I am glad that you choose at times to discuss mental health issues and include these issues in your Talk Back section. However, I must admonish you for supporting, or at least, not tempering some of the cynical remarks about depression and the use of antidepressants. Whether reflective of your beliefs or callers’ statements, you made a statement that depression is a result of a lack of religion, poor moral character, and family break up, among other issues. Hopefully I am mistaken in what I heard you say, but, either way, to a listener suffering from symptoms of depression, possibly suicidal, these statements can be crippling in the effort to get help. Depression, or any mental illness, is just as serious as diabetes or heart disease. If you were to suggest that a person’s reliance on medication for the treatment of diabetes to be a character flaw, this comment would be outright irresponsible. Your radio show is so impressionable, and I cringe to think that someone on the verge of getting help might have heard the things that were said and feel that they are defective and should just get over it.
I did make attempts to call in my comments so that listeners with depression and other mental illnesses would know that there is someone to support them, but was cut off. Nonetheless, I am sending this cc’d to fellow mental health advocates for whom I encourage to let you know what they think about the issue. There should be more efforts to fight the stigma of mental illness, and less cynicism about it for the sake of entertainment. I look forward to your response and would like to post it to our website.
Sincerely, Valerie Holcomb, NAMI Tyler Board Member
Greetings and I thank you for your comments.
When I add statements during the Morning Talk Back subject, it is almost always a review of comments already made by callers to generate more discussion. In other words, "Why are so many Americans on Anti-Depressants?...lack of religion, breakdown of the family...etc." The suggested reasons were comments already advanced by listeners.
On a complete personal level, I am a reader of the Bible, which speaks frankly about various mental illnesses cured by the Lord Jesus Christ. Thus, to me (personally), all discussion ends here. Mental illness is a fact. It is treated in the Bible just the same as physical infirmities. Again, to me, all debate ends here!
Respectfully,
Garth Maier
To Mr. Maier and all my NAMI associates,
I very much agree with Robin Peyson and Valerie Holcomb about your very harmful comments regarding persons that live with Depression. We all enjoy the right to free speech and think that in fairness an opportunity should be afforded to Ms. Holcomb to respond to you and your radio audience. I do not know the format of your program but about 15 years ago there was a fellow here in Dallas that had an afternoon radio talk show that said some terrible things about persons that lived with Mental Illnesses and the Homeless. After several calls to him, his producer and the station manager I was given the opportunity to be on a subsequent broadcast and discuss the comments with him and his call in audience.
Please consider this.
Thanks.
Mike Katz
Dallas
I have no idea why Ms. Holcomb passed her comments on to so many people who did not hear the program. Her comments to not accurately represent the morning news format or my statements. Nevertheless, I have explained the format to her and my personal feelings. I stand by the "Talk Back" format and the basis for the programming.
Respectfully,
Garth Maier
The format offers your chance to voice your opinion "on the air."
Your e-mail was sent out to people who don't even listen to the radio station.
The subject matter, by the way, was "depression," and not necessarily "mental illness" (a word never used).
There is a difference. To continue this discussion by e-mail is fruitless.
Respectfully,
Garth Maier
Sent: Tuesday, August 04, 2009 10:41 AM
To: garthmaier@ktbb.com
Subject: Talkback question regarding the rise in the use of antidepressants - Action Requested
To: Garth Maier, KTBB Program Director, garthmaier@ktbb.com
CC: NAMI members and other mental health advocates
Mr. Maier,
I am glad that you choose at times to discuss mental health issues and include these issues in your Talk Back section. However, I must admonish you for supporting, or at least, not tempering some of the cynical remarks about depression and the use of antidepressants. Whether reflective of your beliefs or callers’ statements, you made a statement that depression is a result of a lack of religion, poor moral character, and family break up, among other issues. Hopefully I am mistaken in what I heard you say, but, either way, to a listener suffering from symptoms of depression, possibly suicidal, these statements can be crippling in the effort to get help. Depression, or any mental illness, is just as serious as diabetes or heart disease. If you were to suggest that a person’s reliance on medication for the treatment of diabetes to be a character flaw, this comment would be outright irresponsible. Your radio show is so impressionable, and I cringe to think that someone on the verge of getting help might have heard the things that were said and feel that they are defective and should just get over it.
I did make attempts to call in my comments so that listeners with depression and other mental illnesses would know that there is someone to support them, but was cut off. Nonetheless, I am sending this cc’d to fellow mental health advocates for whom I encourage to let you know what they think about the issue. There should be more efforts to fight the stigma of mental illness, and less cynicism about it for the sake of entertainment. I look forward to your response and would like to post it to our website.
Sincerely, Valerie Holcomb, NAMI Tyler Board Member
I didn’t hear the show nor the comments so do not have all the facts on which to base a decision.
