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Testimony by NAMI PA 2008

The House Health and Human Services Committee’s
Health Subcommittee
Testimony
James W. Jordan, Jr.
Executive Director
National Alliance on Mental Illness
(NAMI PA)

August, 11, 2008

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Chairman Wheatley and members of the House Subcommittee on Health, thank you for inviting the National Alliance on Mental Illness, Pennsylvania (NAMI PA). We appreciate the opportunity to identify challenges we see in the mental health system as well as to highlight the success both of the state system and of our organization.

I am James Jordan, Executive Director of NAMI PA. NAMI PA is a statewide grass roots non-profit organization dedicated to helping mental health consumers and their families rebuild their lives and conquer the challenges posed by severe and persistent mental illness. Our purpose is to help all people who are affected by mental illnesses. We know that help comes in a variety of ways - educating the public, members of the criminal justice system, families and consumers, networking through national organizations, and participating in government programs.

We strive to educate the public about the true nature of mental illness and to combat the stigma and discrimination often faced by persons with mental illness. We have 60 affiliates across the Commonwealth who meet monthly. These affiliates provide support, education and advocacy in their communities.
My testimony today is intended to present a balanced perspective on achievements and challenges we face as family members and consumers, customers, of the State and the services it provides. This system has been built over many years by members of both political parties. The current system is the outcome of the best efforts of both parties in addressing the needs of one of the Commonwealth’s most vulnerable populations, persons with a mental illness. For meaningful enhancements to occur, a commitment for a bipartisan effort is essential. It is important to remember that mental illness is an equal opportunity disease. It respects no barriers real or imaginary. It does not respect income levels, education or background. Nor does it respect ethnic or religious backgrounds. It is a disease that affects everyone.

Current System- Positive
There are many positive developments and components to our current mental health system. I have listed just a few:
• Research has created a better understanding about mental illness, the workings of the human brain and physical and mental capabilities of humans.
• Enhancements in treatment for persons with mental illness.
• Improvements in developments of new medications.
• Endorsement and support for the “Recovery” concept.
• NAMI ranks Pennsylvania as number two in the nation for overall funding for mental health services.
• Development of community based services.
• Downsizing of state psychiatric hospitals.
• Reduction in inappropriate hospitalizations.
• Support of innovative programs like A.C.T. (Assertive Community Treatment)
• OMHSAS promotion and support for the peer specialist program.
• OMHSAS focus on housing and employment.

NAMI Pennsylvania – Accomplishments
NAMA PA has many accomplishments. I have listed a few below:
• We have affiliates throughout the Commonwealth. These affiliates provide support to family members and consumers in need. They sit on MH/MR and other community boards. They also work with members of the criminal justice system including judges, attorneys and others to assist in education and advocacy for consumers and families.
• Education is at the core of our advocacy activities. These educational programs have a profound impact on persons who take them. We provide these classes free of charge to families and consumers. NAMI provides education to families, to consumers, to providers and others regarding mental illness and co-occurring disorders. We also provide education and training to members of the criminal justice system.
• Forensic Interagency Task Force (FITF). Several years ago, NAMI PA established a FITF. The primary purpose of the FITF is to facilitate communications between state agencies, counties, providers and advocates. Participants include the State Departments of Corrections, Welfare, Health, and several counties including Philadelphia and Allegheny. In addition, service providers from across the state and county prison officials are to be counted as members of this task force.
• We also provide critical additional education and training through our Annual Conference and Regional Conferences.
• We work with governmental entities at the Federal, State, County and Municipal levels on behalf of those with a mental illness. We also work with community organizations including schools, religious or faith based organizations and businesses.
• NAMI PA’s Board composition includes a Consumer Advisory Council and a Veteran’s Advisory Council.

