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The United States Supreme Court has termed involuntary civil commitment to a psychiatric hospital "a massive curtailment of liberty" Humphrey v. Cady, 405 U.S. 504, 509 (1972). The court has also emphasized that "involuntary commitment to a mental hospital, like involuntary confinement of an individual for any reason, is a deprivation of liberty which the state cannot accomplish without due process of law" Specht v. Patterson, 386 U.S. 605, 608 (1967) .
WVMHCA believes that involuntary treatment of any kind should be used only if a person is a harm to themselves or someone else, and only as a last resort. Due process such as prompt probable cause hearings before any treatment is given must be in place to protect the rights of individuals at risk of losing their liberty through involuntary psychiatric treatment.
Outpatient commitment is an infringement of an individuals constitutional rights. Outpatient commitment is court ordered treatment in the community. This strategy not only infringes on rights, it also is based on an unproven prediction that the individual may become violent at a indefinite time in the future. There is no test to prove "lack of insight" on the part of the individual, or the potential for the individual to relapse into their illness.
We do not currently have adequate services in our state to prevent individuals who otherwise could live at home from moving into nursing homes or other treatment facilities out of state. Full implementation of West Virginia's Olmstead Plan would provide resources right here at home that could assist individuals with disabilities live in the community instead of a institution.
Along with peer support, and other community supports, medication and clinical interventions is an important part of treatment for mental illnesses. People with mental illnesses are more likely than people in the general population to have serious physical ailments and need medications for those illnesses. Medicaid is a prime insurance benefit for most of these people. We believe it is important that Medicaid enable access to the best and most modern medications, and provide equal access for behavioral health services. Preventing access to new effective medications in the Medicaid formulary will create a small initial savings, but true savings will come over time using modern medicines combined with the most effective therapy and supports. It is also important to assure that medications are provided in combination with supports and effective therapies. WVMHCA also will support policies that would mandate more public input and transparency into recommended changes to services and supports covered by Medicaid.
Every night, an estimated 600,000 people are homeless in America. According to a recent study by the urban institute 46% of people who are homeless also have a mental illness. (Burt 2001) homelessness is not just an urban issue. Rural communities in West Virginia face unique challenges in serving people experiencing homelessness and mental illness.
The lack of safe and affordable housing is a serious problem. Many people cannot be discharged from hospitals because they have no place to go. WVMHCA recently has been recognized by the substance abuse and mental health services administration (Samhsa) as having one of the top four projects for assistance in transition from homelessness (path) funded projects in the united states. Funding for this project is very limited. Model programs such as this need to be expanded in West Virginia and financed with state funds in an effort to end homelessness.
The opportunity to work is extremely important to most people. People with mental illnesses are no different. However, because of their illnesses they find it difficult to work at times, and they often cannot handle the stress of low-paying jobs such as in fast food restaurants. There are programs, however, where consumers have job coaches, are matched with jobs that suit their particular skills, and have back-up support in the job when they can't cope. People are working, contributing to the tax base, and Medicaid-reimbursed programs are reduced. WVMHCA supports a increase in the resources available for employment services, and will support policies that encourages the employment of people with disabilities.
Samhsa's office of applied sciences using 2004 - 2005 data, reports that an estimated 84,000 individuals in our state age 12 and older have participated in nonmedical usage of a pain reliever, and 40,000 people in this age group needed treatment for drug abuse however did not access treatment. People who have become addicted need to be able to obtain treatment and support services to acquire and maintain recovery. There are limited resources in West Virginia for inpatient long term substance abuse treatment. WVMHCA will continue to advocate to expand access to substance abuse/addiction treatment in West Virginia.
West Virginia Mental Health Consumers Association
713 Bigley Ave.
Charleston, WV 25302