I can and will say I deal with mental illness on a regular basis in my the family law court. It is horrible to say the jails are the primary provider of mental health services. That is because untreated mental illness leads to self-medication with illegal drugs and/or alcohol which leads to criminal behavior. Drug addiction is taking a huge toll on our community.
I also see a huge impact in the CPS (child protective services dockets.) There is such a lack of services not only for parents but for children. We know from research that children who suffer trauma have a change in brain chemistry similar to many mental illnesses. Because the chemicals in the brain can over produce in trauma, the brain can be injured permanently much as a brain injury from a car wreck or other physical trauma. This is progressive and ultimately, as I have on my caseload, children become permanently mentally ill. I am currently working with mental health providers to try to do something to prevent this in children who are in foster care. The moves traumatize children additionally.
Mental illness is difficult because it is stigmatized. It is often chronic, like some cancers, heart conditions, diabetes, and other chronic physical ailments. With proper treatment, people’s brain chemicals can be rearranged to their proper functioning levels.
I am currently working with Dr. Karyn Purvis at TCU on attachment disorder in children. She has done a great deal of research on the brain chemical components in children who have been traumatized and I recommend her work.
If you have questions, please call me or e-mail me.
Judge Carole Clark
321st District Court
Greetings and I thank you for your comments.
When I add statements during the Morning Talk Back subject, it is almost always a review of comments already made by callers to generate more discussion. In other words, "Why are so many Americans on Anti-Depressants?...lack of religion, breakdown of the family...etc." The suggested reasons were comments already advanced by listeners.
On a complete personal level, I am a reader of the Bible, which speaks frankly about various mental illnesses cured by the Lord Jesus Christ. Thus, to me (personally), all discussion ends here. Mental illness is a fact. It is treated in the Bible just the same as physical infirmities. Again, to me, all debate ends here!
Respectfully,
Garth Maier
Mr. Maier,
I share Ms. Holcomb’s point of view. Statements to the effect that depression is the result of a lack of religion, poor moral character, family break up’s, or other similar explanations, have no basis, as the science and research clearly show. Furthermore, it continues the stigma and spread of misinformation. To take this position, when one in every four adults will experience mental illness, is irresponsible.
President George W. Bush issued the Presidents New Freedom Commission Report on Mental Illness and this report speaks directly to how this country can best address mental illness and the devastating toll it takes on those who suffer from these illnesses.
The link to this report is below.
http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Public_Policy/New_Freedom_Commission/Default1169.htm
Please consider changing your approach on this issue during your show and providing your listeners with accurate information.
Thank you.
Robin Peyson
Executive Director
National Alliance on Mental Illness Texas
(512) 693-2000
To Mr. Maier and all my NAMI associates,
I very much agree with Robin Peyson and Valerie Holcomb about your very harmful comments regarding persons that live with Depression. We all enjoy the right to free speech and think that in fairness an opportunity should be afforded to Ms. Holcomb to respond to you and your radio audience. I do not know the format of your program but about 15 years ago there was a fellow here in Dallas that had an afternoon radio talk show that said some terrible things about persons that lived with Mental Illnesses and the Homeless. After several calls to him, his producer and the station manager I was given the opportunity to be on a subsequent broadcast and discuss the comments with him and his call in audience.
Please consider this.
Thanks.
Mike Katz
Dallas
My feelings are directly in sympathy with Valerie's. It could not have been said it better, so I will not even try. I am sure that there are many out here who agree with her passion, information and impassioned statements. Here is a strong supporter.
Sunny Davidson
I have no idea why Ms. Holcomb passed her comments on to so many people who did not hear the program. Her comments to not accurately represent the morning news format or my statements. Nevertheless, I have explained the format to her and my personal feelings. I stand by the "Talk Back" format and the basis for the programming.
Respectfully,
Garth Maier
Mr. Maier,
In response to your previous comment,
Your morning news segment solicits opinions. I merely provided mine and encouraged others to do so, as well. I am familiar with your format because I have been listening since the digital TV conversion. I have not upgraded my TV in my bedroom.
I appreciate your loyalty to the format of your radio station and I do not offer an opinion about changing that; in fact, if you have an audio archive that I can provide a link to yesterday morning's broadcast I will put that on the NAMI website for anyone to hear.
I've re-read my email and do not see anything inaccurate or skewed, but I welcome your comment on this. My purpose is simple - to decrease the stigma of mental illness.
I suspect you underestimate the power of your words. It is irrelevant who generated the stigmatizing comments on your program; you supported and perpetuated them by stating these same "choices" repeatedly and with emphasis, thereby, implicating a forced choice response. This is a common technique used in arguments and debates to furtively elicit a desired response from the other party. The "choices" you repeatedly stated were only subtly different - lack of faith, breakdown of family (the two that standout in my mind) - all imply character flaws. Mental illness is not a character flaw and responsible solicitation of comments should not encourage the same through implied force choice.
