[NYAPRS Enews] Bazelon: Federal Funding & Legislative Update, NYS Top Court Rejects Forced ECT Challenge

[Harvey Rosenthal]

Bazelon Center Mental Health Policy Reporter 

Volume VI, No. 3, June 29, 2007

 

Mental Health Funding (Fiscal Year 2008)

The House and Senate Appropriations Committees with jurisdiction over
mental health funding have rejected cuts proposed in the President's
fiscal year 2008 budget for vital community based programs (see Bazelon
Policy Reporter 2/07). The Center for Mental Health Services (CMHS)
within the Substance Abuse and Mental Health Services Administration
(SAMHSA) was facing a huge $76-million cut in its Program of Regional
and National Significance (PRNS). However, appropriators in both
chambers increased the PRNS budget over last year's levels. 

Notably, the two programs the Administration slated for elimination, the
consumer support technical assistance centers and the seniors mental
health program, received respectively $2 million and $5 million. And the
jail diversion program ($6.9 million) and the State Incentive Grants for
Transformation ($26 million) were also restored to FY 2007 levels. 

The following programs also received increases over last year's level:
school violence prevention (level-funded at $93 million by the Senate
and increased to $96 in the House); suicide prevention ($37 million in
the House and $40 million in the Senate) and post traumatic stress
disorder ($32 million in the House and $35 million in the Senate). 

The Senate committee provided a new pot of funds ($15 million) under the
SAMHSA discretionary budget (PRNS) to assist local communities in
coordinating and improving the integration of behavioral/mental and
physical health services. PRNS funds are used for programs that move the
field forward, build new service capacity and translate research into
practice at the community level.

The core CMHS programs were continued at FY '07 levels (children's
mental health services program at $104 million; PATH program at $54
million), except for the mental health block grant, which received a
welcome $13 million increase by the House, and the protection and
advocacy program, which received an additional $5 million by the Senate.


 

Mental Health in the Schools 

Recognizing that schools are an important tool for the delivery of
mental health services, bipartisan Senators Ted Kennedy (D-MA), Pete
Domenici (D-NM) and Mike Enzi (R-WY) introduced the Mental Health in
Schools Act (S. 1332). The bill would increase funding for the Safe
Schools-Healthy Students program to enable states to expand school-based
mental health services for children in K-12. It allows for a flexible,
state-based approach to creating a comprehensive mental health
school-program and promotes formal collaboration between families,
schools, welfare agencies, and substance abuse and mental health
systems. 

As schools are vital settings for recognizing and addressing a child's
mental health disorder, S.1332 also explicitly provides for training of
school personnel in mental illness identification, referral and
intervention strategies. The act is a welcome initiative to addressing
the mental health crisis among our nation's youth.

Significantly, this bipartisan legislation takes an important step
beyond addressing only students with, or at-risk for, a mental illness,
by seeking to promote a school-wide positive environment for all
students. The Mental Health in Schools Act encourages schools to
implement positive behavioral interventions and supports (PBIS) into
their school curriculum. A report by the Bazelon Center for Mental
Health Law found that PBIS implementation in schools resulted in fewer
disciplinary problems and an atmosphere of learning instead of constant
power struggles between teacher and students. 

Due in large part to PBIS implementation, sponsors Kennedy, Domenici and
Enzi anticipate that the Mental Health in Schools Act's success may be
measured in a decrease of truancy, school suspensions and substance
abuse and an increase in academic competency, family-functioning and
graduation rates.

S. 1332 has been referred to the Senate Health, Education, Labor and
Pensions Committee. For more information on PBIS, please see the Bazelon
Center's publication, Way to Go. 

 

Offender Treatment and Crime Reduction Funding

The House and Senate Appropriations Subcommittees with jurisdiction over
the Department of Justice doubled FY 2008 funding for the Mentally Ill
Offender Treatment and Crime Reduction Act (MIOTCRA) to $10 million.
MIOTCRA provides grants to states and localities to develop
collaborative programs for offenders with mental illnesses, including
pre- and post-booking jail diversion, law enforcement training, mental
health courts and other court-based and re-entry services. 

