Mental Health America of Indiana
2007 Public Policy Agenda
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ISSUE: ACCESS TO MENTAL
HEALTH MEDICATIONS
STATEMENT: Access to medications is critical for people
with serious mental illness and addiction. Due to research in the
last decade, new medications have been developed that can have
better outcomes and fewer side effects for individuals with serious
mental illness. Studies have shown that by cutting costs in the
area of mental health medications, states have spent more money
on even more costly services such as crisis care and hospital services
for the long term. Most importantly, quality of life for individuals
is impaired and the individual may not fully recover to the functioning
level that they had achieved before switching medications.
The Mental Health America of Indiana, consistent the recommendations
from the Transformation Work Group (TWG), will work to ensure that
persons with mental illness and addiction have access to the most
appropriate medications, whether they are provided by Medicaid,
Medicare, DMHA, DOC, private insurance, or by any other payer source
or in any other treatment setting.
PRIORITY LEVEL I
ISSUE: FORENSIC ISSUES
STATEMENT: Mental health, addictions and corrections issues
often overlap and persons with mental illness and/or addictive
disorders fall through the cracks in our criminal justice system.
Historically, our correction facilities have been inadequate for
persons with a mental illness or addictive disorder. MHAI has commissioned
a study to evaluate DOC services and implement recommendations
based on the results. Ultimately, prevention may avoid the criminalization
of mental illness and addictions and the resulting labeling that
often creates barriers to housing, employment, and the ability
to be a productive member of society.
MHAI, consistent with the recommendations from the Transformation
Working Group, will advocate for a comprehensive change in our
system so as to provide for a continuum of mental health and addictions
treatment for forensic patients, both juveniles and adults. The
continuum must include: a statewide pre-& post-diversion program
with treatment for individuals charged with misdemeanors and non-violent
class “D” felonies; a statewide community corrections program with
a mental health and addiction treatment component; re-entry programs,
including eligibility for financial assistance, treatment, employment
and housing; and a forensic facility designed to treat forensic
patients that includes access to appropriate mental health medications.
Further, police and correction officers must receive adequate mental
health and addictions education and programming.
PRIORITY LEVEL II
ISSUE: MENTAL HEALTH AND
ADDICTION FUNDING
STATEMENT: According to an actuarial study conducted by
Mercer, there are 228,971 persons in need of services from the
Division of Mental Health and Addiction at 200% of poverty level
while 153,477 people are not receiving services from the Hoosier
Assurance Plan. Historically, the funding for the Division has
been flat-lined creating a net deficit in funding due to cost of
living increases and inflation. It is imperative that the Division
of Mental Health and Addiction budget for hospital and community
services be adequate to meet designated outcomes for SMI, SED,
SA, and Forensics. The huge gap that currently exists between the
need and the services provided already has left the system in crisis.
The Mental Health America of Indiana will work to insure that
mental health and addiction services are increased as appropriate.
PRIORITY LEVEL II
ISSUE: INSURANCE PARITY
STATEMENT: Full health insurance coverage is typically
available to provide coverage for patients with diabetes or cancer,
and now for persons who have been diagnosed with a mental illness.
Such coverage is the cornerstone of any prevention program. Certainly,
untreated mental illness and addictive disorders create additional
costs, both in mental and physical health care. While SAMHSA studies
show the cost of substance abuse parity to be minimal, the Indiana
legislature has only supported the concept for state employees
and limited the private sector to a mandatory offering.
With regard to the uninsured, the issues are no different. Any
health insurance program targeted to the uninsured must have mental
health and substance abuse coverage—and at the same level as physical
health care.
MHAI will work for full parity legislation that prohibits any
discrimination of insurance coverage against all persons across
the lifespan in need of treatment for mental illness and substance
abuse, irrespective of the sector for which the coverage is provided.
PRIORITY LEVEL I
ISSUE: INCREASE ALCOHOL
AND TOBACCO TAX
STATEMENT: Mental Health and Addictions treatment is significantly
under funded in Indiana. MHAI supports additional alcohol and tobacco
taxes and recommends that a portion of this additional funding
be utilized to support mental health and addictions treatment services
as recommended by the Transformation Working Group.
MHAI will work for revenue enhancements to support mental health
and addictions treatment.
PRIORITY LEVEL II
ISSUE: CHILDREN, YOUTH
AND JUVENILE MENTAL HEALTH AND ADDICTION SCREENING POLICY
STATEMENT: The prevalence of mental illness, addiction
and serious emotional disorders in children and youth under age
18 is oftentimes not adequately or appropriately diagnosed. At
the same time, the efficacy of early treatment for mental illness,
addiction and serious emotional disorders is proven and the benefits
have been demonstrated.
