Complexities of untreated mental illnesses

The issues surrounding untreated mental illnesses are very complex. Jo Ciavaglia, a reporter from the Bucks County Courier Times took on this assignment and delivered an excellent overview of how this issue affects individuals who have a diagnosis of a mental illness and who have anosognosia (lack of insight) and do not receive treatment as well as the affect on their families and friends. In her article, "Bill mandates treatment for mentally ill," Ms. Ciavaglia gives a very clear description of our current law in Pennsylvania that requires "clear and present danger to self or others" before someone can be required to receive treatment as well as the proposed legislation, Senate Bill 226.

The points made by those who are opposed to SB 226 include that there "is little evidence that court orders are effective." However, there is very clear proof as seen in the outcomes of New York's Kendra's Law, which SB 226 is modeled after and which show a major reduction in homelessness, hospitalizations, and incarcerations.

There are also concerns that there is a "lack of funding for expanded treatment and support services" that would be required under this bill. However, Pennsylvania is ranked second against other states in its expenditures for mental health services according to NAMI National's Grading the States. Although some additional funding might be needed in setting up a new system for assisted outpatient treatment (AOT) as defined by SB 226, perhaps another look at how we are spending our mental health dollars might also be beneficial, especially since NAMI gave PA an overall grade of "D+" in mental health care services and systems.

The other fear that was stated by patient advocates was that the "law could be abused by applying it whenever a patient disagrees with a doctor's recommendations." As explained further in the article, there is very stringent criteria for someone to be on a court-ordered AOT and this law would only affect those individuals with a history of non-compliance of treatment and of hospitalizations or incarcerations.

While the majority of individuals with a diagnosis of a mental illness are able to move forward in their own recovery by deciding what treatments are best for them, there is a small minority of people who have a mental illness such as schizophrenia or bipolar and also have anosognosia, or lack of insight, and who do not understand the benefits or need of treatment. SB 226 would enable that very small group of people to have access to the treatments that will help them move forward in their lives and, then be able choose the treatments for themselves that would be most beneficial. It is a short-term court order that in the long run, could help someone to regain the life they once had and take control of their future.

Isn't that what we wish for everyone?