Policy Research

Humble Beginnings: A Brief Introduction to Mental Health Policy

What is Mental Health Policy?

Mental Health Policy governs the legal mechanisms by which resources for mental health care are distributed, as well as the definitions that determine who can be civilly committed, that is who can be involuntarily committed in mental healthcare facilities for treatment.

Because those with severe mental illness can qualify as people who can have their freedom legally restricted by authorities who deem them a threat either to themselves or to others, it is imperative that mental health policy not only be comprehensive in terms of the resources it allots to treatment but in terms of the lengths that we go to ensure that we are creating explicitly ethical policies.

It may seem that reiterating the need for ethical policy is redundant; indeed the goal should be ethical policy in all aspects of legislative creation.

 

Federal Policy on Mental Health

At the national level, policy on mental health is responsible for allocating large budgets for mental health resources, as well as creating policy that protects the rights of those with mental illness, both in the workplace and during treatment.

According to MentalIllnessPolicy.org, the current federal foci should include:

  • Build more psychiatric hospitals, I will write in a later post on the systematic de-funding and closures of state-funded mental hospitals and the commensurate rise in the mass incarceration of the mentally ill
  • Make more use of “Assisted Outpatient Treatment (AOT)”
  • Provide resources for families of seriously mentally ill to deal with HIPAA Handcuffs, policies that – while ensuring patient-provider confidentiality – make it difficult for families to have enough information about their loved one to support them effectively.
  • Reform or eliminate SAMHSA so that resources go to those with serious mental illness (as opposed to those with mild symptoms of anxiety or depression, here termed the “worried well”).
  • Reform Protection & Advocacy for Individuals with Mental Illness (PAIMI), in order to better aid families in acting as legally supported advocates for their loved ones with mental illness.  The goal in reforming these programs is to ensure that families do not have to fight with federally-funded lawyers in order to be able to care for their loved one.

The ‘Federal Bills’ page of the website continues, saying that while the federal government should be focusing on these critical areas, the bulk of attention regarding mental health policy continues to be directed to “improving mental wellness in the highest-functioning [the bold accent is my own],” rather than directing resources to the plight of the mentally ill.

 

California Policy on Mental Health

The Mental Health Services Act (MHSA) is the primary legislation by which the State of California has governed the increase in allotted funding, resources, personnel (and training of said personnel) dedicated to the task of treating mental illness.  MHSA was first passed as Proposition 63 in 2004 and was recently amended in 2018, and is funded by a 1% increase in income taxes on incomes in excess of $1 million.

These funds, which since the bill’s passage have come to around $15 billion, are then implemented by the California Department of Mental Health to support programs at the county level, many of which have their own particular, locally-founded structures and principles in loose accordance with those set by the state agency.

In addition to allocated funding for programs, it is at the state level that much of the policies on interaction with people with severe mental illness is also set, especially concerning requirements and protocols for involuntary commitment and treatment.

The most commonly known policy for involuntary treatment comes from the Lanterman-Petris-Short Act, and governs the criteria that must be met before a person can be qualified for a “5150”, or a 72-hour hold.

Involuntary commitment is an important but contentious policy, so I will be returning to it in later blog posts as well, not from a policy and programmatic perspective, but by exploring my personal experience with involuntary commitment as well.

 

Orange County Policy on Mental Health

Orange County, home to the Bluth Family and my Masters’ of Public Policy Program, is also home to a very comprehensive behavioral health program implemented by the Orange County Healthcare Agency (OCHCA).

OCHCA’s Behavioral Health Services and available resources span needs for youths and for adults, whether for mental health services specifically, for concerns with a combination of substance abuse and mental illness, and for specialized behavioral health resources for pregnant teens and for homeless peoples.

The county’s Behavioral Health Services also offer trainings for healthcare providers and practitioners, dedicates a significant amount of county resources to the maintenance of both inpatient and outpatient treatment facilities, and of course reserves a great deal of focus for the prevention of substance abuse and the onset of mental illness as well.

The current policies and procedures for the Behavioral Health Services are publicly available here.  I will endeavor to go through the full breadth of each policy in future postings, but a few titles that jumped out at me from the beginning were policies regarding Electro-Convulsive Treatment (ECT), the entire scope of ‘Client Rights’, and the management of information and privacy for clients.

 

Stay tuned, I look forward to exploring Mental Health Policy in greater depth soon!

AKA.CLouise


The mentally ill know.
.     .    .   .  . ……………………….to imagine beyond………………………. . .  .   .    .      .


Do you have any questions you’ve been dying to ask me? Do you have any comments or suggestions?  Let me know in the comments below!

Follow me on Twitter @akaclouise or on Facebook at /AKA.CLouise!

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