By Wayne Jebian
The rush to mental health reform in the wake of Sandy Hook is running into opposition from mental health advocates who fear the legislation could further stigmatize the mentally ill, while some Latino experts are concerned new tougher laws may prevent some Latinos from even acknowledging mental health needs or finding adequate care.
Juan Medina, manager of Latino services at Rushford Center, a Meriden-based mental health services organization, says, “For instance, when you talk to Hispanics, many will say that they have ‘nerves’,” when they seek treatment. He also says that certain types of outreach might still be needed for Latinos whose backgrounds are not Puerto Rican. “The majority of the population we serve is Puerto Rican. Other cultural groups coming from South America and the Dominican Republic, there is some sort of stigma.”
At the same time, State Rep. Hilda Santiago (D-Meriden) is concerned about having the right treatment programs in place to help patients and their families who are struggling with the life challenges that mental illness exacerbates. She and other legislators are also grappling with the issue of individuals who won’t seek treatment, or won’t stay in treatment, and trying to find the best way to help them and protect the public. “What happens is, they discharge themselves from programs like Wheeler Clinic and Rushford, because sometimes they think they don’t need the help,” said Santiago, who is concerned that Connecticut does not have laws in place to address this problem. “The system lets them do that.”
Two bills being advanced by Latinos in the House of Representatives illustrate the conflict between protecting the public versus the rights of families and individuals: one bill establishes mental health screening for children; another is for parents concerned about their kids being committed to psychiatric care without their knowledge.
Proposed House Bill 5567, introduced by state Rep. Juan Candelaria (D-New Haven) and co-sponsored by state Rep. Christina Ayala (D-Bridgeport) seeks to create a comprehensive mental health plan for children. Proposed House Bill 5727, co-sponsored by state Rep. Victor Cuevas (D-Waterbury) seeks to protect the rights of families of children “admitted to the hospital for diagnosis or treatment of a mental disorder” without parental knowledge, specifying that parents must be informed within one day of the admission. Current law allows for five days before informing parents.
Many of these proposed laws state their goals in the broadest of terms; for instance, the full text of the Candelaria/Ayala bill reads, “To establish a comprehensive children’s mental health plan to identify and manage mental health issues in children eighteen years old or less.”
The lack of specifics — not only in this bill but in many of the proposed laws — raises concerns among mental health experts who argue that the devil is in the details. “It depends on how the legislation is crafted, whether I could personally endorse it or not,” said Jeff Walter, president and CEO of Rushford. He speculated that “it’s possible that all those bills will get put into one bill, and that’s the one we’re going to need to focus on and see if it’s going to do more harm than good.”
The leadership of Advocacy Unlimited Inc. is wary of the Candelaria/Ayala bill because no one knows how it would be implemented. “We are ambivalent because we agree that there is a need to provide support and tools for young people experiencing emotional distress in schools but we are concerned that this bill will lead to more labeling and psychiatric drug use,” said Deron Drumm, co-executive director.
DMHAS is also concerned about how labeling people as mentally ill affects how people view them and potentially limits their opportunities. “Recovery is possible, and they’re living full lives in recovery,” says Mary Kate Mason, mental health program manager at DMHAS. “I think that’s the message that’s so important for people to hear.” She argues that the most effective way to reach the people who most need mental health treatment is to work to reduce existing stigmas and misunderstandings so that people will seek treatment voluntarily. Mason says that one in four people in the United States have a mental health disorder.
“There are a very small percentage of patients who, because of the nature of their illness, they are in denial that they have an illness,” said Jeff Walter of Rushford. Connecticut does have provisions under current law that allows for commitment of individuals deemed by medical or psychiatric professionals perceived as an immediate danger to themselves and others; however, individuals not deemed an imminent threat have easy exits from treatment, as Santiago described.
Other legislators share her concerns, and have pointed out that other states have laws that allow for the involuntary commitment of individuals to outpatient treatment programs, while Connecticut does not. Three proposed house House bills, numbered 5683, 5659, and 5652, attempt to close this gap; however, the group Advocacy Unlimited considers this a dangerous move. “Individuals need to have their human rights and constitutional rights respected regardless of any category they fit in or any label that’s placed upon them,” said Greg Benson of Advocacy Unlimited. “These proposed bills in the state legislature make it legal to impose involuntary outpatient commitment on individuals who haven’t committed any crime but do not want to seek certain types of treatment.”
Image (c) Yuri Arcurs via ShutterStock
By Wayne Jebian