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President Bush’s Call to Action: Transform the Mental Health System. Statement of Michael Fitzpatrick, Executive Director, National Alliance for the Mentally Ill
August 26, 2005 Three years ago, President Bush visited Albuquerque, New Mexico and made a call to action to transform the nation’s mental health care system.
Last week’s tragedy in Albuquerque is a wake-up call that there is much work still to be done.
NAMI extends its condolences to the families of Officers Michael King and Richard Smith, as well as those of David Fisher, Garrett Iverson and Benny Lopez.
When tragedies occur, it is essential that we understand the nature of mental illness. We need to find out where the mental health system may have failed.
The U.S. Surgeon General correctly reports that the overall likelihood of violence from people with mental illness is low: "The overall contribution of mental disorders to the total level of violence in society is exceptionally small."
Acts of violence are exceptional. They are a sign that something has gone terribly wrong.
Severe mental illness is a brain disorder. People get sick. They also can get better. Treatment works - when it is provided and done right.
One out of five Americans experience mental illness of some kind. We must not make the mistake of stigmatizing them or their families. In Albuquerque, President Bush observed: "It is incredibly painful to watch someone you love struggle with an illness that affects their mind and their feelings and their relationships with others."
The sad fact is that the tragedy of mental illness within a family sometimes is compounded by additional tragedies.
We owe it those who died to determine what went wrong in John Hyde’s case. We need to know everything that contributed to the tragedy---and to act on the lessons learned.
In moments of extreme psychiatric crisis, police officers often are our first responders.
Along with other cities around the country, the Albuquerque Police Department has been a leader in developing a Crisis Intervention Team (CIT) and mental health court. But there is still a need nationwide for giving all police officers throughout the ranks the proper training for understanding and handling psychiatric crises.
In Albuquerque, CIT training should be expanded throughout the police and sheriff’s departments
It is important to know Hyde’s full treatment history. Where was he seen? By whom? How often? Was his care coordinated among different professionals?
Four months ago, Hyde’s mother is reported to have told police her concern that he wasn’t taking his medication.
Why wasn’t he taking it?
Over the course of 15 years, Hyde is reported as having had no trouble with the law, except for a speeding ticket.
What other circumstances may have led to the tragic crisis?
The most cost effective, state-of the-art program for ensuring adherence to prescription medications and other treatment needs is that of Assertive Community Treatment (ACT). In Albuquerque, the first ACT program did not begin until July 1st of this year.
Even when treatment is available, a small number of individuals with severe mental illness may be too sick to realize that they are ill - and that they need medical help. Brain disorders like schizophrenia may involve lack of insight, delusions and hallucinations.
In such cases, court-ordered intervention - inpatient or outpatient - can save lives. It must be available as a last resort, when voluntary treatment is not possible.
Wheviolence occurs in cases involving mental illness, there often is a connection to substance abuse. Was that the case here? In New Mexico, state programs aimed at treating substance abuse only reach 10 percent of those who need it.
Did Hyde’s family receive enough support in trying to cope with his illness?
NAMI New Mexico offers a free Family-to-Family Education program for families coping with mental illness. It also offers In Our Own Voice, a civic education program presented by people living with mental illnesses.
Families, medical providers, teachers, employers and others all have a role in educating our communities and transforming the system. That includes not just the Albuquerque community, but also state and federal government leaders.
Lessons learned from the tragedy must result in legislative action. The City of Albuquerque already has taken steps to strengthen behavioral health services financed through a voter-approved mill levy. Those kinds of efforts deserve support.
Lessons learned should be coordinated with New Mexico’s Behavioral Health Purchasing Collaborative. The tragedy should result in efforts to improve the mental health system statewide.
President Bush declared in Albuquerque: "Our country must make a commitment: Americans with mental illness deserve our understanding, and they deserve excellent care…They deserve a health care system that treats their illness with the same urgency as a physical illness."
Last week’s tragedy underscores that urgency.