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Treatment of mental illness due for change

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Less than a month after Gov. Susana Martinez vetoed legislation to help mentally ill persons and their families, a 24-year-old man probably suffering from schizophrenia attacked members of an Albuquerque church.

In New Mexico, while nearly 72,000 adults live with mental illness, the public mental health system services less than one-fourth of them. In 2010, there were approximately 32,500 visits to New Mexico hospital emergency rooms for mental disorders.

At an average cost of $688 per visit, counties pay a large portion of what amounts to $22.4 million annually. One of five arrestees in Bernalillo and Dona Ana counties receives mental health services.

Mentally ill people who end up in jail or the ER don’t take their medication as needed, miss appointments with mental health professionals, are unlikely to be employed and advocate poorly for themselves.

House Floor Substitute for House Health, Government and Indian Affairs Committee Substitute for House Bill 588, sponsored by Rep. Rick Miera, went before several legislative committees and passed both houses with only a single dissenting vote. HB 588 created community engagement teams of mental health professionals to intervene before a mentally ill person spirals out of control, requiring hospitalization or incarceration.

These locally staffed and locally based teams would personally connect with the untreated seriously mentally ill people and link them not only to mental health treatment but also to housing, food, transportation and other services.

In her veto message, the governor agreed that mental health teams have merit. However, as is too often the case, the governor discounted the collective judgment of the Legislature in favor of her own. HB 588 placed this program in the Department of Health, which has a proven track record with similar community-based models, giving the state’s ineffective and unproductive Interagency Behavioral Health Purchasing Collaborative only a consulting role. The governor vetoed the bill to establish her own community engagement team program under the sole oversight of the collaborative.

There are several successful community-based programs under the DOH. The harm reduction program, which provides clean needles to addicts, and the crisis intervention teams established through the Emergency Medical Services Act are among them. At a recent New Mexico Public Health Association conference, the DOH highlighted a successful community-based program that provided pneumonia vaccinations to more than 2,400 elderly persons – many of whom are homebound.

Yet in her veto message, the governor claims that the DOH doesn’t have the expertise necessary to oversee community engagement teams.

The Legislature placed this program under the DOH because of the Interagency Behavioral Health Purchasing Collaborative’s track record, which doesn’t include even one mental health pilot project that has been implemented or completed since the collaborative’s inception. As the vice chair of last year’s interim Behavioral Health Services Subcommittee, before which the collaborative made several presentations, I have been disappointed by the collaborative’s performance.

The governor claims that community engagement teams would infringe on the privacy of people who are not seriously mentally ill. However, the bill limits teams to engaging with and linking “a person with serious mental illness” to voluntary treatment and services, and requires that team members have the requisite professional credentials and expertise to make clinical mental health determinations.

Nothing in the legislation authorizes coercion; in fact, the bill expressly states that the teams would help the mentally ill person voluntarily seek treatment and other services. It is disingenuous for the governor to suggest that these teams would be any more intrusive than the volunteers who went door to door in two counties to vaccinate homebound elderly people.

I agree with Martinez that delivering effective services to people with mental illness is important public policy. It’s time for the Martinez Administration to go with what works and to admit that the Interagency Behavioral Health Purchasing Collaborative has not fulfilled its promise to the state’s mentally ill residents, and to those who love and care for them.

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