What if you were to offer a genuinely alternate "choice" by saying, "or is it an increase in awareness?" With the power of your words, by offering a mitigating choice, you can educe change in the stigma.
I could go on with this analysis or just come out and ask that, when it comes to mental illness, will you do more to temper stigmatizing comments? I do not see how complying with this request could be considered incongruent with the current format. Do you have any other suggestions how to accomplish this?
Thanks for your consideration in this matter, VH
The format offers your chance to voice your opinion "on the air."
Your e-mail was sent out to people who don't even listen to the radio station.
The subject matter, by the way, was "depression," and not necessarily "mental illness" (a word never used).
There is a difference. To continue this discussion by e-mail is fruitless.
Respectfully,
Garth Maier
Dear Mr. Maier,
Regarding your recent Talk Back program on Depression and Medication, I would appreciate your reading on the air Ms. Valerie Holcomb's message which she sent to you after not being able to actually speak during your program. Her message is valid and one which would be of help to your listeners -- to us all. I appreciate the fact that you have a program which allows listeners to express themselves and hopefully would actually serve to the betterment of our community.
Thank you for your consideration to my request.
Because I care,
Janet Helgesen
Monday, July 27, 2009
House Approves 2010 Funding for Mental Illness Research and Services
July 27, 2009
On July 24, by a vote of 264-153, the House cleared legislation that includes funding for mental illness research and services for FY 2010. The bill, known as the FY 2010 Labor-HHS-Education Appropriations bill (HR 3293) includes a $52 million increase for mental illness research at NIMH, as well as an $8.4 million increase for the PATH program (outreach services for homeless individuals with serious mental illness) and a $17 million for the Childrens Mental Health program. The Senate takes up the FY 2010 Labor-HHS-Education Appropriations bill in Committee next week.
On July 24, by a vote of 264-153, the House cleared legislation that includes funding for mental illness research and services for FY 2010. The bill, known as the FY 2010 Labor-HHS-Education Appropriations bill (HR 3293) includes a $52 million increase for mental illness research at NIMH, as well as an $8.4 million increase for the PATH program (outreach services for homeless individuals with serious mental illness) and a $17 million for the Childrens Mental Health program. The Senate takes up the FY 2010 Labor-HHS-Education Appropriations bill in Committee next week.
Mentally Ill Immigrants have little hope for care when Detained
Mentally ill immigrants have little hope for care when detained
11:20 PM CDT on Sunday, July 12, 2009
By EMILY RAMSHAW / The Dallas Morning News
eramshaw@dallasnews.com
AUSTIN – Jose Fernandez Sanchez was delusional when he broke a window to enter his neighbor's apartment. The schizophrenic and epileptic 45-year-old, who had gone to an Austin hospital the day before, complaining of hearing voices, told police he was trying to light a candle for his dead mother. But instead of taking Sanchez to get medical attention, authorities started deportation proceedings against him, leaving the legal permanent resident in a detention-center cell for eight months. By the time a judge saw Sanchez, he was so catatonic that he couldn't answer a simple question.
Sanchez was one of the lucky few: His siblings pooled their money to hire an attorney, who made a compelling case to an immigration judge. Sanchez went from the detention center to a San Antonio psychiatric hospital, where he should have been all along.
But most mentally ill immigrants aren't so fortunate. They get limited mental-health care while in detention, advocates say – and that's only if they're diagnosed. They aren't entitled to competency hearings before standing trial. And the majority of them face judges without legal counsel, and with little recourse to defend themselves from deportation.
"I felt like I didn't have the power to get help. They didn't care how they were taking care of me," said Sanchez, who emigrated from Mexico in 1988 and received amnesty in the United States. "I was very scared, because I knew if I was sent back to my country, they wouldn't be able to help me like the U.S."
National guidelines
Immigration detention officials say they have strict guidelines for mental-health care in detention centers. All inmates receive a mental-health screening as part of their intake exam, they say. Those with suspected mental illness are referred for more tests and treatment. In fiscal 2008, detention-center personnel performed nearly 30,000 mental-health interventions – including providing emergency care to detainees seen as suicide risks.
"We are continuing to work ... to improve the services and the availability of health care to those in our custody," said Tim Counts, spokesman for U.S. Immigration and Customs Enforcement.
But immigration court officials acknowledge there's little guidance for how to handle mental health once these detainees come before a judge. Although judges can't accept an admission of guilt from an "unrepresented incompetent," there are no immigration-court proceedings to determine a person's competency. Judges have to go with their gut – which can be tough to gauge with language barriers and the frequent use of long-distance video conferencing.
"There are no rules or any guidelines or any laws related to determining mental competency," said Elaine Komis, spokeswoman for the Executive Office for Immigration Review, which oversees deportation hearings for the U.S. Department of Justice. "When judges encounter someone who seems to be mentally incompetent, they do try as much as possible to arrange for some kind of pro bono counsel."
