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State Mental Health Citizens' Group, Mental Health Association in Michigan, Lauds Report of Governor's Mental Health Commission.

SOUTHFIELD, Mich., Oct. 25 /PRNewswire/ -- The Mental Health Association in Michigan (MHAM), the state's oldest advocacy organization for persons experiencing mental illness, commended Governor Granholm's Commission on Mental Health for its just-released report. The Association called on the legislative and executive branches to begin planning and developmental work immediately to lay the groundwork for implementation of key report recommendations.

Governor Granholm appointed the Commission last December to make recommendations for improving services in Michigan for adults with mental illness and minors experiencing emotional disturbance. MHAM had been the leading statewide proponent throughout 2003 of the need for such an endeavor. Association President & CEO Mark Reinstein was one of 29 voting members whom the Governor appointed to the Commission, which began its work this February.

Mental Health Association leadership highlighted seven key areas for action from among the report's 70 recommendations:

* The need for greater uniformity of service management and provision across the state. The Michigan Department of Community Health (MDCH) and state government must play a more aggressive and effective role in assuring that service eligibility, availability, and access are guided across the state's Community Mental Health Services Programs (CMHSPs) by uniform standards, definitions, and operating procedures. Among Commission recommendations here is a call for certain serious diagnoses (e.g., schizophrenia) to qualify an individual automatically for "enhanced access" to a suggested statewide array of comprehensive services. The model array includes protected therapeutic care for persons whose clinical needs require a hospital or specialized residential stay of greater than acute length. This is a service that the state has not always been willing to foster, but one which the Commission report characterized as an "immediate attention area."

* Michigan must develop ways to better assist adults with mental illness and minors experiencing emotional disorders in the early stages of their disease. While the state's publicly funded mental health system is required (and should continue) to prioritize cases that are severe and/or involve psychiatric crisis, Michigan must do more to connect with persons in the early stages of their illness, when treatment can be most cost-effective and future problems of severity and/or crisis can be prevented.

* Michigan must join the more than 35 states which have adopted mental health insurance parity (equality) law. It is still legal in Michigan for private insurers to discriminate against persons with mental disorders, forcing them for mental health care to pay considerably more out-of-pocket and accept significantly fewer benefits than is the case for their other medical coverage. The Commission concluded that mental health parity helps reach individuals earlier in their disease states, takes some pressure off the publicly funded mental health system, has minuscule direct cost implications for employers, and has the potential for major long-term cost savings to businesses and society.

* The rights of persons receiving publicly funded mental health service in Michigan must be better promoted and protected. Prominent among several recommendations in this regard is the call for all CMHSP recipients and applicants to have opportunity to appeal a local service decision to the state, with the state's hearing of the appeal to incorporate review by and input from an independent clinician. The report also calls for state action to promote consumer use of Advance Psychiatric Directives, and for stronger authority of local and state Recipient Rights Offices in the investigation and determination of possible violations of consumer and family rights accorded by law.

* Michigan must stop the excessive flow of persons with mental illness and emotional disturbance into the adult and juvenile justice systems. There is some evidence to suggest that Michigan may have one of the nation's highest rates of adults with mental illness becoming incarcerated in local jails, often for minor offenses that may not have occurred if mental health treatment were more available and accessible. Problems have also been seen with respect to emotional disturbance in juvenile justice facilities and mental illness in state prisons. The Commission report includes multiple recommendations for assuring that treatment rather than incarceration is the practical option for responding to mental disorders. Among the recommendations is the establishment of mental health courts that have proven successful in several communities across the country.

* The state should facilitate an ongoing public-private campaign for community education about mental disorders. One of the biggest drawbacks to advances in mental health service is the stigmatizing, stereotypical view of mental disorders still held by too many people in our state. The public needs to know that mental illness and emotional disturbance are highly common, affecting all population groups within society, and highly treatable, with success rates greater than for many other medical conditions. Recovery from a mental disorder is the rule rather than the exception if treatment is available and accessible. In a related recommendation, the Commission endorses creation of a state mental health institute to develop and disseminate evidence- and practice-based guidelines and research, and to help forecast and plan for future trends, needs and environmental changes. An example of one area that will require newer and stronger consideration is the rapid increase expected in aged individuals, and the attendant problems that will accompany such increase in terms of depressive conditions, Alzheimer's disease and other disorders. This will have huge implications for mental health service.

* Funding of public treatment and support services for mental illness and emotional disturbance must be improved. For some time, Michigan's public mental health system has not been armed with the resources needed to keep pace with service demand. This has been especially true regarding adults and minors with mental disorders, who make up the large majority of the system's clients. (Persons with developmental disabilities also are eligible for services through Michigan's CMHSPs.) Funding problems have been exacerbated by the state's push to put as much service provision as possible under the umbrella of Medicaid, which is a double-edged sword. It allows the state to receive federal matching dollars for many services, but also leaves relatively little unencumbered state General Fund money for mental illness service. This is important because up to half of the 160,000 annual CMHSP mental illness clients (adult and minor) are not enrolled in Medicaid. The Commission advances a number of recommendations across multiple fronts for improving mental illness service funding. Included is the proposal of a dedicated state fund that would annually provide some of the support needed for improved services. In conjunction with this recommendation, the Commission has identified for illustrative purposes thirteen tax loophole closures or use fees that collectively could double the current $300 million in unencumbered state General Fund appropriations presently available to mental health.

MHAM Board Chair Oliver Cameron, M.D., Ph.D., noted that the issuance of the Commission report represents half the battle, with much more work ahead. "The Commission has given us an excellent road map for where we need to go," he said, "but those who care about quality mental health services now have to see that the road map is followed, rather than winding up with a report that gathers dust on someone's shelf." Cameron and Reinstein said their organization would quickly begin working with legislators, executive branch officials, and other mental health groups for steps to implement critical report recommendations.

"Treatment and support services for mental disorders are sorely lacking in Michigan. That's why the Governor appointed this Commission," Reinstein noted. "We can use the impetus of the Commission report to make significantly positive changes, which will ultimately benefit everyone in Michigan, or we can let problems fester till they're beyond the point of repair. That is the choice at hand, and I believe the people of our state will want to make the right choice."

Based on the best national data, there are about two million Michiganians experiencing some manner of mental disorder annually, with between 450,000- 650,000 representing serious cases. Publicly funded services for mental disorders are managed in Michigan by 46 CMHSPs, some of which have contracts with the state to serve both Medicaid and non-Medicaid individuals, and some of which have state contracts only for service to persons not receiving Medicaid. The Commission report calls on MDCH to have plans in place by January 2006 for reducing the state's number of CMHSPs by at least seven, and for returning to a system of state contracts with all CMHSPs for both Medicaid and non-Medicaid service. By such date, the state would also be required to complete an evaluation of the different service delivery models presently employed by various CMHSPs across the state.

Founded in 1937, the Mental Health Association in Michigan (MHAM) is a statewide citizen membership organization that advocates for improved care and treatment of persons experiencing mental disorders. Headquartered in Southfield, MHAM is affiliated with the National Mental Health Association and is partly funded by local United Ways.

MHA in Michigan would like to thank Eli Lilly and Company for distributing this press release via PR Newswire. The press release has been solely controlled and created by MHA in Michigan based on information it has collected, analyzed and reviewed.

CONTACT: Mark Reinstein of Mental Health Association in Michigan, cell: +1-734-646-8099
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Date:Oct 25, 2004
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