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.

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