Saturday, February 22, 2014

Bill That Would Fund Pilot Programs for Assisted Outpatient Treatment Needed

The following op-ed in support of AOT in Tennessee and the "Helping Families in Mental Health Crisis Act" was written by Karen Easter (and DJ Jaffe) and appeared in Knoxville News Sentinel

Bill that would fund pilot programs for assisted outpatient treatment needed
by Karen Easter and DJ Jaffe 

Saturday, February 22, 2014

The recent stabbing of Laurie Nichols, allegedly by her daughter Katie, shows the dire need for Gov. Bill Haslam and state legislators to overrule the Tennessee Department of Mental Health and pass a meaningful assisted outpatient treatment bill.

Assisted outpatient treatment would allow local courts to order and monitor treatment for the most seriously mentally ill, while a federal bill could provide the mechanism to fund it.

A neighbor told WVLT-TV journalists that Katie Nichols was “unstable.” After allegedly stabbing her mother, Katie Nichols told reporters, “The satanic cult in this city has been casting satanic spells on me for three or four days. I found out my mom was the ringleader. She was the Antichrist.”

Many people with untreated serious mental illness become psychotic with delusions and hallucinations. About four years ago and a mile down the road from where this stabbing occurred, Abdo Ibssa fatally shot a staff member and himself at Parkwest Medical Center because he believed doctors had implanted a tracking device in his body. People that ill will not accept voluntary services because they don’t believe they are ill.

Assisted outpatient treatment is one way to help. It allows courts — after extensive due process — to order a very small group of the most seriously ill to stay in mandated and monitored treatment as a condition of living in the community. Assisted outpatient treatment is reserved for those with a past history of violence, arrest, incarceration or needless hospitalization caused by a failure to remain in treatment.

Research shows assisted outpatient treatment reduces homelessness, arrest, hospitalization and violence by more than 70 percent each. It also cuts costs. Because Tennessee didn’t offer assisted outpatient treatment, Nichols is likely to be incarcerated or involuntarily committed at enormous expense to taxpayers.

Tennessee is one of only five states without an assisted outpatient treatment law, and blame rests with the state Department of Mental Health, which has forsaken helping the most seriously ill in favor of improving the mental health of all others. Commissioner E. Douglas Varney closed Lakeshore Mental Health Institute, leaving the most seriously ill with nowhere to go. Residents of Tennessee with mental illness are now three times as likely to be incarcerated as hospitalized.

Many with serious mental illness are too sick to recognize they are ill. In scientific terms, this is called anosognosia. We have to help these individuals rather than pretend they don’t exist.

State Sens. Doug Overbey and Becky Duncan Massey were able to get a tiny pilot assisted outpatient treatment program started in Knoxville over the objection of the department, but compromise made it so restrictive and deficient as to be practically useless. Tennesseans deserve better.

A proposed federal law, the Helping Families in Mental Health Crisis Act, would fund pilot assisted outpatient treatment programs. While Tennessee should implement assisted outpatient treatment with or without federal funding, this bill could provide a welcome offset to those who worry about cost. The closing of Lakeshore freed up $6 million.

Money is not lacking. Leadership is.

Karen Easter is an advocate mom and blogs on serious mental illness at D.J. Jaffe is executive director of Mental Illness Policy Org., a nonpartisan, nonprofit think tank on serious mental illness.

Op-ed available (with registration) at

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