The Mental Health America of Indiana supports and will work to
guide and create, consistent with recommendations made by the President’s
New Freedom Commission, the Surgeon General and the Transformation
Working Group, opportunities for systematic, standardized and regular
screening of children for mental illness, addiction and serious
emotional disorders and youth in any and all appropriate settings
including but not limited to public and private schools; child
welfare; juvenile courts; and primary care settings. Any screening
program must:
- ensure that only qualified personnel conduct the screening
and assessment, and develop the treatment program;
- ensure that records of the screening, assessment and treatment
are kept confidential in accordance with current privacy standards
for these types of records; and
- prohibit discrimination based on the screening, assessment
and treatment.
- provide for active parental consent
- not be used as an assessment
MHAI supports all efforts to avoid stigmatization as well as the
parent’s right to opt out. Once an illness is identified, treatment
must also be made available.
PRIORITY LEVEL: I
ISSUE: MENTAL HEALTH HOSPITALS
STATEMENT: Indiana’s commitment to the provision of mental
health care is stated in the Constitution. This commitment has
historically taken the form of serving large numbers in state hospitals
to now serving individuals in the least restrictive setting, with
only a small proportion served in state institutions. Indiana must
insure that consumers of mental health and addiction services have
access to the full continuum of care, including long-term inpatient
psychiatric services, when required. The state must also insure
the quality of these services and whenever appropriate, ensure
that they are evidence-based.
As the state moves toward the provision of inpatient care in the
state hospital setting, MHAI will advocate to insure access to
appropriate and quality services. Specifically, MHAI will work
to ensure that an appropriate, evidenced-based, continuum of mental
health services, including addiction services, are provided by
appropriately credentialed personnel for current patients and individuals
for whom long term in-patient services are appropriate. The Association
will advocate for the provision of services in the least restrictive
setting and the appropriate use of inpatient beds. Adequate funding
must be made available and all dollars generated from potential
efficiencies must be reinvested in the mental health system.
PRIORITY LEVEL: I
ISSUE: OUR TOWN
STATEMENT: Our Town is a program of the Mental Health Association
of Greater Indianapolis and is a replication of a program recognized
as a best practice by the President’s Freedom Commission. Our Town
supports and assists young adults with psychiatric disabilities
in recognizing and using their strengths and abilities to live,
work and thrive in the community.
MHAI will advocate for the funding necessary to continue and potentially
expand Our Town in Marion County and in other communities when
appropriate.
PRIORITY LEVEL: I
ISSUE: DEATH PENALTY and
PEOPLE with MENTAL ILLNESS
STATEMENT: The process of determining guilt and imposing
sentence is necessarily more complex for individuals with mental
illness. A high standard of care is essential with regard to legal
representation as is a psychological/psychiatric evaluation for
individuals with mental illness involved in death penalty cases.
MHAI believes mental illness should always be taken into account
during all phases of a potential death penalty case and opposes
the death penalty in cases where the defendant has a Serious and
Persistent Mental Illness.
PRIORITY LEVEL: II
ISSUE: MENTAL HEALTH TRANSFORMATION
STATEMENT: The President’s Freedom Commission recognized
that the country’s mental health system was woefully inadequate
and found that it must be significantly transformed to appropriately
serve individuals in need of mental health services. The Commission
called on each State to plan to transform their system of mental
health care. Indiana has taken on this responsibility by creating
the Transformation Working Group to develop recommendations to
Transform the Mental Health Delivery system in the Hoosier State.
Emphasis will be placed on effectiveness, efficiency, coordination
and collaboration between state agencies.
MHAI will support and allocate available resources to provide
leadership to the Mental Health Transformation effort.
PRIORITY LEVEL: I
ISSUE: SOCIAL HOST LIABILITY
STATEMENT: In a 2005 poll of 13-18 years olds, conducted
by the American Medical Association, one out of three minors said
it is easy to obtain alcohol from their homes with their parent’s
knowledge. That number increases to 40% when the alcohol is obtained
from a friend’s parent. One out of four parents polled agreed that
children should be able to drink in their own homes in the presence
of their parents. Some local Indiana polls indicate that more than
half of minors get their alcohol from their parents. Annual data
from the Indiana Prevention Resource Center shows that 26% of Indiana
high school seniors engage in binge drinking, and the 2006 Indiana
Collegiate Alcohol Use Survey data shows that 45% of Indiana college
students engage in binge drinking.
Parents are often a first source of alcohol for minors, whether
the parents give it to them, allow drinking in their home, or the
minors take it from their parents without their knowledge. Other
adults such as older friends and siblings also provide alcohol
to minors or allow minors to drink in their homes. The current
penalty for providing alcohol to minors is a Class C misdemeanor.
MHAI supports increasing penalties for providing alcohol to minors
to send a stronger message to parents and other adults that providing
alcohol to minors is a serious offense. We support legislation
to increase the penalties for providing alcohol to minors to a
Class B misdemeanor for a first offense, Class A for subsequent
offenses, and imposing and automatic D Felony if the drinking results
in a serious injury or death to the minor or another person.
PRIORITY LEVEL I
2005 Public Policy
Agenda
2003 Public Policy Agenda
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