On February 18, the San Francisco Chronicle�s entire Sunday editorial page became a demand that California�s mental health laws and system be reformed so as to help those overwhelmed by mental illness. Perhaps most singled out was the need for laws that protect the right for treatment rather than the "right" to remain psychotic.

Today�a little over two weeks later�the Chronicle again is our crier, calling above all for treatment for those with mental illness. The editorial even reminds its readers of the fate of AB 1800, last year�s most prominent attempt to bring treatment to Californians suffering from mental illness (and one we are familiar with�to say the least). This editorial is the first item below.

Having two editorials so closely spaced on a (to most people) non-mainstream subject is virtually unheard of. It is obvious that the Chronicle hears us and cares.

After the Chronicle editorial is a message recently sent to the New York Treatment Advocacy Coalition (NYTAC). That group is New York�s counterpart to CTAC. The efforts of its members were crucial to that state�s adoption in 1999 of Kendra�s Law, which established assisted outpatient treatment (a/k/a outpatient commitment or community assisted outpatient treatment) and an eligibility standard for it encompassing far more than imminent danger. Kendra�s Law did more or less for New York what the bill we fought so hard for last year would have done for our state�s law.

We hope someday to send you a similar message, but one with a subject line instead reading "California Treatment Advocacy Coalition."

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MARCH 7, 2001, WEDNESDAY

EDITORIAL

STATE OF NEGLECT;

Diagnosing California's Mental Health Faults

EVERY DAY, headline-grabbing violence reminds us what happens when we neglect those who appear to suffer from mental illness.

A 15-year-old high school student smiles, pulls the trigger of his gun and kills two teenagers. A college student, screaming he is the "angel of death," rams his car into a crowd and takes the lives of four students.

We shake our heads in disbelief. We search for wisdom. If only people had understood their mental problems. If only there had been a safety net.

No more excuses. We must build a new system of prevention and care.

For 30 years, as our recent editorials noted, this state has neglected the severely mentally ill.

When California closed its mental hospitals in 1969, community-based treatment centers were supposed to care for those who suffer from mental illness. But the Legislature never funded the centers and no neighborhood welcomed them. As a result, the severely mentally ill began filling up jails, living on the streets and building encampments under bridges.

Last year, Assemblywoman Helen Thomson, D-Davis, introduced a measure to establish an involuntary outpatient program. It easily passed the Assembly, but John Burton, D-San Francisco, the Senate president pro tem, blocked Thomson's bill, fearing it might violate patients' rights.

Instead, Burton asked researchers from the Rand Corp. to find out what has worked best in other states. Rand found that both voluntary and involuntary methods work well -- but only when the severely mentally ill are given comprehensive treatment.

Rand also found, in its 110-page report released last month, that nearly all California's mental health officials and psychiatrists agree that the Legislature needs to make a new and sustained financial commitment to provide outreach and treatment.

The Legislature must act quickly -- not just in response to dramatic headlines that fill us with regret -- but to care for the severely mentally ill who, every day without fanfare, languish in prison, camp on the streets, or commit slow suicide at home.

With but one caveat, those who suffer from mental illness are usually no more dangerous than anyone else: Their illnesses must be diagnosed and treated.

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To: New York Treatment Advocacy Coalition Members
From: DJ Jaffe
Date: March 6, 2001
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The Office of Mental Health recently released a report entitled "Progress Report On New York State�s Mental Health System." On the first page of the report is Governor George Pataki�s brief opening message, which includes this statement:

"Recent initiatives, such as the enactment and implementation of Kendra�s Law, underscore my commitment to ensure that mentally ill individuals get the help they need."

He does not mention any other specific program. But, as nice as it is for Kendra�s Law to be placed on such a public pedestal by the Governor, turn to the section of the report on assisted outpatient treatment ("AOT") and it gets better.

As of January "over 400 individuals assessed through AOT have been determined to need court-ordered treatment." When those who have entered formal treatment contracts are included, "the result is that over 1300 individuals with serious needs are now receiving case management and other services as a result of AOT." And the data presented in the report indicate that the mental health system is making ever-increasing use of AOT.

Because of Kendra�s Law New York has turned its attention to the most severely ill:

"All localities have developed new mechanisms to ensure that individuals most in need receive highest priority access to services."

"A wide variety of stakeholders, case management providers, county officials, family members, and individuals receiving services, acknowledge that AOT has improved access to case management and other services for those most in need."

Most startlingly, based on preliminary findings for the first 141 people in AOT, are the outcome numbers. Among them are that because of the Kendra�s Law program the group has experienced a:

129% increase in medication compliance;
26% decrease in harmful behavior;
194% increase in the use of case management;
107% increase in the use of housing services;
67% increase in the use of medication management services;
50% increase in the use of therapy; and
100% decrease in homelessness.

How do those numbers sound?

You should feel proud.

The entire report is available (in PDF) at:

Thank You

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California Treatment Advocacy Coalition
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