The program was first funded in FY '06 at $5 million. The department has
struggled with inadequate funding to meet the high demand from for
grants to help address the much-increased rate of incarceration of
people with mental illnesses, reaching a point of national crisis. 

 

Children's Mental Health: Early Intervention

Only one in five adolescents who suffer from severe mental illnesses
receives needed specialty mental health services. On June 6, Senator
Christopher Dodd (D-CT), along with Senators Pete Domenici (R-MN) and
Edward Kennedy (D-MA), introduced the Child Adolescent Mental Health
Resiliency Act of 2007 (S. 1560). The legislation addresses this
discrepancy in adolescent mental health care and ensures that all
children have access to necessary mental health services.

S. 1560 authorizes $205 million in grant opportunities for states to
improve the quality and availability of their adolescent mental health
services. The bill encourages integration of early intervention and
prevention services for adolescents with, or at risk for, mental health
disorders within the state's school systems, educational institutions,
juvenile justice systems, substance abuse programs, child welfare
systems and other support organizations. Ultimately, S. 1560 exhorts
states to create a unified, interagency approach that reinforces access
to care.

Senator Dodd called the legislation a "strong first step toward
addressing our children's mental health so they can focus on succeeding
in school and achieving their goals." S. 1560 awaits action in the
Senate Health, Education, Labor and Pensions Committee, chaired by
Senator Edward Kennedy. 

 

Mental Health Parity

Efforts to bring mental health parity to the Senate floor are underway.
Senator Kennedy is prepared to offer a manager's amendment as a
substitute for the bill text (Mental Health Parity Act of 2007, S.558,
see http://op.bna.com/hl.nsf/id/sfak-747s3n/$File/June%2013%20Bill.pdf
). The amendment would attempt to address concern about preemption and
severability of state parity laws. The sponsors are prepared to move
forward but will do so only with assurances that floor amendments that
further change the bill will be opposed.

In the House, the Committee on Energy and Commerce heard testimony from
Rep. Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) on June 15, urging
quick action to pass the House bill (H.R. 1424, The Paul Wellstone
Mental Health and Addition Equity Act) so as to give the chamber
leverage in negotiations with the Senate. There is hope on both sides
that the bills will be approved in the House and Senate before Congress'
August recess so as to continue prospects for parity enactment this
year. Both bills have major bipartisan support, with 268 Co-sponsors of
the House bill and 52 co-sponsors in the Senate. 

 

New York Court Allows Forced ECT Treatment

(NYAPRS Note: NYAPRS wrote in favor of this suit and is very
disappointed with the court's ruling; more in a future posting).

On June 27, 2007, the New York State Court of Appeals, the state's
highest court, affirmed a lower court decision approving the forcible
administration of electroconvulsive treatment (ECT) for a state
psychiatric hospital resident. The case, In the Matter of Simone D.,
involved a long-time Creedmoor State Hospital resident who had already
received 148 ECT treatments over 12 years in the hospital. The hospital
sought permission to administer another 30 treatments against Simone's
will. 

The Bazelon Center joined with other disability rights groups in an
amicus curiae brief written by John Gresham of New York Lawyers for the
Public Interest. Among other things, the amicus brief noted that past
ECT treatments had helped Simone only marginally at best; to the
contrary, ECT had caused lasting harm to her cognitive ability. The
brief further noted that, despite its legal obligation to seek forced
treatment only as a last resort, the hospital failed to try the less
restrictive alternative of placing Simone on a bilingual ward where she
might get some meaningful talk therapy in her native Spanish language.
Simone speaks little English. 

In affirming the lower court decision, the Court of Appeals did not
address any of these issues. Instead, in a two-page opinion, it stated
that the sole ground for its decision was that the trial court did not
abuse its discretion in limiting Simone's counsel's cross-examination of
the state's psychiatric expert witness.

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