Refining Mental Health Care After Newtown

The have put a spotlight on mental illness and how it can have deadly consequences when combined with guns.

Despite common perception, there is significant evidence that people in treatment for mental illnesses are no more violent than the general population. Living with mental illness is a struggle. People with mental illnesses are people first, with the same hopes and fears as all other people. The most humane avenue for a person with mental illness is to receive the best care along the continuum of treatment options that are
available.

However, there is a small number of people with serious mental illness who, when untreated for long periods, can be dangerous. This is often related to an untreated psychotic disorder with a co-occurring substance abuse problem or an anti-social personality disorder.

As a society, we must strengthen our community response to this type of untreated problem:

• We must continue to build upon our community support for people with mental illness, so agencies such as ours, the Mental Health Association of Morris County, and others can provide services in the home and monitor people with mental illness in the community to make sure they are receiving the treatment they need. This means continued and expanded funding for outreach and case-management services, mobile screening and outpatient services.
• We must review our involuntary commitment laws. In most states commitment laws favor the civil rights of the individuals with mental illnesses, at times over concerns of community safety and often over the safety concerns of families. It is important for family members who witness the disturbing behavior of their loved ones to have somewhere to go to get immediate professional help. This help should be not only readily available, but also easily accessible and responsive to the family’s concerns. For the person with a mental illness, it is inhumane to leave someone with untreated symptoms, such as active psychosis, in the community where the person suffers needlessly.
• We must fully fund services in the community that mandate treatment for the small number of people with serious mental illness who may pose a threat. In some New Jersey counties, we have Assisted Outpatient Treatment, but the program is not funded statewide. This program involves people with mental illness being on “commitment status” while living in the community, which means they must accept treatment, including medication, or be sent back to involuntary psychiatric units.
• We must re-examine the national trend toward eliminating long-term hospitalization for people with psychiatric conditions that need that level of care. It is a fact that providing services in the community for people with severe mental illness is more cost-effective. However, we in the field know that while many people recover readily, for some people the best form of care is long-term psychiatric hospitalization. This is particularly true for people with severe mental illness who continue to be symptomatic despite treatment. In New Jersey in the past 20 years, we have closed two major  state psychiatric hospitals and lost beds in community hospitals, as well. We must build and sustain a continuum of care that includes independent living on one end and long-term hospital care on the other for those who need it.

We need to build a society where we create accessible, affordable, effective mental health treatment available to anyone who needs help, and a society in which any family or community member can get help for their loved one or another person in  need when they see a problem in front of them.

Louis A. Schwarcz, MAP
President and Chief Executive Officer
Mental Health Association of Morris County