Mental-Health Advocacy Gears Up

Jul. 29--Mental health advocates rolled up their sleeves with renewed focus last week, after a presidential panel outlined vast goals to improve the nation's system of caring for people with psychiatric illness.

Sixteen national groups are gearing up their advocacy efforts under the umbrella of the Campaign for Mental Health Reform.

By combining their efforts and their influence, the groups hope to keep the panel's goals at the top of the public agenda.

"One reason we brought the campaign together was because we anticipated there'd be a great deal of work to do," said coordinator Bill Emmet. The campaign plans to focus on federal mental health policy and how that affects state delivery of services.

The presidential panel, called the New Freedom Commission on Mental Health, criticized the current emphasis by mental health care providers on managing disease symptoms, rather than helping clients achieve full recovery. Crucial to reform, the panel wrote, is the seamless integration of a variety of services – including not just health care but financial, employment and housing support.

A national survey released last week suggested how far some services for the mentally ill have to go. The survey, of members of the National Alliance for the Mentally Ill, focused on the experiences of group members, which include people with mental illness, family members and friends.

Among the findings:

-- More than half the respondents with mental illness had annual incomes of $10,000 or less.

-- More than half have had more than one diagnosis, most commonly schizophrenia and manic depression.

-- Eighty-five percent had been hospitalized for psychiatric illness.

-- One-quarter lived with parents.

Half the NAMI members in the survey cited high housing costs as a barrier to independent living; almost 40 percent cited a lack of local support services.

In addition, respondents gave low grades to employment support. Stigma against the mentally ill, fear of losing health benefits or disability income, and inadequate treatment were the most-cited barriers to employment.

"These results depict a disenfranchised group of Americans in the prime of their lives," the survey noted, "struggling with serious mental illness without the benefit of needed services and support."

The survey is part of the group's ongoing Treatment/Recovery Information and Advocacy Database project, known as TRIAD. As a reflection of the state of mental health care, the project should help reveal whether the goals of the presidential commission are being achieved, said Rick Birkel, NAMI's executive director.

"That's the way to gauge whether we're making progress or not," he said. "Surveys like that over time every year should show a change, that more people are working, that more people have access to services."

The federal government, meanwhile, is taking steps toward one of the presidential commission's goals of integration of services for the mentally ill, officials said.

U.S. Health and Human Services Secretary Tommy Thompson has directed one of his agencies, the Substance Abuse and Mental Health Services Administration, or SAMHSA, to evaluate how the federal government can work toward the goals in the new report.

SAMHSA administrator Charles Curie, a member of the presidential panel, said his agency will ensure that all federal agencies serving the mentally ill take part in a broad plan to improve services, streamline care and promote recovery. Those agencies include the Centers for Medicare & Medicaid Services; the National Institutes of Health; the Departments of Housing and Urban Development, Education and Veterans Affairs; and the child welfare system.

"That also will mean engaging the states," said Mr. Curie, "because the states is where the action is when it comes to mental health services." To that end, SAMHSA is overseeing grants to encourage states to develop their own comprehensive plans.

"I do think we're going to be seeing the hard work done at the state level ... and also at the community level," said Dr. Birkel.

Although revolutionizing the entire nation's system of care can take a long time, some significant change can be achieved fairly quickly, Dr. Birkel said.

"There are communities today that could evolve such a model within three years. There are states today that could get to that within five years," he said. "For many, it may take much longer."

Undaunted, advocates said they are committed to a common agenda: promoting the wholesale reform of the mental health system that the president's commission outlined.

"We saw this as a ... once-in-a-generation opportunity," said Mr. Emmet, of the National Association of State Mental Health Program Directors, one of the participants in the Campaign for Mental Health Reform. Other groups include the American Psychiatric and Psychological associations, the National Mental Health Association, and the National Alliance for the Mentally Ill "We knew from the past if we weren't speaking with one voice," Mr. Emmet said, "that Congress and the administration would dismiss what we were saying."

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(c) 2003, The Dallas Morning News. Distributed by Knight Ridder/Tribune Business News.

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