Bazelon Center Mental
Health Policy Reporter
Welcome
to the Bazelon Center Mental
Health Policy Reporter. Available exclusively online and to
our email subscribers, the Reporter supplements the Bazelon Center's
Action Alerts by providing a periodic bulletin on significant
policy developments that affect people with mental illnesses.
Volume
VI, No. 3, June 29, 2007
Legislative Updates
in this Issue:
Newsbyte
Mental Health Funding
(Fiscal Year 2008)
The
House and Senate Appropriations Committees with jurisdiction
over mental health funding have rejected cuts proposed in the
President's fiscal year 2008 budget for vital community based
programs (see Bazelon
Policy Reporter 2/07). The Center for Mental Health Services
(CMHS) within the Substance Abuse and Mental Health Services
Administration (SAMHSA) was facing a huge $76-million cut in
its Program of Regional and National Significance (PRNS). However,
appropriators in both chambers increased the PRNS budget over
last year's levels.
Notably,
the two programs the Administration slated for elimination, the
consumer support technical assistance centers and the seniors
mental health program, received respectively $2 million and $5
million. And the jail diversion program ($6.9 million) and the
State Incentive Grants for Transformation ($26 million) were
also restored to FY 2007 levels.
The
following programs also received increases over last year's level:
school violence prevention (level-funded at $93 million by the
Senate and increased to $96 in the House); suicide prevention
($37 million in the House and $40 million in the Senate) and
post traumatic stress disorder ($32 million in the House and
$35 million in the Senate).
The Senate committee provided a new pot of funds ($15 million) under
the SAMHSA discretionary budget (PRNS) to assist local communities
in coordinating and improving the integration of behavioral/mental
and physical health services. PRNS funds are used for programs
that move the field forward, build new service capacity and translate
research into practice at the community level.
The
core CMHS programs were continued at FY '07 levels (children's
mental health services program at $104 million; PATH program
at $54 million), except for the mental health block grant, which
received a welcome $13 million increase by the House, and the
protection and advocacy program, which received an additional
$5 million by the Senate.
Mental Health in
the Schools
Recognizing
that schools are an important tool for the delivery of mental
health services, bipartisan Senators Ted Kennedy (D-MA), Pete
Domenici (D-NM) and Mike Enzi (R-WY) introduced the Mental Health
in Schools Act (S. 1332). The bill would increase funding for
the Safe Schools-Healthy Students program to enable states to
expand school-based mental health services for children in K-12.
It allows for a flexible, state-based approach to creating a
comprehensive mental health school-program and promotes formal
collaboration between families, schools, welfare agencies, and
substance abuse and mental health systems.
As
schools are vital settings for recognizing and addressing a child's
mental health disorder, S.1332 also explicitly provides for training
of school personnel in mental illness identification, referral
and intervention strategies. The act is a welcome initiative
to addressing the mental health crisis among our nation's youth.
Significantly,
this bipartisan legislation takes an important step beyond addressing
only students with, or at-risk for, a mental illness, by seeking
to promote a school-wide positive environment for all students.
The Mental Health in Schools Act encourages schools to implement
positive behavioral interventions and supports (PBIS) into their
school curriculum. A report
by the Bazelon Center for Mental Health Law found that PBIS
implementation in schools resulted in fewer disciplinary problems
and an atmosphere of learning instead of constant power struggles
between teacher and students.
Due
in large part to PBIS implementation, sponsors Kennedy, Domenici
and Enzi anticipate that the Mental Health in Schools Act's success
may be measured in a decrease of truancy, school suspensions
and substance abuse and an increase in academic competency, family-functioning
and graduation rates.
S.
1332 has been referred to the Senate Health, Education, Labor
and Pensions Committee. For more information
on PBIS, please see the Bazelon Center's
publication, Way
to Go.
