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COMMISSION ON MENTAL HEALTH IGNORES PEOPLE IN CRISIS
Added: 12/17/2003
 Type: Summary
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COMMISSION ON MENTAL HEALTH IGNORES PEOPLE IN CRISIS

The President’s New Freedom Commission on Mental Health squandered an opportunity to be a champion for the people most severely impacted by mental illnesses – a group that uses a disproportionate amount of public services, particularly crisis care, because they lack awareness of their illness.

Much of what is suggested is commendable. But seemingly overwhelmed by political correctness, this Commission ignored people in crisis and powerful tools proven to help that group, and reinforced harmful stereotypes about recovery and stigma. Many mental health advocates are praising the report – none will mention what was omitted.

Assisted outpatient treatment is proven to save lives.

The Commission’s hesitancy to address assisted outpatient treatment is especially astonishing given the results from instituting such measures. For instance, in New York, of those placed in six months of assisted outpatient treatment, 77% fewer were hospitalized, 85% fewer experienced homelessness, 83% fewer were arrested, and 85% fewer were incarcerated.

The Medicaid IMD exclusion is discriminatory and costly.

The Medicaid IMD exclusion prevents the federal government from reimbursing states for Medicaid-eligible people with severe mental illnesses who are in state psychiatric hospitals, although reimbursement is allowed for medical and psychiatric treatment in most other settings. This policy was largely responsible for massive closings of state psychiatric hospitals, which discharged patients from their Medicaid-ineligible facilities to nursing homes and the community, where Medicaid reimbursement was available.

A major factor in stigma is lack-of-treatment crimes.

The report ignores findings from the 1999 Surgeon General’s Report, that "the perception of people with psychosis as being dangerous is stronger today than in the past…” and that "Stigma was expected to abate with increased knowledge of mental illness, but just the opposite occurred: stigma in some ways intensified over the past 40 years even though understanding improved." Public information campaigns are ineffective in reducing stigma. Conspicuously absent from the report are interventions for those crises that lead to headline-making tragedies.

Everyone with a severe psychiatric disorder will not fully recover.

The idea that people can recover from mental illness by sheer will alone is a cruel message to send to the many consumers struggling with these brain diseases and implies that the person with the disease is somehow at fault. Although a focus on recovery is understandable and recovery for all is a laudable long-term vision, it is important to remember that full recovery is not currently possible for every person who has a severe psychiatric illness.

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