Everyone failed Cho: VA Tech panel calls for better commitment law

What happened to keep Seung Hui Cho from getting needed treatment and at what point could the Virginia Tech massacre have been prevented? The state-appointed panel charged with answering those questions released its report today, stating in part that “The Virginia standard for involuntary commitment is one of the most restrictive in the nation and is not uniformly applied.”

The report details Cho's mental health history and the many lost opportunities to help him, and makes recommendations to improve Virginia’s restrictive mental health treatment law.

The scope and extent of how Cho was ultimately failed by every facet of the system is stunning. Read TAC's press release on the report.

Mental health and the Virginia Tech review panel

The Virginia Tech Review Panel will hold its fourth public meeting on Wednesday, July 18th, at the University of Virginia in Charlottesville. The meeting, which is scheduled to begin at 9AM, will focus heavily on mental health issues with presentations on civil commitment law reform and mental health issues. The agenda for the meeting can be found here. Directions and a campus map are available here.

Advocates should note that extra time has been allotted at this meeting for public comment, so we encourage everyone with an interest in seeing effective mental health care for Virginia to attend the meeting and make your voices heard.

State of the Union: Mental Illness

From National Journal - mental illness is one of the issues you will NOT hear addressed in tomorrow's State of the Union ...

After 40 years of blue-ribbon panels, myriad reports, and poorly aligned public policies, severe mental illness remains an intractable and deepening problem in America. For proof, look no further than the homeless lady muttering on the corner outside your office building.

"Mental illness is the No. 1 public health crisis in the U.S. today," declared Ron Honberg, legal director for the National Alliance for the Mentally Ill, an advocacy group based in Arlington, Va. ...

In 2001, the most recent year for which official figures are available, the U.S. spent $85 billion on mental health treatment. Experts estimate that figure is closer to $130 billion today, with federal prescription coverage included. The costliest subset by far is the severely and persistently mentally ill -- about 12 million adults with schizophrenia, bipolar disorder, and major depression -- who account for 58 percent of the spending, according to researcher and activist E. Fuller Torrey ....

It doesn't help that the federal government continues a long-standing ban on the use of Medicaid money to fund state mental hospitals, said Mary Zdanowicz, executive director of the Treatment Advocacy Center. The policy led to a wholesale emptying of state psychiatric hospitals in the mid-1960s and another wave of discharges in the early 1990s. "In Virginia, we've closed 50 percent of state hospital beds in the last 20 years," Zdanowicz said. "That's a critical -- and often overlooked -- loss for people who need intensive treatment for a severe mental illness."

SHORT BITS

• One Florida judge gives the state 60 days to figure out how it will move mentally ill inmates out of Orange and Osceola jails and get them the treatment they need, saying “"I wanted to have something done today, but years of neglect of the mental health system is nothing something that's going to be fixed overnight."
• A Maine advocate applauds Robert Bruce’s lawsuit against the state claiming state negligence played a role in his wife's death at the hands of their son. The letter-writer noted “What a shame when the difference between life and death are a few pills a day, and you can't make your loved one take them. His fight isn't just for him, but for all of us who have been there.”
• A Virginia paper comes out in support of Virginia State Supreme Court Chief Justice Leroy Hassell’s Commission on Mental Health Law Reform.
• Kaiser Permanente is charged in skid-row dumping in Los Angeles, California.

The task force blues

It is always a question ... actually act to change the system or spend time meeting about acting? Many in Oregon are pushing for the former ...

Doris Cameron-Minard, a past president of the National Alliance for the Mentally Ill in Oregon, whose son suffers from mental illness, said she has served on two governors' mental health task forces. She said she's been frustrated that many of the ideas that came out of those reports are still gathering dust. Steps that need to be taken, she said, include expanding access for the mentally ill to community treatment, and providing diversion treatment programs so people suffering from mental illness don't end up in jail. - The Oregonian, Nov. 1, 2006

We commend Oregon advocates like Cameron-Minard and state Sen. Avel Gordly for realizing that meeting alone won't solve anything.

Acting when nobody else will ...

