NAMI National Convention and AOT Letter to the Editor

I returned from the NAMI National Convention yesterday and was reflecting on the many workshops I attended and the connections I was able to make in order to gain further information about the two advocacy efforts I spoke about as one of the presenters at a workshop on advocacy, assertive community treatment (ACT) and assisted outpatient treatment (AOT).

I learned from a phone message from my brother that a letter to the editor that I had written a couple of weeks ago was published in the Bucks County Courier Times on Monday, June 16, "New law would ensure that the mentally ill get needed Help" (I hadn't chosen that title). I was glad to see that the information regarding our advocacy efforts for SB 226 appeared in our local paper. Please send any comments you might want to share to this newspaper.

Although I spoke with many people at the convention who were very supportive of both ACT and AOT, I did meet with some who shared their concerns about how AOT laws are implemented. After listening to their comments, I realize that there is still a lot of misunderstanding about issues such as who would be affected by AOT (my answer: a very small minority, less than 1% of the people with a severe mental illness and history of hospitalizations or incarcerations or violence) and that there are still some people who do not believe that lack of insight or anosognosia exists and stands in the way of people seeking treatment on their own (my answer: to read Dr. Xavier Amador's book, I Am Not Sick I Don't Need Help! as well as the briefing paper on the Treatment Advocacy Center's web site which explains how lack of insight impairs someone's ability to seek and remain in treatment.)

It is still my hope that, over time, more understanding about the benefits of AOT for those whose lives are often devastated by lack of treatment will enable more states, including my own, to pass these life-saving laws.

Advocating for change to mental health laws

As I've been preparing for a presentation at the NAMI National Convention, I've been thinking about the reasons I am involved in advocating for a change to our mental health treatment laws.

My personal involvement with accessing treatment for my family member who has schizoaffective disorder and lacked the insight of understanding that she had a treatable illness is what first drew me to learning about how our mental health system, governed by our Mental Health Procedures Act, operates. After meeting many parents who also shared their stories of the difficulties of accessing timely treatment, it reaffirmed the need to become actively involved in changing our laws that put family members on hold, waiting for a clear and present dangerous situation to first occur before needed help was provided.

Research shows that untreated mental illness is the cause of frequent hospitalizations, homelessness, and incarcerations. An article that appeared in the Wall Street Journal, Compassion, Compulsion and the Mentally Ill, by Dr. E. Fuller Torrey, states the statistics from a recent study on homicides committed by individuals with severe mental illness in Indiana which shows that, "homicides were preventable, since the perpetrators in most cases were not being treated."

Assisted outpatient treatment laws have been shown to make a difference, as the outcomes from New York's Kendra's Law prove. And so, besides my own personal reasons and those of other families, the research studies and outcomes from mental health treatment laws that are effective are all the reasons that I continue to advocate for changes to the laws in my state.

The Effects of Untreated Mental Illness

Over the last few days, three articles, two from newspapers in Pennsylvania and one from California, appeared in newspapers on the issue of the effects of untreated mental illness.

One appeared in the Bucks County Courier Times and was written by a student, Lisa Clattenburg, from the college where I work, All alone: Who will help the families of the mentally ill?. I've never met Lisa, but she raises points that many families and friends of someone with a mental illness and a lack of insight to remain in treatment often wonder how to resolve regarding the treatment laws that do not provide treatment until someone is a danger to themselves or others.

Lisa states, "These laws make it very difficult for family members to get needed help for these patients. Unless they are suicidal or homicidal, it is almost impossible to force them to get treatment. It has gone from one extreme to another. We should come up with an 'in between' so that patients who suffer from this illness can receive the help they need and deserve. "

The second article, from the Philadelphia Daily News was written by Elmer Smith: The cycle for mentally ill homeless must end. He writes about people with untreated mental illness, "whose homelessness results from untreated mental illnesses, [and] find themselves suspended between periods of life on the streets and enforced stays in homeless shelters, mental-health institutions and jail cells."

But even when housing is available, if someone who has been prescribed medications does not take them because they lack the insight to remain in treatment, then all of the programs, services, and housing options available will not help them.

The third article, State's shameful neglect of mental illness, by John Diaz appeared in the paper today. Although California has passed an effective treatment law, it has not been implemented across the state. The result is one that, "divides families, contributes to the crowding in our prisons and jails, explains why so many people are living on the streets, and causes more pain and suffering that can be calculated by any government statistic."

Providing timely, compassionate treatment is the answer and the results of Kendra's Law in New York offer a solution on how to solve these problems. In PA, once the proposed assisted outpatient treatment bill, SB 226, is passed, it will benefit many people including those with untreated mental illnesses and the family and friends who love them.