KEVIN’S LAW: NEW YEAR BRINGS NEW HOPE FOR MENTALLY ILL

Governor Granholm signs legislation improving Michigan’s mental health treatment law

ARLINGTON, VA – Gov. Jennifer Granholm significantly reformed Michigan’s mental illness treatment law by signing a package of bills known as Kevin’s Law (SB 683-86). Bipartisan sponsors Sens. Tom George (R, 20th District) and Virg Bernero (D, 23rd District) battled together for three years to give Michigan a way to better help those who refuse treatment because of incapacitating symptoms of illnesses like schizophrenia and bipolar disorder. The legislation is effective immediately.

Kevin’s Law allows a judge to order outpatient treatment for someone with an untreated severe mental illness who meets specific criteria, including a recent history of hospitalizations or behavior dangerous to themselves or others. Forty-two states have provisions allowing the use of this powerful treatment mechanism, known as assisted outpatient treatment.

The progressive measure is named for Kevin Heisinger who was beaten to death in a Kalamazoo bus station in August 2000 by Brian Williams, a man who had untreated schizophrenia. Williams' illness caused him to cycle in and out of institutions and the criminal justicesystem for years. When he was in treatment, he was functional, but his condition would deteriorate when he would stop taking his medication.

This preventable tragedy spurred Sen. George, a doctor and then state representative, and Sen. Bernero, a consistent champion in the legislature of those afflicted by mental illness, to introduce Kevin’s Law.   “Kevin’s Law will make our communities safer and at the same time provide compassionate, earlier care for people who seriously need it,” Sen. George said. “Until today, families had to wait until their loved ones made a threat or actually hurt someone before they could get help, and then the only option was inpatient care. Now people can be helped earlier, and on an outpatient basis. If the treatment is successful, the person never needs to reach a crisis point and hospitalization may be altogether averted.”

“Gov. Granholm and Michigan’s legislature are to be congratulated for reaching out to help a small group of people whose severe and untreated mental illnesses shatter their lives,” said Treatment Advocacy Center Executive Director Mary T. Zdanowicz. The Treatment Advocacy Center is a national nonprofit dedicated to removing barriers to treatment of severe mental illnesses. “States that have effectively implemented assisted outpatient treatment laws have had well-documented successes in reducing rates of hospitalization, homelessness, arrests, and incarceration, saving both lives and money.”

Statistics on the first three years of New York state’s similar program, Kendra’s Law, revealed that for people placed in assisted outpatient treatment, 63 percent fewer were hospitalized, 55 percent fewer experienced homelessness, 75 percent fewer were arrested, and 69 percent fewer were incarcerated. Individuals under Kendra’s Law were also more likely to regularly participate in services and take prescribed medication. The number of individuals exhibiting poor adherence to medication decreased 67 percent and those exhibiting poor engagement to services decreased 42 percent. Kendra’s Law has also had a dramatic effect on individuals with co-occurring substance abuse problems: participation in substance abuse services doubled.

The unwillingness to stay in treatment is often due not to denial or stubbornness, but to a lack of insight. “Anosognosia, the neurological term for lack of awareness of illness, is the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications,” said psychiatrist E. Fuller Torrey, president of the Treatment Advocacy Center. “Caused by damage to specific parts of the brain, anosognosia affects about half of those with schizophrenia and bipolar disorder. They don’t believe they are ill.”

Donna Orrin, MSW, can speak firsthand about the powerful problem of lacking insight into a mental illness. Orrin, of Washtenaw, is the author of Consumer Involvement in Policymaking for the Michigan Department of Community Health and served as a member of Gov. Granholm's Mental Health Commission. There were times Donna was experiencing severe symptoms but did not believe she had bipolar disorder. "My mother had me committed against my will three times, and I would get so mad at her," Orrin said. "But thanks to her willingness to help me when I was not able to help myself, I have now been in treatment for a number of years, and have gained insight into my illness. I have also worked on my recovery process and have created a quality life of my personal choice. I often now think that my mother must have loved me very much to intervene when my illness made me push her away."

Orrin's experiences have made her a strong advocate for consumers and for Kevin's Law. "Assisted outpatient treatment is meant to help those who cannot identify their symptoms, and therefore do not seek help. As a result, they could be at risk for suicide, homelessness, incarceration, or vulnerability to danger from others. They could lose their spouses or other family members; they could lose their jobs. They could become violent, solely because of their symptoms. They deserve better. Kevin's Law can give them the same chance I had."

"There are too many people with serious mental illness whom we have not been helping, and Kevin's Law can change that," agreed Mark Reinstein, President and CEO of the Mental Health Association in Michigan (Southfield) and a member of the Governor's Mental Health Commission.  "We are worried about people who are homeless and living under a bridge, who would never choose that lifestyle if their brain disorder was being treated.  They merit our intervention.  The sponsors of this legislation deserve credit for their efforts to improve conditions for those with severe mental illness.  Combined with simultaneous advance psychiatric directive legislation that was adopted, and with the report of Gov. Granholm's Mental Health Commission, Kevin's Law is an important step toward a broader vision to address the many challenges - from treatment to housing to funding - that confront our system."

Advocates across the country hailed the change in Michigan law, including Pat Webdale, board member for the New York chapter of the National Alliance for the Mentally Ill and mother to Kendra Webdale, for whom New York’s “Kendra’s Law” was named. “When Kendra was killed by a man with a long history of untreated schizophrenia, the grief we felt was unspeakable,” she said. “Assisted outpatient treatment can save the lives of people like my daughter and Kevin Heisinger, innocent bystanders to the psychosis caused by untreated mental illnesses. And it can save the lives of people like their assailants, imprisoned by brain diseases that they could not fight alone.”

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