Social-justice advocates say that's not good enough. Researchers from the nonprofit advocacy group Texas Appleseed have teamed up with pro bono attorneys from the Akin Gump law firm to study mental-health procedures in detention and deportation proceedings. Their focus is on Texas, which houses a third of the country's immigrant detainees and is home to eight of the nation's 55 immigration courts.
These advocates say detention facilities don't consistently follow mental-health standards, and often don't have enough mental-health workers to handle the estimated 15 percent of detainees suffering from mental illness.
Until early this year, they say, two Texas detention centers housing a combined 2,700 people shared a single psychiatrist. As a result, they say, detainees who receive mental-health treatment in the community rarely get it once they're incarcerated. They miss medicine doses, get misdiagnosed or are prescribed drugs with which they aren't familiar.
"There are no real standards for diagnosing or dealing with mental-health issues while in the system," said Steve Schulman, a partner with Akin Gump who heads the firm's pro bono practice.
Lack of hearings
Advocates say that even if someone is diagnosed with mental illness in the detention setting, it's rare for that to get passed along to a judge.
Unlike in the criminal- justice system, there are no mental-competency hearings. Fewer than half of detainees have legal representation. Immigrants represented by attorneys are 50 percent more likely to avoid deportation, but the government has no obligation to appoint counsel for those who can't afford it.
"The end result is that people are being deported without regard for their mental health," said Ann Baddour, senior policy analyst at Texas Appleseed.
In one case, advocates say, a severely mentally ill woman was nearly deported to Russia because she told authorities she was a Russian immigrant. She was actually a U.S. citizen from Indiana. In another, a Haitian immigrant whom a criminal court had declared incompetent to stand trial was taken into custody by immigration officials at a psychiatric hospital.
Sanchez's siblings are sure their brother would have wound up back in Mexico – or worse, dead – if they hadn't been able to hire an attorney.
"He was never evaluated properly, never given proper treatment," said Sanchez's brother, who asked not to be identified because of his immigration status. "He was all alone in there. We feared the worst, that he would be deported or even take his own life."
11:20 PM CDT on Sunday, July 12, 2009
By EMILY RAMSHAW / The Dallas Morning News
eramshaw@dallasnews.com
AUSTIN – Jose Fernandez Sanchez was delusional when he broke a window to enter his neighbor's apartment. The schizophrenic and epileptic 45-year-old, who had gone to an Austin hospital the day before, complaining of hearing voices, told police he was trying to light a candle for his dead mother. But instead of taking Sanchez to get medical attention, authorities started deportation proceedings against him, leaving the legal permanent resident in a detention-center cell for eight months. By the time a judge saw Sanchez, he was so catatonic that he couldn't answer a simple question.
Sanchez was one of the lucky few: His siblings pooled their money to hire an attorney, who made a compelling case to an immigration judge. Sanchez went from the detention center to a San Antonio psychiatric hospital, where he should have been all along.
But most mentally ill immigrants aren't so fortunate. They get limited mental-health care while in detention, advocates say – and that's only if they're diagnosed. They aren't entitled to competency hearings before standing trial. And the majority of them face judges without legal counsel, and with little recourse to defend themselves from deportation.
"I felt like I didn't have the power to get help. They didn't care how they were taking care of me," said Sanchez, who emigrated from Mexico in 1988 and received amnesty in the United States. "I was very scared, because I knew if I was sent back to my country, they wouldn't be able to help me like the U.S."
National guidelines
Immigration detention officials say they have strict guidelines for mental-health care in detention centers. All inmates receive a mental-health screening as part of their intake exam, they say. Those with suspected mental illness are referred for more tests and treatment. In fiscal 2008, detention-center personnel performed nearly 30,000 mental-health interventions – including providing emergency care to detainees seen as suicide risks.
"We are continuing to work ... to improve the services and the availability of health care to those in our custody," said Tim Counts, spokesman for U.S. Immigration and Customs Enforcement.
But immigration court officials acknowledge there's little guidance for how to handle mental health once these detainees come before a judge. Although judges can't accept an admission of guilt from an "unrepresented incompetent," there are no immigration-court proceedings to determine a person's competency. Judges have to go with their gut – which can be tough to gauge with language barriers and the frequent use of long-distance video conferencing.
"There are no rules or any guidelines or any laws related to determining mental competency," said Elaine Komis, spokeswoman for the Executive Office for Immigration Review, which oversees deportation hearings for the U.S. Department of Justice. "When judges encounter someone who seems to be mentally incompetent, they do try as much as possible to arrange for some kind of pro bono counsel."
Social-justice advocates say that's not good enough. Researchers from the nonprofit advocacy group Texas Appleseed have teamed up with pro bono attorneys from the Akin Gump law firm to study mental-health procedures in detention and deportation proceedings. Their focus is on Texas, which houses a third of the country's immigrant detainees and is home to eight of the nation's 55 immigration courts.
