NAMI Michigan

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With over 46 million uninsured people and revenue shortfalls impacting community mental health and Medicaid program eligibility and services, many children and adults with serious or chronic mental health needs have little or no access to care.  And, for those who are insured, existing laws (such as pre-existing condition exclusions) often create barriers to getting needed treatment for mental health and co-occurring disorders.  

Federal health care reform addresses many of the challenges people have in getting and keeping health care coverage.  The chart below identifies key provisions in the federal Patient Protection and Affordable Care Act that offer meaningful benefits to individuals and families who live with mental illness.

Jennie almost lived to 80 years old.  Her life was full of much joy.  She raised seven children and was married to my Dad for 56 years.

Jennie managed depression for over 30 years.  Her first experience with major depression came in 1985 when she was 55.  It hit so fierce that she attempted suicide with an overdose of her meds and was hospitalized.  She was a strong woman and knew that working with Dr. May who she trusted and staying on her meds were key to her survival.  My Dad was diligent in his love, support and help to meet the stresses of live, manage her meds, and recognize the early symptoms of her depression.  Often the first sign was her inability to sleep well.

For 10 years she remained healthy, entertained her ever growing family with grandkids, picnics, golf tournaments, holiday and birthday celebrations--life!  She camped across MI with my Dad and both were Tiger fans.  

...until 1995 when another episode of depression jolted her life.  Our family learned that meds sometimes loose their effectiveness and adjustments are often needed to restabilize.  During this hospital stay, the depression was so severe that her doctor recommended ECT-electroconvulsive therapy.  Amazingly with a few ECT treatments, she was again strong enough and  ready to continue to fight her battle with depression. And the cloud lifted.  

This pattern repeated every 5-7 years but our family supported her and understood that the hospitalizations would get her back to her healthier self. In 2003, we celebrated my Mom & Dad's 50th wedding anniversary with a joyous celebration of their marriage and life.

While she lost two sons in 2007, those tremendous losses did not ignite her depression. She remained strong and committed to life and her family.  She lived to watch her family grow into the next generation with the birth of two great-grandchildren in the winter of 2009.

In February 2010, my Mom died of complications of pneumonia including depression while she was in the hospital being treated.  Her life was full and she fought her illness to the end.

If a mental health court were a college, people with illnesses like bipolar disorder, schizophrenia and major depression would graduate and move on to a better life-a life where they are able to manage their illness. And most importantly, they'd avoid jail.

That's all based on the principle that if the justice system could just get at the underlying issues that cause a person to commit crimes, it could stop the behaviors and help the person become a productive and safe member of society.

Mental illness is one of those underlying issues.

Mental health courts are only one of many options for reducing the prevalence of mental illness in the criminal justice system. Considering a mental health court in your state or community? The CSG Justice Center provides training and technical assistance through the Justice and Mental Health Collaboration Program and its predecessor, the Mental Health Court Program, both funded by the Bureau of Justice Assistance in the U.S. Department of Justice.

Based on experience, here are five key things to do before setting up a mental health court:
 
1) COLLABORATE EARLY
Convene stakeholders early to discuss the issue and identify potential interventions and resources. Those stakeholders include representatives from the criminal justice system, including law enforcement, corrections, court and community corrections practitioners; behavioral health systems, including mental health and substance use; and local government and mental health consumers.  

2) UNDERSTAND THE WAY THINGS ARE WORKING NOW
Spend time understanding your current system: What is the process flow for individuals in your criminal justice system? Are people screened for mental illness or a substance use disorder in the jail? What behavioral health resources are available in your community for individuals involved with the criminal justice system? 

3) GET TO KNOW THE PEOPLE YOU SEEK TO HELP
Use interviews and available data to describe the population of individuals with mental illnesses in your criminal justice system. Recent research has found 17.9 percent of individuals entering jail have a serious mental illness. How is this reflected in your jurisdiction? How many of these people are eligible for benefits upon release into the community?

4) TARGET A GROUP OF PEOPLE
Use your stakeholders to define a potential "target population" for your mental health court or other initiative. Consider the level of charges, residency, clinical criteria and risk assessment to determine who can get help from the program.

5) JUSTIFY
Consider the total number of individuals who would be in the target population based on the jail population and the target population you are focusing on: Is this enough to fill a court calendar for a mental health court? Does the size of the population served by the mental health court justify the time of the stakeholders and team members in planning?

To take a look at the exhibit and tabletop exhibit's tour schedules, or to engage with some of the interactive materials, visitors are encouraged to visit this website

Visitors can also learn more about bipolar depression by checking out www.TalkingAboutBipolar.com.