Leaders in policy and medicine from throughout the country are working together to improve mental health care with new legislation and funding. The state Legislature has introduced several bills to help revamp the mental health services provided in the U.S. this year causing some of Michigan’s health care leaders to act.
“The public and private mental health system needs adequate funding in order for individuals experiencing mental illness to receive adequate care,” said Margaret Keeler, president of the National Alliance of Mental Illness Lansing.
As the tri-county’s voice on mental illness, NAMI Lansing is dedicated to improving the lives of individuals impacted by mental illness through support, advocacy and education. With weekly and bimonthly support groups and regular education programs, NAMI Lansing helps families and individuals cope with mental illness. Mental health professionals in the Greater Lansing area are working collaboratively to make resources and training available for patients and caregivers.
Several bills currently in the Michigan House and Senate aim to impact the way mental health issues are addressed within the state. Some topics of the bills include training teachers in mental health first aid, creating a statewide electronic hospital bed registry and strengthening of Kevin’s Law or assisted outpatient treatment.
Of greatest concern over the past two years is Public Act 268 of 2016. According to the Michigan Department of Health and Human Services (MDHHS), the law is an effort to improve the coordination of publicly funded physical and behavioral health services in the state. Section 298 of the law includes recommendations regarding the most effective financing model and policies for behavioral health services for individuals with mental illnesses, intellectual and developmental disabilities, and substance use disorders. When Public Act 268 was signed into law, the original 2017 budget called for taking $2.6 billion from the public health system and turning the funds over to private insurance companies, the Medicaid health plans. This shifting of funds would have several impacts on public mental health funding.
“The net effect is that there are isolated legislative efforts to improve mental health in our state; however, these efforts are advanced in the context of a Legislature attempting to privatize mental health services,” said Keeler.
When it comes to the mental health of the nation’s children and in schools, it seems Congress has taken more precautionary measures to keep youth safe. The STOP School Violence Act of 2018 means schools are to develop “threat assessment systems” in line with recommendations from the FBI and Secret Service, in hopes of stopping acts of violence. Anonymous reporting systems are to be implemented for use by students, teachers or others to contact law enforcement about potential threats. Improving school security using technologies and increased personnel is also being deployed. According to Sara Lurie, chief executive officer of the Community Mental Health Authority of Clinton, Eaton, and Ingham Counties (CMHA-CEI), Michigan has an evidence-based K-12 health education curriculum called the Michigan Model that, if fully supported and implemented in schools, would provide a strong foundation of social-emotional skills along with many other health- and safety-related skills.
“We hope that any of these efforts will include not just an emphasis on security, but opportunities to increase the number of school counselors and other behavioral health-trained personnel in our schools as well an increased emphasis on prevention and health education, “ said Lurie.
There can always be improvements made to ensure consistent access to quality services across the state. According to Lurie, Michigan has a well-established, respected and organized public behavioral health system with 46 community mental health service providers that maintain close ties to their communities and serve individuals with severe mental illness, severe emotional disturbance, and individuals with intellectual and developmental disabilities. Continued support and investment in the public behavioral health system and the specialty services and expertise provided by community mental health service providers is needed.
“NAMI Lansing is engaged locally to improve outcomes in tri-county area,” Keeler said. “In collaboration with Community Mental Health of Clinton, Eaton and Ingham Counties and other community stakeholders, NAMI Lansing has been involved with Sequential Intercept Mapping (SIM).“
SIM is a comprehensive workshop that helps communities develop a map that illustrates how people with behavioral health needs come in contact with and flow through the criminal justice system. As an outcome of the workshop for Clinton, Eaton and Ingham counties, participants were able to identify priority areas for linkage to services for those who intercept with the criminal justice system.
“Our community is one of two communities in the state that has completed this nationally recognized process,” said Keeler.
NAMI Lansing has also joined efforts with CEI-CMH and local law enforcement in the development of the Tri-County Crisis Intervention Team (CIT). According to the Tri-County CIT website, CIT is an innovative, police-based, first-responder program of pre-arrest jail diversion for those in a mental illness crisis. This program provides law enforcement-based crisis intervention training for helping those individuals with mental illness. Involvement in CIT is voluntary and based in the patrol division of the police department to prevent unnecessary incarcerations, injury and trauma.
“This effort provides 40 hours of training to equip law enforcement officers with the skill to identify, respond and de-escalate individuals who are experiencing a behavioral health crisis,” said Lurie. “The training effort was modeled after a similar program started in Memphis, Tennessee, and is coordinated through a steering committee led by Lansing Police Department, National Alliance on Mental Illness Lansing and CMHA-CEI. To date, it has resulted in over 160 trained CIT officers across the tri-county area.”
CMHA-CEI has also taken efforts to advocate for and educate on mental health in the Lansing area by offering a Facebook Toolkit created with educators in mind. The toolkit helps educators disseminate information about behavioral health, prevention and wellness to the parents, students and the community they serve. The ultimately goal is to increase awareness, promote local resources and training opportunities, and reduce the stigma around behavioral health issues affecting communities. The kit is available on the organization’s website and contains pages of facts and tips meant to be copied and pasted directly to social media.
In February, a group commissioned by the MDHHS gave its final report on a study of inpatient psychiatric care in the state. The recommendations encouraged long-term projects like making more use of computers in recording and sharing information with health care providers, as well as additional long-term plans that could start within months.
In the 2017 report, CMHA-CEI stated it found 35 of the 59 “chronically homeless” (living on the street or in a shelter) were provided with housing after CMHA-CEI teamed with Volunteers of America. They’re collaborating with the Ingham County Sheriff’s Office and others to create a rapid-response team able to react quickly to those experiencing an opioid overdose. A state opioid abuse study reported 39 drug-related deaths in 2015 in Lansing, up almost 25 percent from the year before.
Several recommendations in the report pushed for revised and updated paperwork requirements to streamline the hospital admissions process, as well as making sure psychiatrists and others are appropriately licensed and supported. A $300,000 grant from the Michigan Health Endowment Fund, a fund provided by Blue Cross Blue Shield of Michigan, is going toward some of the short-term plans, while MDHHS has not announced how it will fund the long-term ideas.
About one in five U.S. adults experience mental illness in a given year, according to the National Institute of Mental Health (NIMH). The term “mental illness” covers a broad spectrum of conditions, from the those addressed by the Legislature’s bills — suicide and thoughts of violence — to what might be subtler, like depression, eating disorders and post-traumatic stress disorder. Treatment also extends to drug and alcohol abuse, and recovery from traumatic events like being the victim in a car accident or crime. These conditions are not discriminatory by age. They can happen to anyone at any time. NIMH estimated a severe mental disorder affects about 21.4 percent of teens at some point in their lives. Just over half of the children in the U.S. with a mental health condition received mental health services in the last year. With around 41 percent of adults with a mental health condition received mental health services in the past year.