What choices do they have?

• A Florida jail has installed 4 padded cells with cameras (at the cost of $131,00) in the wake of the deaths of two inmates with mentall illnesses.
• A Virginia Supreme Court justice has launched a mental heath commission – as one legislator notes: "They [the judiciary] have been put in the situation where at every level and at every court, the people with mental illness are confronting the judges. And they don't have the tools for confronting these people. I think [the judges] are acting responsibly and reacting to our actions and lack of actions."

Corrections officers, judges, law enforcement officers … all of them are filling the gap left by the mental health community. People are left untreated, land in the criminal justice system and … surprise … we expect the criminal justice system to make everything OK.

We’ve said it before … where are the grand juries to investigate the mental health system?

The criminal justice system has no other choice but to build in safety nets for the many people who have fallen through the cracks.

But instead of fixing the cracks, the mental health community seems intent on criticizing the quality of the nets.

The Commission's real mission ... action

We commend Virginia Supreme Court Chief Justice Leroy R. Hassell Sr. for launching a new Commission tomorrow that will look at Virginia's laws for mental health treatment.

He has the right vision and the right mission - to actually see change take place.

However, as TAC executive director Mary Zdanowicz said in today's Washington Post, there have been many commissions and reports in the past. "Something needs to be done now," she said, and we think the power of this Commission is that the Chief Justice agrees.

Finding real ways to help people lost to symptoms of untreated mental illness is a commendable goal. Acting on those answers is where too many commissions and blue-ribbon panels fall down on the job. We believe this one will be different. We hope we are right.

NJ Senate votes today

The full New Jersey Senate will vote on SB 1093 TODAY at 2:00 pm. It is supported by grops like NAMI New Jersey, The New Jersey State Association of Chiefs of Police, and The New Jersey Psychiatric Association.

It was also recommended by The New Jersey Governor's Task Force on Mental Health. "The Task Force concluded that any comprehensive reform of a mental health system requires that the needs of the people with the most severe and persistent mental illnesses be addressed," said Task Force Chair Bob Davison."Our careful deliberations and extensive research led us to conclude that for those who are too ill to access mental health services, IOC strikes the appropriate balance of individual's well being and their constitutional liberties."

NJ hospital admissions and AOT

“Admissions and census levels at the state hospitals have remained at higher levels than would be preferred.”

That quote comes from the New Jersey Department of Human Services, responding to a question regarding the continually high census rates at state hospitals despite significant investments in community resources. Unfortunately, these investments havn't resulted in the sort of reductions the state anticipated. In fact, the total hospital census for FY 2006 is over 125 individuals higher than it was in FY 2001.

One factor that directly contributes to these numbers is New Jersey’s lack of an assisted outpatient treatment law. Without an effective means for ensuring that the most severely mentally ill maintain their treatment in the community, New Jersey’s most ill are allowed to cycle in and out of hospitals, jails, and the streets.

Data from the state shows just how drastic a problem New Jersey is facing. The Division of Mental Health Services reported that almost 10% of individuals between the ages of 18-64 admitted to a state hospital are readmitted within 30 days of discharge. The readmission rate jumps to 22% in the 6-month period following discharge. According to the New Jersey Office of Mgmt. & Budget, readmission rates are estimated to be as high as 35% at one of the state hospitals.

Fortunately, hope is on the horizon. Senator Richard Codey, with the support of groups like NAMI NJ, the NJ Psychiatric Association and the Governor’s Task Force on Mental Health, introduced SB 1093, a bill that would finally provide for an AOT law in New Jersey – and give hope to the most severely ill.

Support builds for NJ reform

“For New Jersey's mental-health reform to be truly comprehensive, we must reach those individuals who fall between the cracks,” notes Phil Lubitz, Director of Advocacy Programs for the New Jersey chapter of NAMI in a letter to the editor this week in the Philadelphia Inquirer.

New Jersey is one of only 8 states without the option for assisted outpatient treatment (AOT) – support from power players like acting Governor Codey and a recommendation for passage from the task force he created are a hopeful sign. Letters like this are another.