These advocates say detention facilities don't consistently follow mental-health standards, and often don't have enough mental-health workers to handle the estimated 15 percent of detainees suffering from mental illness.
Until early this year, they say, two Texas detention centers housing a combined 2,700 people shared a single psychiatrist. As a result, they say, detainees who receive mental-health treatment in the community rarely get it once they're incarcerated. They miss medicine doses, get misdiagnosed or are prescribed drugs with which they aren't familiar.
"There are no real standards for diagnosing or dealing with mental-health issues while in the system," said Steve Schulman, a partner with Akin Gump who heads the firm's pro bono practice.
Lack of hearings
Advocates say that even if someone is diagnosed with mental illness in the detention setting, it's rare for that to get passed along to a judge.
Unlike in the criminal- justice system, there are no mental-competency hearings. Fewer than half of detainees have legal representation. Immigrants represented by attorneys are 50 percent more likely to avoid deportation, but the government has no obligation to appoint counsel for those who can't afford it.
"The end result is that people are being deported without regard for their mental health," said Ann Baddour, senior policy analyst at Texas Appleseed.
In one case, advocates say, a severely mentally ill woman was nearly deported to Russia because she told authorities she was a Russian immigrant. She was actually a U.S. citizen from Indiana. In another, a Haitian immigrant whom a criminal court had declared incompetent to stand trial was taken into custody by immigration officials at a psychiatric hospital.
Sanchez's siblings are sure their brother would have wound up back in Mexico – or worse, dead – if they hadn't been able to hire an attorney.
"He was never evaluated properly, never given proper treatment," said Sanchez's brother, who asked not to be identified because of his immigration status. "He was all alone in there. We feared the worst, that he would be deported or even take his own life."
Wednesday, July 22, 2009
Loved One Refusing Meds in the Hospital?
In the state of Texas, even if a person is committed involuntarily to the hospital for treatment, that person has a right to refuse medication. So what can be done to help your loved one? An application can be made to the county judge under Texas Health and Safety Code § 574.104. "PHYSICIAN'S APPLICATION FOR ORDER TO AUTHORIZE PSYCHOACTIVE MEDICATION." This can actually be done at the same hearing for the commitment order, but may be done as far out as 30 days after the application is filed with the court. Or, if the hospital is in a different county (as Rusk State Hospital and Terrell State Hospital is for Smith County) the original county court may transfer this type of jurisdiction to the hospital's county court. This way the person does not have to be transported back to their original county for the hearing. Sounds logical doesn't it?
So how does Smith County compare? Smith County has typically longer hospital stays than other counties with a cost to taxpayers of $363 per person per day as indicated in this DSHS report. Statewide, the average length of stay in a state hospital is 36 days. For Rusk State Hospital it is 45 days. Why is this? Are the patients getting more treatment? Actually the opposite is true. For those from Smith County and refusing medications, the application for court ordered medications is probably sitting on the county judge's desk. These hearings are not scheduled in an expedient manner and the Smith County Judge refuses to transfer the jurisdiction to Rusk County because this costs a few hundred dollars. So, by saving a few hundred dollars, the county judge is costing the taxpayers thousands.
Now, I have mentioned the financial impact not because that's the most important concern, but, because (1) it's easy to follow the tax dollars, and, (2) dollar signs speak louder to politicians than humanity issues. Nothing speaks louder than dollar signs to politicians seeking re-election except for maybe voters calling and stating their concern. What can you do about it? Contact the Smith County Judge and tell him you are concerned about the probability that applications for court ordered medications are not being handled in an expeditious manner. Or, just ask him questions about how long this process takes or how it happens. Be polite and your concerns will probably be taken seriously. This is the grassroots way of making a change in government.
Please leave your experiences in the comments section.
So how does Smith County compare? Smith County has typically longer hospital stays than other counties with a cost to taxpayers of $363 per person per day as indicated in this DSHS report. Statewide, the average length of stay in a state hospital is 36 days. For Rusk State Hospital it is 45 days. Why is this? Are the patients getting more treatment? Actually the opposite is true. For those from Smith County and refusing medications, the application for court ordered medications is probably sitting on the county judge's desk. These hearings are not scheduled in an expedient manner and the Smith County Judge refuses to transfer the jurisdiction to Rusk County because this costs a few hundred dollars. So, by saving a few hundred dollars, the county judge is costing the taxpayers thousands.
Now, I have mentioned the financial impact not because that's the most important concern, but, because (1) it's easy to follow the tax dollars, and, (2) dollar signs speak louder to politicians than humanity issues. Nothing speaks louder than dollar signs to politicians seeking re-election except for maybe voters calling and stating their concern. What can you do about it? Contact the Smith County Judge and tell him you are concerned about the probability that applications for court ordered medications are not being handled in an expeditious manner. Or, just ask him questions about how long this process takes or how it happens. Be polite and your concerns will probably be taken seriously. This is the grassroots way of making a change in government.
