Mental Health Ordinance

Mental health preventive programs can be difficult to enact in local communities. Mental health policy decisions often follow a cyclical policymaking pattern. Mental health policy will have periods of decline in which policymaking sets the field of mental health backward. While at other times mental health policy is seen as being in need of reform and policy changes are made to address these concerns. Recent gun violence that has erupted in the United States has led to a debate on not only gun ownership but also on the status of students with mental illness and mental health services in our communities. Through the creation of a mental health ordinance designed to develop an outpatient commitment program issues of mental health can be prevented at the local community level. 

The intended audience for the proposal would be legislators who would be making the decisions on whether the proposal is enacted. Local mental health professionals would also be the audience as they would need to implement the mental health outpatient commitment programs. Members of the community would also need to be aware of the proposal and reasons for implementation. Mental health is a problem that could be faced by any individual regardless of race, class or gender. The universality of the problem demonstrates that everyone could be a potential audience for the proposal.

The Guide to Community Preventive Services (2012) highlights the results of a task force created to prevent issues of mental health becoming a problem in the community. The task force developed various community-based case management and therapeutic interventions plans that would work towards reducing rates of debilitating mental illness in the community. The task force also demonstrated that mental illness is a public health problem that needs to addressed and that the emergency response system should include access for people with mental health needs. Mental illness affects everyone from children to the elderly. Individuals who are mentally ill and do not seek services are often incapable of being contributing members of society. Many individuals who do not get the mental health treatment that they need end up on prisons or homeless. There is also a lack of education and a strong stigma attached to receiving mental health services. These factors also contribute to individuals not receiving the treatment that they need. If individuals sought out the preventive mental health treatment that they need they would have an improved quality of life. Public systems would also not have a strain on their resources from individuals who need to be receiving mental health treatment at a facility. The mental health ordinance would aim to solve these problems.

The ordinance would create a mental health outpatient commitment program. “Outpatient commitment refers to a court order that directs a person who has a serious mental disorder to adhere to a prescribed community treatment plan and to be hospitalized for failure to do if the criteria for involuntary hospitalization are met” (Monahan, 2001 1). The ordinance is designed to ensure that those who need outpatient mental health treatment are receiving the services they need so as to prevent the debilitating results of leaving mental illness untreated.

Outpatient mental health commitment would solve this problem of individuals not receiving much-needed treatment by forcing them to receive services. A procedure currently exists which can commit individuals to inpatient mental health if they demonstrate intent to harm themselves or others. However these individuals often end up back in the community with their condition unimproved. Individuals must demonstrate an intention to harm themselves or others within the past 30 days. This could include being unable to care for themselves, physically harming themselves or attempting to kill themselves. The client would first be admitted to a psychiatric facility. If it is deemed necessary for an individual to receive outpatient services by a judge they will be taken to a facility by a peace officer from the hospital. The facility they are taken to then has the responsibility to develop a plan which includes the types of services the client will be provided, what medications will be administered if they are needed and who will be providing the services to the client. The client could be eligible for receiving a number of services including substance abuse treatment, job training or counseling services. These services are provided to the client at no cost to them due to their involuntary commitment to the facility. Once the services providers deem the client no longer needs services they will be freed from the requirement to continue to participate in services.

The benefits of the ordinance would be seen in multiple areas. Studies have demonstrated that outpatient commitment is effective in reducing rates of the turnover of mentally ill patients returning back to hospitals. “Outpatient commitment can work to reduce hospital readmissions and total hospital days when court orders are sustained and combined with intensive treatment, particularly for individuals with psychotic disorders” (Swartz, 1999 1968). By making individuals receive the services they need their quality of life would be improved. Their families would also benefit as they would get their family member back. Individuals who receive services may become contributing members of society again. The amount of money spent on the mentally ill population within the prison setting would be reduced. Suicide and homicide rates may be reduced. Substance abuse rates may also decrease as individuals are able to receive treatment. Instituting an outpatient commit program would also increase the dialogue between community members regarding the need for mental health reform. The outpatient mental health program would improve the community as a whole and would begin to take steps to prevent mental illness from being left untreated.

References

Improving mental health and addressing mental illness. (2012). The Guide to Community Preventive Services. Retrieved from <http://www.thecommunityguide.org/mentalhealth.index.html>

Monahan, J., Bonnie, R. J., Appelbaum, P. S., & Hyde, P. S. (2001). Mandated community treatment: beyond outpatient commitment. Dev. Mental Health L., 21, 1.

Swartz, M. S., Swanson, J. W., Wagner, H. R., Burns, B. J., Hiday, V. A., & Borum, R. (1999). Can involuntary outpatient commitment reduce hospital recidivism?: findings from a randomized trial with severely mentally ill individuals. American Journal of Psychiatry, 156(12), 1968-1975.