Category Archives: Assisted Outpatient Treatment

CALL TO ACTION – Assisted Outpatient Treatment

We are pleased to report that our Assisted Outpatient Treatment bill – SB 646 – was reported favorably by the Senate Health & Human Services Committee on Monday.

Your help is needed to get the House AOT bill (HB 2212) through committee. It would be very helpful if you could email the members House Public Health Committee and ask for their support on HB 2212. If you are a constituent of one of the members on that committee, please call them as well. Here are the names and contact information of the committee members we need to reach:

garnet.coleman@house.state.tx.us of Houston, Tx (512) 463-0524

nicole.collier@house.state.tx.us of Fort Worth, Tx (512) 463-0716

philip.cortez@house.state.tx.us of San Antonio, Tx (512) 463-0269

sarah.davis@house.state.tx.us of Houston,Tx (512) 463- 0389

bobby.guerra@house.state.tx.us of McAllen, Tx (512) 463-0578

susan.king@house.state.tx.us of Abeline, Tx (512) 463-0718

jodie.laubenberg@house.state.tx.us of Murphy, TX (512) 463-0186

jd.sheffield@house.state.tx.us of Gatesville, Tx (512) 463-0628

bill.zedler@house.state.tx.us of Arlington, Tx (512) 463-0374

Here is a sample letter of support for the AOT bills that you may choose to use or modify in your emails (Don’t forget to personalize):

Subject: Support SB 646 and HB 2212

Dear Rep or Sen Name

I am writing to kindly urge you to support the passing of SB 646 / HB 2212 through committee.

This bill would aid the recovery of individuals with mental illness, save the state money by keeping people out of the costliest settings, and untie the hands of family members who without AOT have limited tools to keep their loved ones with mental illness from continuing to go untreated.

An evaluation of the New York State AOT law found that that incarcerations fell by 87%, arrests by 83%, psychiatric hospitalizations by 77%, and homelessness by 74%.

Well-designed AOT programs not only have the potential to reduce costs and improve individual outcomes, they also protect public safety.

The bill respects the rights of the individual while enhancing the capability of family members and judges to link individuals with mental illness to the services they need.

Thank you for your time.

Sincerely

(Your Name &

Address)

Thank you for making a difference in the lives of Texans with mental illness!

Testimony in support of HB 2212 (AOT) committee substitute, 3.27.13

My name is Greg Hansch. I work as Policy Coordinator for the Texas chapter of the National Alliance on Mental Illness, also known as NAMI Texas. We have 27 local affiliates throughout Texas and nearly 5,000 members made up of mental health consumers, family members, friends, and professionals. Our purpose is to help improve the lives of people affected by mental illness through education, support, and advocacy. Thank you for the opportunity to speak with you today.

My testimony is in support of the committee substitute for HB 2212. By strengthening Texas’s assisted outpatient treatment (or “AOT” statute), this bill would aid the recovery of individuals with mental illness, save the state money by keeping people out of the costliest settings, and untie the hands of family members who without AOT have no tools to keep their loved ones with mental illness from continuing to go untreated. AOT has proven to be effective based on a number of indicators and the state should strongly consider enacting the proposed statutory changes.

As a point of reference, New York State passed a law in 1999 that gives judges the authority to require people meeting a certain set of criteria to participate in outpatient treatment. An evaluation conducted five years after implementation found that incarcerations fell by 87%, arrests by 83%, psychiatric hospitalizations by 77%, and homelessness by 74%. The average number of days hospitalized went from 50 before AOT to 22 during AOT to 13 after completion of the AOT program. These reductions resulted in significant cost savings for the state of New York. Furthermore, participant improvement in day-to-day functioning, self-care, and community living were observed. Participants in the AOT program also showed sustained improvements in overall functioning and reductions in harmful behaviors. Well-designed AOT programs not only have the potential to reduce costs and improve individual outcomes, they also protect public safety. Additional evidence shows that both individuals participating in an AOT program and their caregivers self-report improved quality of life following completion. These indicators can be explained by greater treatment adherence and lower prevalence of symptoms. Though individuals with mental illness may not initially understand how they would benefit from treatment, the evidence suggests that they will acknowledge the positive impact of court-ordered outpatient treatment after completing it.

Assisted outpatient treatment has the potential to save lives and money, but in order for it to be effective, judges need to have the authority and drive to use it. The committee substitute for HB 2212 would give judges the tools they need to order, but not compel, a reasonable set of outpatient treatment program components, including supported housing, medication, and other services considered clinically necessary to assist the patient in functioning safely in the community. It respects the rights of the individual while enhancing the capability of family members and judges to link individuals with mental illness to the services they need. Overall, the committee substitute to HB 2212 would initiate a much-needed and long overdue reform that would improve the quality of life for individuals with mental illness and save the state from unnecessary spending on jails, prisons, and emergency rooms. On behalf of NAMI Texas and our 27 affiliates around the state, I strongly encourage the committee to vote in support of the bill and would be happy to answer any questions.

Texas Appleseed report – “Recommendations for Updating the Texas Mental Health Code”

Texas Appleseed, along with Disability Rights Texas, recently released a report with recommendations on updates to the Texas Mental Health Code. They received a two-year grant from the Hogg Foundation for Mental Health to do this work. This undertaking is the result of a recommendation made by the Continuity of Care Task Force (convened by the Texas Department of State Health Services) to update the Texas Mental Health Code.

Here is a link to the report: http://www.texasappleseed.net/index.php?option=com_docman&task=doc_download&gid=834&Itemid=

The report contains the following 25 recommenations, broken down into 7 sections of the Code.  

I. TITLE

  1. No change to the Title of the Texas Mental Health Code

II. PURPOSE

    2.     Clarify the Preference for Voluntary over Involuntary Interventions

    3.     Move Least Restrictive Alternative Provisions to this Section of the Code, and Add Language Reflecting the Olmstead Decision to the Code

    4.     Move Rights of Patients Provisions to this Section of the Code, and Clarify That These Rights Are Fundamental, but Not Comprehensive

III. DEFINITIONS

    5.     Eliminate References to the Texas Department of Mental Health and Mental Retardation and Board Functions

    6.    Clarify Terminology Around Behavioral Health Facilities

    7.     Clarify Definitions of Local Mental Health Authorities and Community Centers

    8.     Revise the Definition of Mental Illness

    9.     Standardize Definitions of Hazardous Weather

IV. VOLUNTARY MENTAL HEALTH SERVICES

    10.   Clarify Age of Consent

V. EMERGENCY DETENTION

     11.   Promulgate Statewide Training Forms Around Emergency Detention

     12.   Eliminate Provisions Under the Code Requiring Warrants for Emergency Detention

     13.    Clarify Medical Clearance Provisions

     14.     Forcible Entry

      15.     Furlough

      16.     No Change in Emergency Detention Time Periods

      17.     Securing Dangerous Weapons

      18.     Temporary Emergency “Hold” Provisions, Transportation

VI.  COURT-ORDERED MENTAL HEALTH TREATMENT

      19.    Explore Better Ways to Use Para-professionals in Mental Health Commitment Processes

      20.    Consider Incorporation of “Gravely Disabled” Language in Inpatient Civil Commitment Criteria, Assisted Outpatient Treatment, Involuntary Medication Orders, Electroconvulsive Therapy, Restraint/Seclusion

VII. COURT PROCESSES, PENALTIES

     21.    Notice

     22.    Associate Judges

     23.    Court Administration Fees

     24.    Attorney Roles

      25.     Video-Conferencing, Court Jurisdiction and Transfer