Secretaries' Innovation Group

Helping individuals succeed in substance abuse and mental health treatment using mandatory Assisted Outpatient Treatment - July 2024
* Outpatient Civil Commitment: A compassionate response to anosognosia
Amy Lukes, Treatment Advocacy Center

With substance abuse and mental illness such a large feature in non-functioning adults receiving benefits or preparing for work, how can agencies better help individuals caught in the cycle of repeat hospitalizations, homelessness, and incarcerations? Assisted outpatient treatment (AOT) aims to motivate and assist individuals with severe mental illness (SMI) usually with the cooperation of the civil court system to enforce participation.
The AOT participant is court-ordered to follow an individualized treatment plan in the community for a specific period, and the local mental health system monitors adherence to the treatment plan. When implemented effectively, AOT significantly increases treatment adherence.

Youth Qualified Residential Treatment Programs - December 2023
*Addressing the Crisis in Youth Mental Health
Lisette Burton, ACRC

In 2021, a diverse coalition of over 600 national, state, and local organizations signed a joint letter urging Congress to exempt Qualified Residential Treatment Programs (QRTPs) from the Institutions for Mental Diseases (IMD) exclusion. Members of Congress introduced The Ensuring Medicaid Continuity for Children in Foster Care Act of 2021, a bipartisan, bicameral legislation to ensure that children in foster care with assessed behavioral and mental health needs would not be at risk of losing their federal Medicaid coverage if placed in a QRTP over 16 beds. Unfortunately this bill was not passed into law. California, in an effort to comply with the IMD 16-bed limitation, has lost over 1000 QRTP beds in the last 18 months. At least 18 states are currently not implementing QRTPs. There is bipartisan, bicameral movement on the effort to address the QRTP-IMD issue this Congress (HR 4056/ S. 3196).
This issue has been routinely raised by SIG members. Joining us for a discussion of this issue is Marie Cohen of the Child Welfare Monitor
and Lisette Burton of the Association of Children’s Residential and Community Services ARPA.
2023 QRTP-IMD Overview and Support Letter

How to best help the seriously mentally ill - November 2022
* Severe Mental Illness: What Can a Governor’s Administration Do?
Lisa Dailey, Executive Director, Treatment Advocacy Center

Individuals with severe mental illness (e.g. schizophrenia) are under-treated as compared to the less severe where the money is flowing and who can be helped through voluntary community settings. Yet individuals with severe mental illness can be the most disruptive and potentially dangerous to society, especially if they are subject to anosognosia (unaware they are sick).
Assisted Outpatient Treatment (AOT) is the practice of providing community-based mental health treatment under civil court commitment, as a means of motivating and requiring the adult with mental illness who does not voluntarily adhere to his treatment plan to fully comply. In addition AOT focuses the attention of treatment providers themselves on the need to work diligently to keep their subjects engaged in effective treatment.
SIG states using AOT include OH, TX. SIG states not using AOT at all include FL, IN, TN.

Spend less on “mental health” and more on serious mental illness - November 2018

Mr. Jaffe takes a contrary view from that of advocacy groups and established industry stance. He writes: If you’re a mental-health advocate, you want to teach the public the mentally ill are no more violent than others. You don’t want to teach the public that the untreated, seriously mentally ill are more violent - - but instead that everyone can live in the community, not that some people do need institutional care. So the mental-health groups have kind of disengaged themselves from treating the seriously mentally ill in favor of re-defining mental illness as something everybody has.
Mr. Jaffe argues in favor of improved treatment regimens including Asissted Putpatient Treatment (AOT), and its benefits to society and the mentally ill themselves.

Substance Abuse and Mental Health - June 2018

* SAMHSA: Addressing National Mental Health and Substance Use Issues
Dr. Ellie McCance-Katz, Assistant Secretary for Mental Health and Substance Abuse, HHS

No issue facing the states and Congress is more threatening to society and the labor force than the growth of drug abuse. From heroin and pills to the spread of legalized marijuana, we must tackle needed interventions but move beyond to larger prevention strategies. What are some of the long term strategies we can enlist now which will slow the growth of use among adults and children? We will be joined by Dr. McCance-Katz who has worked in the addiction field and is in charge of the federal program. Dr. McCance-Katz has published extensively in the areas of clinical pharmacology, medications development for substance use disorders, drug-drug interactions, addiction psychiatry, and treatment of HIV infection in drug users.

Implementing Policies to Assure that the Mentally Ill are on their Medication - July 2017

The session will focus on the historical consequences of the release of hundreds of thousands of untreated mentally ill patients from hospitals and the subsequent criminalization of this population in jails and prisons throughout the nation. The presenters will discuss the lack of preparation that community-based facilities have experienced to treat the severely mentally ill, what state agencies can do to help ameliorate this large scale societal change, and the opportunities posed by the current environment to coordinate responses between public health and criminal justice systems.

Mental Illness - November 2015

Ms. Berger will discuss the historical consequences of the release of hundreds of thousands of untreated mentally ill patients from hospitals in the 60s and 70s, and what state agencies can do under certain laws to require mentally ill patients to take their prescribed anti-psychotic medication they need to maintain their health. Dr. Smith will describe such a program he manages in Summit County Ohio, operational considerations and the results.

Conference Materials: Mental Health

**To view power point presentations and supporting materials, click on * bold, underlined title.