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New guide for policymakers and practitioners details Mental Health Courts research

The Council of State Governments Justice Center has announced the release of Mental Health Courts: A Guide to Research-Informed Policy and Practice. The guide examines available studies on mental health courts and translates the findings to help policymakers and practitioners understand their design and function, as well as their success.

Supported by the John D. and Catherine T. MacArthur Foundation, the guide reviews how mental health courts address the issues related to people with mental illnesses in the criminal justice system.

"Individuals with mental illnesses often cycle through our courts and mental health systems without positive outcomes for the individual, the community, or taxpayer spending," said Justice Center board member and Idaho Administrative Director of the Courts Patti Tobias. "It is so important that we look to mental health court research to inform our responses to the needs of these individuals and to make the most effective use of court and public safety dollars."

Research findings suggest that mental health courts Are increasingly likely to accept individuals charged with more serious offenses, including felonies and, in some jurisdictions, violent crimes.
• Lead to lower rates of recidivism for people with mental illnesses—in particular, participants are less likely to be arrested for new crimes than defendants in the traditional criminal court system.
• Are more effective than the traditional court system and jails at linking participants to mental health services.
• Have the potential, over time, to save money through reduced recidivism and avoiding associated jail and court costs, and through decreased use of the most expensive treatment options, such as inpatient care.

The Justice Center report, as well as related materials from a Bureau of Justice Assistance-supported series, can be downloaded for free at http://consensusproject.org/issue_areas/courts Included is a report on the Essential Elements of a Mental Health Court.  Similar rsearch reports on law enforcement and community corrections’ responses to people with mental illnesses can be found at http://consensusproject.org/jc_publications.

Study estimates value of providing mental health care to disaster survivors

Making evidence-based mental health services accessible to everyone in a disaster-stricken area would have substantial public health benefits, according to a statistical model developed by National Mental Health Institute-funded researchers.

Research on survivors of Hurricanes Katrina and Rita show these individuals continue to face many persistent mental health issues—conditions that may at times be worsened by lack of availability or access to proper mental health care services.

To help guide future disaster plans, a group of researchers led by Kenneth B. Wells, M.D., MPH, of RAND Corporation and UCLA Semel Institute, Health Services Research Center, developed a model to estimate the costs and outcomes of providing enhanced, evidence-based mental health care in a post-disaster setting.

According to their model, providing comprehensive mental health care coverage would cost around $1,133 per person—or about $12.5 billion for the entire disaster-affected population—over the period from seven to 24 months following the disaster.  Nearly half this amount would be spent in months seven through 12 due to screening and an initial surge in need.

The researchers estimated that, overall, this spending would reduce the total number of episodes of mental illness associated with the disaster in the affected population by 35 percent, compared with providing no mental health treatment.  Reducing either the level of service coverage or available treatments would reduce both costs and benefits.

Though formal cost-effectiveness analysis was beyond the study’s scope, researchers estimated that the cost of such comprehensive care would be within the range of other accepted medical practices and that the gains of preventing psychiatric episodes would be comparable to the cost benefits of screening people for high blood pressure. However, given the considerable costs and resources required of extending mental health care to all those involved in disaster, further studies are needed to determine whether such broader efforts are advisable and, if so, to what degree.

SAMHSA hopes System of Care approach will improve mental services for children

From 5 to 9 percent of American children between ages 9 and 17 have emotional disturbances severe enough to impair their functioning, according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).  Yet most of them do not get the care they need because services are either too expensive or unavailable.

Caring for these children with serious emotional issues is a challenge for families and mental health professionals. To help, SAMHSA's Center for Mental Health Services (CMHS) has a successful program to coordinate care and keep the focus on the child.

Launched in 1992, SAMHSA’s Comprehensive Community Mental Health Services Program for Children and Their Families promotes a coordinated, community-based approach to care for children and adolescents with serious mental health challenges and their families.  There are currently 59 active grantees involved in the program. They bring together everyone involved in a child’s life to formulate a plan—a “system of care.” With the child and family at the center of the decision-making process, a workable plan is created.

To read more, see Coordinating Care for Children with Serious Mental Health Challenges on the SAMHSA News website .  You can also sign up for the SAMHSA newsletter at the website and access archived copies. 

Major NIMH research project to test approaches to treating schizophrenia

The National Institute of Mental Health (NIMH) has launched a large-scale $40 million research project to explore whether early and aggressive treatment—individually targeted and integrating a variety of different therapeutic approaches—will reduce the symptoms and prevent the gradual decline of functioning typical of chronic schizophrenia.

