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NAMI Washington 2014 legislative agenda
- Our state laws must require fair and just access to medical treatment and related supportive services for individuals with mental illnesses and their families and/or other support networks.
- Early intensive care and treatment - including hospitalization in some cases - have proven to reduce long-term illness and disability. It is the best way to reduce the State's long-term costs for the mental health system and, most importantly, to promote the potential for recovery for as many people as possible. In order to ensure the highest possible quality of service, the State should require programs, treatments and other services to be evidence-based or promising practices and engagement.
- Treatment and related assistance need to be holistic and comprehensive and should include the person's psychiatric and general physical health, employment potential, housing, social network and mobility. These programs need to work in collaboration with one another and be recovery based.
- Involved family members, friends and others in an individual's chosen support network should have a positive, pro-active role in treatment planning and evaluating treatment effectiveness.
- Community mental health organizations, private business and government entities must come together as collaborative partners in the treatment of mental illnesses and the reduction of societal stigma surrounding mental health issues.
1. Change the content of fiscal notes attached to bills in the legislature to include costs of not implementing proposed legislation.
Currently the fiscal notes provided to legislators give only the projected cost of enactment and implementation of the proposed legislation. They do not show the cost of not implementing the legislation-an important consideration in any reliable cost/benefit analysis. We have seen the perils of the current system firsthand. It is imperative that legislators understand that larger picture so that they can make truly informed decisions. They should not be forced to make decisions with incomplete information. This is a matter of good business and good governance.
2. Create adequately funded Assisted Outpatient Treatment options coupled with a "substantial likelihood of serious harm" standard to provide better involuntary treatment and early intervention tools.
Currently, the ITA provides for emergency involuntary hospitalization if a person "presents an imminent likelihood of serious harm, or is in imminent danger because of being gravely disabled," R.C.W. § 71.05.153 (2012). The "imminent" standard is used only in this statutory section; other code sections simply use "likelihood of serious harm. We want the "imminence" requirement removed from the emergency detention statute and replaced with a "substantial" standard to allow more of those who really need help get it before life-threatening danger gets so close as to be "imminent." Along with that less demanding standard, we want to establish universally available assisted outpatient treatment as an alternative to hospitalization that would allow those who meet criteria to remain in the community under close supervision and with all necessary services rather than actually being hospitalized. Because this provides a less restrictive alternative to hospitalization, these provisions go hand in hand and meet the intent and policy statements of R.C.W. § 71.24.01. Moreover, a recent Duke University study shows that AOT can result in significant cost savings once the program is established.
3. Increase access to PEER-infused Crisis Stabilization Units/Triage Centers.
Because there are not enough mental health crisis stabilization units/triage centers in the state, many people living with mental illnesses who need crisis intervention and stabilization services instead are being booked into jails or brought to hospital emergency rooms –at great public cost and contrary to the stated "least-restrictive treatment alternative" intent of R.C.W. § 71.24.015. Where these centers do exist, they operate with extraordinary cost-effectiveness and positive effect. Further, trained PEER Counselors are increasingly being recognized as effective, empathetic advocates, whose understanding and credibility with people in mental health crises comes from their own recovery experience. Use of PEER counselors in such centers will maximize the positive effects of diversion from the criminal justice system and help encourage stabilization without hospitalization as well as active engagement with treatment. It is both fiscally and humanely imperative that we establish universal access to these important facilities and programs throughout the State. Current funding is providing two additional programs but this still does not provide adequate availability and access to serve the entire state.
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