Please leave your experiences in the comments section.
Monday, July 20, 2009
Public Comment on Community Mental Health Block Grant Plan
Public Comment on Community Mental Health Block Grant Plan
The Texas Department of State Health Services (DSHS) is submitting an application to the Substance Abuse and Mental Health Services Administration (SAMHSA) for Block Grant funding for Federal Fiscal Year (FFY) 2010 for Community Mental Health services for youth and adults throughout the state’s 11 health and human services regions. These federal funds provide approximately 31 million dollars a year to Texas for the provision of Community Mental Health Services.
The Mental Health Block grant program awards funds to states to establish or expand an organized, community-based system for providing mental health services for adults with serious mental illness (SMI) and children with serious emotional disturbances (SED). Funds awarded are to be used to carry out the approved state plan, to evaluate programs and services set in place under the plan, and to conduct planning, administration and educational activities related to the provision of services under the plan. The Community Mental Health Services Block Grant accounts for approximately 7% of DSHS expenditures of Community Mental Health.
For complete details on submitting public comments on the Draft Mental Health Block Grant (MHBG) Plan, please see the MHBG page. Comments must be received by 5:00 p.m. Central Daylight Saving Time, Thursday, August 14, 2009.
The Texas Department of State Health Services (DSHS) is submitting an application to the Substance Abuse and Mental Health Services Administration (SAMHSA) for Block Grant funding for Federal Fiscal Year (FFY) 2010 for Community Mental Health services for youth and adults throughout the state’s 11 health and human services regions. These federal funds provide approximately 31 million dollars a year to Texas for the provision of Community Mental Health Services.
The Mental Health Block grant program awards funds to states to establish or expand an organized, community-based system for providing mental health services for adults with serious mental illness (SMI) and children with serious emotional disturbances (SED). Funds awarded are to be used to carry out the approved state plan, to evaluate programs and services set in place under the plan, and to conduct planning, administration and educational activities related to the provision of services under the plan. The Community Mental Health Services Block Grant accounts for approximately 7% of DSHS expenditures of Community Mental Health.
For complete details on submitting public comments on the Draft Mental Health Block Grant (MHBG) Plan, please see the MHBG page. Comments must be received by 5:00 p.m. Central Daylight Saving Time, Thursday, August 14, 2009.
Tuesday, July 14, 2009
Criminal Justice Symposium at NAMI Convention
The Criminal Justice Symposium at last week’s NAMI Convention in San Francisco featured excellent presentations by Judge Stephen V. Manley of Santa Clara County’s Mental Health Court and Kathleen Connolly-Lacey who co-founded San Francisco’s Behavioral Health Court. Santa Clara’s Mental Health Court is the largest such court in the nation, serving 1,600 individuals with mental illness and substance abuse disorders, most of whom have been charged with felonies. San Francisco’s Behavioral Court is a collaboration in the best sense of the word between the court system and the mental health system. Individuals served by the Court (also primarily charged with felonies) have access to an array of services, including Assertive Community Treatment, supportive housing, and supported employment.
A particularly moving moment occurred when Judge Manley introduced a young woman who was a graduate of his Court five years ago. Since her arrest and diversion, she has made great progress in recovery, has moved to Albuquerque, NM and was attending the NAMI Convention as a representative of NAMI-New Mexico. She later told me that she believes that Judge Manley’s compassion and support “saved my life.”
Prior to speaking at the Convention, Judge Manley, this year’s recipient of NAMI’s Sam Cochran Criminal Justice Award, stopped by the studio’s of KQED, Northern California’s public radio station, and gave an interview about the Santa Clara Court. Here is a link to that interview.
http://www.californiareport.org/archive/R907090850/a
Thanks to Judge Manley and Ms. Connolly-Lacey for their excellent presentations and for compassion and strong commitment to recovery for people with mental illnesses.
A particularly moving moment occurred when Judge Manley introduced a young woman who was a graduate of his Court five years ago. Since her arrest and diversion, she has made great progress in recovery, has moved to Albuquerque, NM and was attending the NAMI Convention as a representative of NAMI-New Mexico. She later told me that she believes that Judge Manley’s compassion and support “saved my life.”
Prior to speaking at the Convention, Judge Manley, this year’s recipient of NAMI’s Sam Cochran Criminal Justice Award, stopped by the studio’s of KQED, Northern California’s public radio station, and gave an interview about the Santa Clara Court. Here is a link to that interview.
http://www.californiareport.org/archive/R907090850/a
Thanks to Judge Manley and Ms. Connolly-Lacey for their excellent presentations and for compassion and strong commitment to recovery for people with mental illnesses.
