NAMI Indiana Supports Changes to the Following:
• Ensure that law enforcement agencies within Indiana, including police, sheriffs, the courts, local lock-ups, county jails, the state prison system and the mental health system supporting these entities have appropriate training and resources regarding interacting with and providing services for individuals with mental illness within their custody or control, and that their practices and procedures protect the rights of these individuals..
• Support the implementation of diversion programs, problem-solving courts, and Crisis Intervention Teams.
• Eliminate medication formularies for all persons with mental illness, including those incarcerated in lock-ups, county jails and the state prison system.
• Indiana Mental Health Law allows for Assisted Outpatient Treatment (AOT; Indiana Code 12-26-1-1). This fact should be publicized and implemented throughout the state.• Ensure that jails and prisons accept and maintain medical records regarding each detainee from licensed health care professionals, and act on them. Further, make certain that the records always follow the individual, when within the criminal justice system and upon release, as required by Indiana Code 11-10-4-9.
• Support the abolishment of the death penalty for people with mental illness.• Cost: It costs two to six times as much to execute one person than to incarcerate him or her for life. * *The Abolitionist Action Committee, 2006
RESTRAINTS and SECLUSION
• Discourage the use of restraints and/or seclusion, since there is no therapeutic value to their use. In fact, the effect of this approach is likely to exacerbate the problem being addressed. Restraints and/or seclusion are acceptable only as an emergency measure when the safety of the person in crisis or those nearby can be assured in no other way.• Encourage the use of alternatives to restraints and seclusion. These are more effective, and are more likely to lead to long-term success in managing disruptive behavior. The use of these de-escalation techniques should be the approach of choice in dealing effectively with behavior that is out of control.
• Work towards the elimination of homelessness among people with mental illness. Research and experience show that communities can overcome problems of homelessness among people with mental illness. Local partnerships can provide access to affordable housing, suitable employment, and treatment. We can do better than allowing persons with mental illness to sleep under bridges or become residents of the county jails.
• Support efforts to link supports and services to housing specifically for adults with mental illness.• Insist that housing services are flexible and based on an individualized plan, with meaningful input from persons living with mental illness and their families.
ACCESS to TREATMENT
• Seek and promote equal access to services and benefits for people with mental illness, in both the private and public sectors.
• Support the expansion of Medicaid availability as broadly and with as few restrictions as possible.
• Ensure that all release-ready patients and offenders from Indiana psychiatric hospitals, and Department of Corrections are discharged into appropriate care. This process should be monitored by local oversight committees comprised of representatives from CMHCs (Community Mental Health Centers), Clinical Health Professionals, persons living with mental illness, and their family members.
• Support development of the Clubhouse Recovery Model for recovery of individuals with treatable mental conditions as they successfully work in our communities as tax paying citizens.• Promote programs and incentives to increase the number of licensed mental health professionals and service providers. This could be accomplished by promoting parity and by providing tuition subsidies for these persons.
CHILDREN and ADOLESCENTS
• Develop and fund access to home and community based services (HCBS) for children and adolescents who experience serious mental health challenges.
• Develop and fund programs and services to provide early identification and treatment for children and adolescents who experience serious mental health challenges.
• Develop and fund a comprehensive system of care, including programs and services to provide treatment along a continuum that is based upon the child’s unique needs. This includes crisis management and respite care for families. When HCBS cannot maintain a child safely in the home or community, we advocate acute or residential treatment as a last resort.• Divert children and adolescents with serious mental health challenges from the juvenile justice system into treatment and community supports.
• A study by Pitney Bowes (2006) found that by not restricting access to health care for their employees, for every dollar spent on health care, there was a return of five dollars in reduced absenteeism and increased productivity. A national survey by NAMI (2006) that focused on treatment of major depression showed that with restricted access to treatment, there was nearly a three-fold increase in annual expenses for treatment over the expenses for individuals with less restricted access to treatment.
• Advocate for adequate funding for providing mental health services, pointing out that in the long run, this is cost-effective.
• With costs of health care increasing at substantial rates, it is understandable that public policy decisions regarding both governmental and private underwriting of health care are becoming oriented toward reducing support for health care. Careful analysis shows that this trend is the epitome of being “penny-wise and pound-foolish.”• Restricting access to health care to cut costs makes as little sense as deciding to cut costs by not changing the oil in a new car. In the short run, some money will be saved; in the long run, which is what counts, the losses are great.