HF 281 HELPS THOSE WHO NEED IT MOST - A BENEFIT FOR ALL

Treatment Advocacy Center Executive Director Mary Zdanowicz will testify before the Minnesota House of Representatives Civil Law Committee in support of Representative Mindy Greiling’s (D) House File 281, humane legislation essential to improving civil commitment laws in Minnesota. For too long legal barriers have prevented families from lovingly intervening on the behalf of a seriously mentally ill family member who is too ill to help him or herself. Under current law, their loved ones must become dangerous before families can get any help.

Frequently that is too late as the families of Larry Dame and Alfred Sanders learned when Dame, a mentally ill individual, allegedly killed his sister’s family and Sanders, also suffering from mental illness, was killed in an altercation with police. These blockades leave families standing by helplessly while their loved one becomes increasingly more tortured by hallucinations or delusions, becomes hostile or violent, or becomes victimized in prison or on the streets.

Schizophrenia and manic-depressive illness (bi-polar disorder) combined, affect 4.5 million Americans and an estimated 79,000 Minnesotans. Nearly half of this population has limited insight or lack awareness of their illness. Stronger legislation, such as what is proposed in Minnesota, is needed to reach this at-risk population.

HF 281 will help provide access to treatment by allowing for earlier intercession with removal of the requirement that danger be "imminent" for emergency response and by improving the standard for treatment so that a person’s deteriorating psychiatric condition may be considered in the standard for care. In addition to early and humane intervention, this legislation promotes more effective treatment by allowing for lengthened hospital stays to stabilize a person’s condition as well as timely intervention with medication. These progressive measures reflect the growing awareness that brain diseases like schizophrenia and manic depressive illness are degenerative illnesses that, if untreated, can lead to tragic outcomes such as criminalization, suicide, homelessness, or violence.

Thus far, the inability to access treatment in a timely manner has greatly increased the cost to society and to the patient. If forced to wait until a person is gravely ill, lengthier hospitalization may be required or the individual may end up in prison or worse.

According to the Department of Justice, 16% of the population in state jails and prisons are individuals with mental illness. Many of these individuals are incarcerated as a result of the untreated symptoms of their illness. Research suggests that, as in Minnesota, treatment laws based on "dangerousness" can be directly related to the criminalization of those with mental illness.

For a person with a serious mental illness, prison is the worst place to be. A mentally ill prisoner is more at risk for suicide than the general population. But even outside the prison walls, people with mental illness are more likely to take their own life. The Star Tribune reported that 450 people per year commit suicide in Minnesota. The lifetime suicide rate among the general population is about 1 percent. For those with schizophrenia it is 10 to 13 percent. And for those with manic-depressive illness it is 15 to 17 percent. Studies suggest that suicide is more likely to occur in this at-risk population when there is inadequate treatment or no treatment at all.

A person whose judgment and cognition is effected by symptoms of a mental illness may not be able to hold a job or provide shelter for him or herself. A Wilder Research Center survey found that "38%[of homeless people in Minnesota] have a diagnosed mental illness." That is nearly 3,300 Minnesotans. Being on the streets is a dangerous lifestyle, often leading to victimization or physical illnesses. Sadly, this has not always been considered as a criterion that demonstrates a need for treatment. Criteria based on the need for treatment allow for humane intervention for someone suffering from mental illness.

If treated, evidence shows that individuals suffering from mental illness are no more violent than the general population, however, those who are not receiving treatment are more violent. A report published by the National Institute of Mental Health in July 2000 indicated that serious and persistent mental illness is a factor in 10 to 15 percent of violence and that includes homicide.

Because these illnesses are neurological disorders, medication is a key component of any treatment plan. HF 281 will allow for a determination to be made at the initial commitment hearing to prevent inhumane situations where a person may be hospitalized without medical treatment until after a second hearing has taken place.

Early intervention is the best way to prevent such tragedies from occurring and can provide the individual with a greater chance to live a healthy productive life yet it is only one part of a successful treatment plan. A person suffering from serious mental illness who is in crisis also benefits from being treated as long as needed to stabilize the condition. HF 281 addresses this by increasing the maximum duration of early intervention from 10 to 21 days. Allowing for a patient to be treated effectively also increases the likelihood that this patient will voluntarily participate in treatment once released.

HF 281 is a necessary step toward breaking the cycle of suffering, violence, prison, suicide - devastating results of untreated mental illness.

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The Treatment Advocacy Center (www.treatmentadvocacycenter.org) is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. TAC promotes laws, policies, and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.