Monday, July 6, 2009
Doc puts inmates' mental health first
From my SA news:
By Melissa Fletcher Stoeltje - Express-News
It's become a given among mental health professionals that jails are now the largest psychiatric hospitals in the country. In Bexar County, as in others around the nation, roughly one out of four inmates suffers from some kind of mental illness.
That translates into some 800 inmates at the county jail being treated for a psychiatric disorder — hundreds more than patients being cared for at the San Antonio State Hospital.
Dr. Sally Taylor, administrator of psychiatric services at Bexar County Jail, has been on the front lines of the struggle to treat and rehabilitate mentally ill prisoners.
Before that, she was the medical director of the psychiatric emergency room at University Hospital for 17 years, dealing with some of the most disturbed and violent patients and training scores of medical students and other health professionals.
But she's done more than that. By all accounts, Taylor has been a tireless advocate for the mentally ill in San Antonio, working with local advocacy groups to reduce stigma about mental illness, encourage churches to address mental disorders and promote education and community awareness about mental disease.
Recently, she worked with other mental health groups on legislation to compel mentally ill prisoners to take their medication.
This is important for those who have been found incompetent to stand trail and are in jail awaiting transfer to an inpatient competency restoration program.
This will allow treatment for those with severe mental illness who are a danger to self or others or who lack the capacity to understand the risk of refusing treatment, and who have been excluded from court ordered treatment simply because they are located in jail.
It might even help some inmates enough that they could enter outpatient competency restoration.
The bill was signed into law by Gov. Rick Perry.
Because of her work, Taylor was recently one of 41 psychiatrists around the country to be given the prestigious 2009 Exemplary Psychiatrist award by the National Alliance on Mental Illness, for which she was nominated by the local NAMI chapter.
“Psychiatrists who are honored have really gone the extra mile,” said Michael Fitzpatrick, executive director for NAMI. “We awarded Dr. Taylor not only for her work in (University Hospital's psychiatric ER) but for her engagement with us on policy, corrections and faith-based initiatives. She's just outstanding.”
Yolanda Alvarado, chairwoman of the Bexar County Mental Health Task Force, said Taylor was the driving force behind the compelled medication legislation.
“I know that it came from her brain,” Alvarado said. “She got the judges involved, too. She actually went to testify. Because she's a doctor, she carries such credibility.”
Speaking from her office inside the jail, Taylor, who earned her medical degree from the University of Texas Health Science Center, said mentally ill people off their medication often commit petty crimes — criminal mischief and the like — then wind up in jail.
Before the legislation she worked on became law, they couldn't be compelled to take medication in jail, unlike in mental health facilities. They would be judged incompetent to stand trial.
“And then what happens is they end up languishing in jail for two or three months because there are no open beds at the state hospitals,” she said.
“And for all that time they're deteriorating and getting worse. I worry that some of these people might never be restored because the brain stays sick for so long.”
Sometimes an inmate goes into the state hospital for competency restoration, then comes back to the jail and again refuses medication — which sends him or her back to the hospital. It's becomes a cycle.
Taylor, to appease advocacy groups that resist the idea of compelled medication, helped craft the legislation to apply only to those inmates who are deemed a danger to themselves or others.
But her goal is not just to help restore sick inmates to competency. In 2008 she advocated for more than 100 inmates who had committed misdemeanor crimes to have their charges dropped so they could then enter treatment programs, rather than incarceration.
“In coordination with the district attorney's office, the probate court, the jail staff and the Center for Health Care Services, we were able to get civil commitments sending them to the state hospital,” she said. “That may not sound like a lot of people, but for us it was a brand new process, and it became a well-oiled process.”
Taylor applauds the city's award-winning jail diversion program, which trains police officers to recognize mentally ill law-breakers and take them to ERs and other treatment facilities instead of jail.
But she said much more needs to be done with regard to the long-term needs of mentally ill lawbreakers.
“We do a great job recognizing the (mentally ill) at the front door, but the problem is the back door,” she said. “Bexar County is one of the lowest counties in per capita funding for mental health in Texas, and Texas is 48th or 49th out of the 50 states in terms of funding for mental health.
“You can do all the screening and all the jail diversion that is possible, and I'm completely in favor of that, but you've got to have services for people when you send them out in the world.”
Too often, she said, released mentally ill inmates confront a host of obstacles on the outside that hobble them in being compliant with their medical care. And then they re-offend.
“If somebody comes to the jail because it's a place to sleep and eat, you want to be able to provide that on the outside,” she said. “We don't have enough residential units, we don't have enough housing, we don't have enough supported employment, we don't have support services, we don't have intensive case management. So we drop the ball.”
Taylor, who swims and makes jewelry to de-compress from her high-pressure job, said she is drawn to working with the prison population because she is able to help give voice to the voiceless.
