Need for Treatment

Need for treatment (NFT) standards appear in various forms across the country. Some states specifically identify a need for treatment as part of the criteria commitment and some states have a commitment standard that amounts to a need for treatment through court interpretation. Many states NFT standards appear in their definitions of “gravely disabled.” For instance, some states define gravely disabled as a person who is unable to provide for needed psychiatric care. Arkansas’ law moves the country closer to ensuring that individuals suffering from mental illness receive the treatment they need.

"Mental health experts in Arkansas and I had become frustrated by the law's limitations. We were determined to do more than we had in the past. Last year, we pursued legislation that offered greater flexibility for people in need of mental health services."

Johnson introduced House Bill 2681 to clarify the definition of “clear and present” danger. This bill included criteria similar to the criteria for assisted outpatient treatment under Kendra’s Law in New York. Arkansas’ new law became effective in December, 2007 making Arkansas one of nearly 20 states that have adopted improved treatment standards over the past decade. Arkansas’ new law allows for assisted treatment when a person with a severe mental illness has an impaired understanding of condition, needs treatment to prevent harmful deterioration, and has a history of noncompliance.

Suicide Rate Increases

A new study found that suicide rates are increasing. Researchers found that from 1999 to 2005, the overall suicide rate in the United States rose 0.7 percent. However, among middle-aged white women, the annual increase was 3.9 percent; among middle-aged white men it was 2.7 percent. The report did not explain why there was such an increase among these populations. According to Susan P. Baker, a professor at the Johns Hopkins Bloomberg School of Public Health,

[I]t's not clear what might be causing the rising suicide rates among middle-aged whites. "We need to study the individual people who have committed suicide and see what were their living circumstances. Were they depressed, was this impulsive? A lot more specific information is needed," she said.

For more information on suicide please see our Briefing Paper, SUICIDE: ONE OF THE CONSEQUENCES OF FAILING TO TREAT SEVERE PSYCHIATRIC DISORDERS

Every Brother, Everyone Deserves Better

The national policy of blind indifference toward mental illness and the homeless took an ugly turn last week in Los Angeles. 

That was when John Robert McGraham was doused with gasoline and set into a flaming death.  Police still have no information as to who set the 55-year-old homeless man with severe depression on fire.  Perhaps, California should look toward our outdated policies as the killer.

It is a series of bad policies that left McGraham to the dangers of the streets instead of receiving the benefits of treatment.  He was a helpless victim.  There is a long list of things that could be handled better, but let’s focus on one solution within grasp of policy makers to fix.  Los Angeles—and every county—needs to implement Laura’s Law now. 

Laura’s Law would bring assisted outpatient treatment to people like McGraham who had family members trying to help, but because of a symptom his own illness, he was refusing or not staying on treatment.  The state passed Laura’s Law years ago and left it up to each county to implement.  Unfortunately, only one county in the state has put this important measure in place.     

McGraham was a brother, an uncle, a real person.  A person who deserved better.  A person who had a family trying to help.  The least California can do is to fix the law from standing in the way of timely treatment. 

A Safety Net, Now It's Time for a Treatment Policy

Since 1937, when the Golden Gate Bridge first linked San Francisco with the north side of the bay, some 1250 people have jumped to their deaths.  Now, after decades of debate, the Golden Gate District voted on October 13, 2008, to install anti-suicide nets.

The vote was a long-sought victory for mental health advocates.  As it turned out, the symbolic bridge also earned the dubious distinction of being the world’s most popular suicide site.

A safety net is certainly a sound move.  There is, however, much more San Francisco, Marin, and all of California’s other counties can take to help ensure that people with severe mental illnesses receive treatment.  That is to put in place Laura’s Law. 

Laura’s Law can bring assisted outpatient treatment to every county in California.  This is a proven way to both ensure that people who need treatment the most receive help.  It is a proven way to reduce suicide and to keep people alive and well.  Now is the time to put in place this treatment policy in every California County.

Mental Health Parity is Now Law

After more than 10 years in the making, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act is now the law of the land. This landmark legislation requires health insurance plans that offer mental health coverage to provide the same financial and treatment coverage offered for other physical illnesses.

The idea began in 1996 when the two senators from different sides of the aisle experienced what insurance discrimination of mental illnesses did to their own families. They saw it wasn’t right and championed the movement to make it right. Because of their efforts, millions of American families will be better off.

“We are ushering in a new era of health care for those with mental illnesses. No longer will we allow mental health to be treated as a stepchild in the health care system. If you have insurance, then your mental health care must be equal to the benefits you get for any other disease,” Sen. Domenici said. “I appreciate all the partners I’ve had in this long, long effort but most especially Senator Ted Kennedy, who has been remarkable and stepped up to this work after Paul Wellstone’s tragic death. This has been a labor of love for us.”

Because of the dogged efforts of Senators Domenici and Wellstone, a scaled-down version of parity was enacted in 1996, against fierce opposition from insurance industry lobbyists. Each year, it seemed, the full version would come close to passing but never fully making its way to the president’s desk. This year, as part of the Wall Street rescue measure, it became a must sign piece of legislation. While it took more than 10 years for the full measure, the federal government and many states moved toward mental health parity sooner. The Clinton administration revised Medicaid rules to extend parity for that program. That was a major benefit for many families where someone had a severe mental illness.

Now, as a law, it is also a fitting tribute to cap the career of Sen. Domenici who is retiring at the end of this year. The battle could not have been won without his leadership.