The Recovery After an Initial Schizophrenia Episode (RAISE) project is being funded by NIMH with additional support from the American Recovery and Reinvestment Act.
The project “will help us determine whether intervention that is started early, incorporates diverse treatment and rehabilitation approaches, and is sustained over time, can make it possible for more people with schizophrenia to return successfully to work and school,” said NIMH Director Thomas R. Insel, M.D. 

Insel said the interventions being tested will be designed to be readily adopted in real-world health care settings and quickly put into practice.

Despite the availability of moderately effective treatments, such as antipsychotic medications and various psychosocial interventions, people with schizophrenia often do not receive treatment until the disease is already well-established.  In these cases, recurrent episodes of psychosis result in costly multiple hospitalizations and disabilities that can last for decades. 

Periods of unemployment, homelessness, and incarceration are common, making schizophrenia a costly disease for individuals, their families, and the community at large.

“The ultimate goal of the initiative is to eliminate the chronic form of schizophrenia that is so costly and devastating to the individual, family members, and society as a whole," said Robert Heinssen, Ph.D., acting director of the NIMH Division of Services and Intervention Research and project officer for RAISE.
RAISE will test approaches that involve intervening immediately upon first diagnosis of schizophrenia, systematically incorporating the range of options that are now available in a more piecemeal fashion.

These options include medications, psychosocial treatments, and rehabilitation, as well as teaching patients and families how to manage the disease. The hope is that such a coordinated approach tailored to each individual and sustained over time may make lasting differences in the acceptability of treatment and in overall functioning.
Agencies and organizations that play a role in providing health care and other services to people with schizophrenia will have an opportunity to participate in the design of the interventions to be evaluated by RAISE.

There will be two initial phases of the trial, during which the investigators will refine the interventions with input from stakeholders and conduct a feasibility study of whether they can be implemented in community treatment settings and be evaluated in a randomized clinical trial design. With long-term funds committed by NIMH to complete these phases plus a full-scale clinical trial, funding for the study is $40 million.

NAMI Videos now on YouTube

NAMI Florida is taking its “Faces of Hope and Courage” campaign to YouTube, using the popular Web site to share its message with a broader audience. There are five videos on NAMI Florida’s YouTube site, featuring stories of recovery told by Clarissa, John, Jacob, Elizabeth and Robin.  The five describe their illnesses and how they found their personal path to recovery.

To see the videos, go to  http://www.youtube.com/user/NAMIofFlorida.  Each of the videos can be downloaded from YouTube. Also, those advocates who would like make presentations on recovery can contact NAMI Florida to obtain a DVD featuring the five videos. These can be obtained by contacting NAMI Florida at 850-671-4445 or e-mailing namifl@namifl.org.

These five people were able to get their life back due to access to education, services and medications,” said Judi Evans, NAMI Florida’s executive director. 

She urged mental health advocates to share the YouTube link with their legislators to help demonstrate the value of treatment in turning lives around.  ”Everyone deserves this opportunity,” said Evans. “We must not allow Florida's government to limit a person's future.”

NAMI Florida Consumer Council Earns Prestigious National Award

NAMI Florida has been named the 2009 recipient of the Exemplary State Organization Award, which recognizes “exceptional commitment to promoting participation in the NAMI movement by fostering partnerships with consumers, providing consumer leadership opportunities and promoting recovery, independence, and choice.”

The award was presented on July 9 in San Francisco at the National NAMI Business Meeting.  Consumer Council Board members Susan Lang and Mike Mathes received the award on behalf of NAMI Florida.
 
Florida was chosen for this prestigious award because of its development of an exceptional state consumer council, which has helped to build the growth of local consumer councils, consumer education and support programs, and advocacy efforts throughout the state. 

“I believe this is the second time NAMI Florida has received this award, “ said Judi Evans, NAMI Florida executive director.  “This is one of the highest honors NAMI Florida could receive and I am so very proud of our Council and all of their accomplishments,” she said.

The NAMI Florida Consumer Council's Guidebook for Development of a Local Consumer Council is used as a model document throughout the country in assisting other NAMI organizations to grow and strengthen their respective consumer councils. 

Evans noted the efforts of board member Mathes, who has contributed to strengthening and developing the Council and supported its members. She also recognized the contributions of Lang, Jennifer Helsel, Peggy Yackulich, Steven Thompson, Colin Haley and Rose Delaney for their dedication to the Council and the recovery movement.

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