“I like helping people that the rest of society shuns,” she said.
By Melissa Fletcher Stoeltje - Express-News
It's become a given among mental health professionals that jails are now the largest psychiatric hospitals in the country. In Bexar County, as in others around the nation, roughly one out of four inmates suffers from some kind of mental illness.
That translates into some 800 inmates at the county jail being treated for a psychiatric disorder — hundreds more than patients being cared for at the San Antonio State Hospital.
Dr. Sally Taylor, administrator of psychiatric services at Bexar County Jail, has been on the front lines of the struggle to treat and rehabilitate mentally ill prisoners.
Before that, she was the medical director of the psychiatric emergency room at University Hospital for 17 years, dealing with some of the most disturbed and violent patients and training scores of medical students and other health professionals.
But she's done more than that. By all accounts, Taylor has been a tireless advocate for the mentally ill in San Antonio, working with local advocacy groups to reduce stigma about mental illness, encourage churches to address mental disorders and promote education and community awareness about mental disease.
Recently, she worked with other mental health groups on legislation to compel mentally ill prisoners to take their medication.
This is important for those who have been found incompetent to stand trail and are in jail awaiting transfer to an inpatient competency restoration program.
This will allow treatment for those with severe mental illness who are a danger to self or others or who lack the capacity to understand the risk of refusing treatment, and who have been excluded from court ordered treatment simply because they are located in jail.
It might even help some inmates enough that they could enter outpatient competency restoration.
The bill was signed into law by Gov. Rick Perry.
Because of her work, Taylor was recently one of 41 psychiatrists around the country to be given the prestigious 2009 Exemplary Psychiatrist award by the National Alliance on Mental Illness, for which she was nominated by the local NAMI chapter.
“Psychiatrists who are honored have really gone the extra mile,” said Michael Fitzpatrick, executive director for NAMI. “We awarded Dr. Taylor not only for her work in (University Hospital's psychiatric ER) but for her engagement with us on policy, corrections and faith-based initiatives. She's just outstanding.”
Yolanda Alvarado, chairwoman of the Bexar County Mental Health Task Force, said Taylor was the driving force behind the compelled medication legislation.
“I know that it came from her brain,” Alvarado said. “She got the judges involved, too. She actually went to testify. Because she's a doctor, she carries such credibility.”
Speaking from her office inside the jail, Taylor, who earned her medical degree from the University of Texas Health Science Center, said mentally ill people off their medication often commit petty crimes — criminal mischief and the like — then wind up in jail.
Before the legislation she worked on became law, they couldn't be compelled to take medication in jail, unlike in mental health facilities. They would be judged incompetent to stand trial.
“And then what happens is they end up languishing in jail for two or three months because there are no open beds at the state hospitals,” she said.
“And for all that time they're deteriorating and getting worse. I worry that some of these people might never be restored because the brain stays sick for so long.”
Sometimes an inmate goes into the state hospital for competency restoration, then comes back to the jail and again refuses medication — which sends him or her back to the hospital. It's becomes a cycle.
Taylor, to appease advocacy groups that resist the idea of compelled medication, helped craft the legislation to apply only to those inmates who are deemed a danger to themselves or others.
But her goal is not just to help restore sick inmates to competency. In 2008 she advocated for more than 100 inmates who had committed misdemeanor crimes to have their charges dropped so they could then enter treatment programs, rather than incarceration.
“In coordination with the district attorney's office, the probate court, the jail staff and the Center for Health Care Services, we were able to get civil commitments sending them to the state hospital,” she said. “That may not sound like a lot of people, but for us it was a brand new process, and it became a well-oiled process.”
Taylor applauds the city's award-winning jail diversion program, which trains police officers to recognize mentally ill law-breakers and take them to ERs and other treatment facilities instead of jail.
But she said much more needs to be done with regard to the long-term needs of mentally ill lawbreakers.
“We do a great job recognizing the (mentally ill) at the front door, but the problem is the back door,” she said. “Bexar County is one of the lowest counties in per capita funding for mental health in Texas, and Texas is 48th or 49th out of the 50 states in terms of funding for mental health.
“You can do all the screening and all the jail diversion that is possible, and I'm completely in favor of that, but you've got to have services for people when you send them out in the world.”
Too often, she said, released mentally ill inmates confront a host of obstacles on the outside that hobble them in being compliant with their medical care. And then they re-offend.
“If somebody comes to the jail because it's a place to sleep and eat, you want to be able to provide that on the outside,” she said. “We don't have enough residential units, we don't have enough housing, we don't have enough supported employment, we don't have support services, we don't have intensive case management. So we drop the ball.”
Taylor, who swims and makes jewelry to de-compress from her high-pressure job, said she is drawn to working with the prison population because she is able to help give voice to the voiceless.
“I like helping people that the rest of society shuns,” she said.
Thursday, July 2, 2009
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