Offender Treatment
and Crime Reduction
The
House and Senate Appropriations Subcommittees with jurisdiction
over the Department of Justice doubled FY 2008 funding for the
Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA)
to $10 million. MIOTCRA provides grants to states and localities
to develop collaborative programs for offenders with mental illnesses,
including pre- and post-booking jail diversion, law enforcement
training, mental health courts and other court-based and re-entry
services.
The
program was first funded in FY '06 at $5 million. The department
has struggled with inadequate funding to meet the high demand
from for grants to help address the much-increased rate of incarceration
of people with mental illnesses, reaching a point of national
crisis.
Children's Mental
Health: Early Intervention
Only
one in five adolescents who suffer from severe mental illnesses
receives needed specialty mental health services. On June 6,
Senator Christopher Dodd (D-CT), along with Senators Pete Domenici
(R-MN) and Edward Kennedy (D-MA), introduced the Child Adolescent
Mental Health Resiliency Act of 2007 (S. 1560). The legislation
addresses this discrepancy in adolescent mental health care and
ensures that all children have access to necessary mental health
services.
S.
1560 authorizes $205 million in grant opportunities for states
to improve the quality and availability of their adolescent mental
health services. The bill encourages integration of early intervention
and prevention services for adolescents with, or at risk for,
mental health disorders within the state's school systems, educational
institutions, juvenile justice systems, substance abuse programs,
child welfare systems and other support organizations. Ultimately,
S. 1560 exhorts states to create a unified, interagency approach
that reinforces access to care.
Senator
Dodd called the legislation a "strong first step toward
addressing our children's mental health so they can focus on
succeeding in school and achieving their goals." S. 1560
awaits action in the Senate Health, Education, Labor and Pensions
Committee, chaired by Senator Edward Kennedy.
Mental Health Parity
Efforts to bring
mental health parity to the Senate floor are underway. Senator
Kennedy is prepared to offer a manager's amendment as a substitute
for the bill text (Mental Health Parity Act of 2007, S.558, see http://op.bna.com/hl.nsf/id/sfak-747s3n/$File/June%2013%20Bill.pdf ).
The amendment would attempt to address concern about preemption
and severability of state parity laws. The sponsors are prepared
to move forward but will do so only with assurances that floor
amendments that further change the bill will be opposed.
In the House, the Committee on Energy and Commerce heard testimony from Rep.
Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) on June 15, urging quick
action to pass the House bill (H.R. 1424, The Paul Wellstone Mental Health
and Addition Equity Act) so as to give the chamber leverage in negotiations
with the Senate. There is hope on both sides that the bills will be approved
in the House and Senate before Congress' August recess so as to continue
prospects for parity enactment this year. Both bills have major bipartisan
support, with 268 Co-sponsors of the House bill and 52 co-sponsors in the
Senate.
Newsbyte
· New
York Court Allows Forced ECT Treatment
On
June 27, 2007, the New York State Court of Appeals, the state's
highest court, affirmed a lower court decision approving the
forcible administration of electroconvulsive treatment (ECT)
for a state psychiatric hospital resident. The case, In the
Matter of Simone D., involved a long-time Creedmoor State Hospital resident
who had already received 148 ECT treatments over 12 years in
the hospital. The hospital sought permission to administer another
30 treatments against Simone's will.
The Bazelon Center joined
with other disability rights groups in an amicus curiae brief
written by John Gresham of New York Lawyers for the Public Interest.
Among other things, the amicus brief noted that past ECT
treatments had helped Simone only marginally at best; to the
contrary, ECT had caused lasting harm to her cognitive ability.
The brief further noted that, despite its legal obligation to
seek forced treatment only as a last resort, the hospital failed
to try the less restrictive alternative of placing Simone on
a bilingual ward where she might get some meaningful talk therapy
in her native Spanish language. Simone speaks little English.
In
affirming the lower court decision, the Court of Appeals did
not address any of these issues. Instead, in a two-page opinion,
it stated that the sole ground for its decision was that the
trial court did not abuse its discretion in limiting Simone's
counsel's cross-examination of the state's psychiatric expert
witness.
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