Challenges to NAMI PA
Any system can be improved. The following is list of some of the challenges we have identified:
• The lack of a comprehensive state plan for hospital closure which looks at the entire mental health system. This plan would address the impact of closures as it relates to community services currently in place. It would provide a strategy for funding to support both the closure activities and maintain the community programs. This plan would include identified funding.
• Patients are sometimes moved out of their service areas because of a lack of beds.
• There is a growing trend to incarcerate the mentally ill in jails and prisons. This places an unrealistic burden on our corrections facilities, with minimal hope of reducing recidivism. It also places an unreasonable burden on families and consumers who look for services outside of the criminal justice system.
• Inmates with mental illness are likely to max out because of a lack of programs and services in the community.
• There is a need for education and training for members of the criminal justice system including police officers, attorneys, prison guards. administrators and judges.
• Insurance discrimination against persons with mental illness denies needed treatment to consumers and places a major financial burden on families.
• There are increasing challenges presented to families by veterans who return with a mental illness.
• The need for better coordination of funding and treatment for persons with a co-occurring disorder.
• The need for additional housing and better comprehensive services in communities to match the diverse needs of consumers. Pennsylvania has a severe need for additional housing for the mentally ill with appropriate residential services. There is a strong need at every element of a spectrum that extends from those requiring only occasional services to those who require enhanced care on a 24/7 basis. We believe there is a need for a modest degree of congregate living for mentally ill persons as opposed to independent living only.
• System back up which results in long waiting list for services.
• Counties face a shift in funding for services.
• Inadequate wages for direct services workers. This results in a high turnover of staff and a reduction in the quality services being provided.

Challenge to Legislators
This is a challenge to members of this committee and to the Executive Branch of State Government. Create a bi partisan initiative in which the Legislature, the Executive branches of government, family advocates and consumers, all of whom would partner with one another to review the current system of mental health programs and services and develop a comprehensive plan.

Recommendations:
The following are recommendations for consideration by the legislature as it sets in place an agenda on these important issues:
• Develop a comprehensive plan for hospital closures, forensic mental health in patient services and community services.
• Review the current budget and develop a plan to meet the funding requirements of a comprehensive plan.
• Insist that all funds appropriated for hospital care be transferred to the communities that must provide the needed services. Note: It is important that these funds not be transferred to other programs. Use of funds that are currently set aside for hospital operations will move communities forward and make them better able to meet the service and support needs. Moving patients to a community setting should be a positive improvement in the care of patients. The move should result in a system that is better than the one from which patients are leaving. It also should not result in the denial of services to those in the community who are currently in need of services outside of the state hospital system.
• Support innovative, evidence based programs like A.C.T (Assertive Community Treatment) and Mental Health Courts.
• Support family and consumer training.
• Recognize the importance of better integration of state programs for co-occurring disorders.
• Support efforts to establish, through federal and state legislation, parity.
• Support establishment of Mental Health Courts.
• Develop innovative uses for state hospital grounds.
• Support a bi-partisan review of the current mental health system.
• Support education for families, consumers and the general public.
• In addition, we encourage the committee to explore options that would enable small rural communities to pool resources so that community services are available to persons who are in need. Rural communities are limited in terms of available services due primarily to their size. However, they face the same challenges experienced in larger communities.
• Finally, think outside the box regarding the use of state hospital grounds. We believe that revenues generated related to the use of this state property should be used to help fund community based services. We would like to see the state develop a model community using this property. This concept involves development of a supportive community that provides housing and services for persons with mental illness. This community would also support businesses and housing and services for people who do not have a mental illness. Note: in general we support leasing of lands but recommend that property not be sold.

Suggested Resources
Landmark policy Reports on Mental Health Care System:
• Surgeon General’s Report 1999
• President’s Freedom Commission, 2004 (on NAMI National Website)
• A Call for Change, OMHSAS 2005
• Grading the States , NAMI 2006

We commend the members of the House Health and Human Services Subcommittee for holding these hearings. Most importantly, we applaud the efforts being made here today, which may provide relief to families, and consumers who are in need of appropriate treatment for mental illness. I will be glad to answer questions.
Thank you.