1. NAMI-Mass1 The National Alliance for the Mentally Ill of Massachusetts is a nonprofit grassroots education and advocacy group dedicated to improving the quality of life for people affected by mental illness. The State of Mental Health Services in Massachusetts: The Impact of Inadequate Funding Toby Fisher MBA/MSW Executive Director Hearing of the Citizens’ Health Care Working Group August 17th, 2005

2. NAMI-Mass2 NAMI-Mass Legislative Priorities 2005 I.Restore Funding to the Department of Mental Health: 20,000 chronically mentally ill individuals are desperately waiting for DMH services, of which over 3,645 of them are waiting for residential placement. The lack of available DMH services severely impacts the care of individuals with mental illness, gravely affecting families and communities. II. Save Access to Appropriate Medications: All anti-psychotics, antidepressants, and anticonvulsants used for the treatment of mental illness must be made available to optimize successful treatment. III. Promote Housing for People with Mental Illness:Set aside at least 25% of the developed property value in cash to be used in a housing trust, or alternately set aside at least 25% of the housing developed from the liquidation and development of State Hospitals. IV. Encourage Jail Diversion and Coordinated Re-entry Services From the Criminal Justice System.

3. NAMI-Mass3 Massachusetts Picture Financial Outlook Bleak Since 2000-just now improving Deficit was in the range of $3 billion Representing 12% and state budget The rate of Medicaid growth is 13%. This was on top of flat DMH funding through the 1990s and extensive wait lists.

4. NAMI-Mass4 DMH WAIT LIST FY 2000 SERVICE NEEDS Department of Mental Health FY 2000 Waiting Lists for Residential and Support Services Service Needed1 st Quarter 2000 2 nd Quarter 2000 3 rd Quarter 2000 4th Quarter 2000 Change Adult Residential * 3381 3339 3163 3320+157 Child/Adolescent Residential 170 247 177 220+ 43 Adult Case Management1368714,12314,10314,164+ 61 Child/Adolescent Case Management 1938 2076 2224 2497 +273 Supported Employment 226 252 258 256- 2 Turning 22 Services** 100 0 Totals1950220,13720,025 20,457 532

5. NAMI-Mass5 NAMI-Mass Response to Crisis Get to the Table. Remember some changes are not legislative. Protect Base Appropriation/Services Support Tax/revenue Increases Watch Funding Shifts from Dismantled Agencies or Reallocation from Existing Agencies Look for Increased Efficiencies in Mental Health Service Delivery (services reduced or combined) Monitor Medicaid Benefit

6. NAMI-Mass6 NAMI Recommends Evidence-based Practices for Severe Mental Disorders in Adults Evidence-based PracticeDescription Assertive Community Treatment ACT is one of the most well-documented services that help individuals with severe and persistent mental illnesses live in the community and avoid hospitalization. It consists of a diverse team of mental health care providers who together care for consumers, reaching out to them in their own communities and providing the full-range of services needed. Evidence-based Medication Decision Making Various mechanisms can help translate the latest available knowledge about medications into practice by helping physicians and patients choose the appropriate medication. Decisions about medication must be made at the individual level, with the full-support of scientific evidence. Supported Employment This employment service is the most effective in gaining individuals with severe mental illnesses competitive jobs. Working with consumers to identify their interests, supported employment finds a job for the individual and provides ongoing support as needed on the job. Integrated Dual Diagnosis Treatment Because individuals with serious mental disorders often have a co-occurring substance abuse problem, the optimal form of treatment addresses both issues, rather than leaving patients to be ping-ponged between mental health care and substance abuse service providers, as is typically the case. Family Psycho-education Since family members of individuals with severe mental illnesses often provide support and care for their loved one, services that help them understand mental illness and how best to cope with it have been shown to help family members cope better and helps consumers avoid psychiatric crises. An estimated 50 percent of family members provide intensive care for individuals with severe and persistent mental illness—and thus should be receiving psycho education services. Illness Self-Management Interventions that help consumers better understand their illness and take charge of their treatment decrease symptoms and improve outcomes. All consumers with a severe and persistent mental illness should receive this intervention. Jail Diversion Services A variety of programs, including mental health courts, police training, and special police/treatment professional outreach teams can reduce inappropriate criminalization of people with mental illnesses.

7. NAMI-Mass7 The National Alliance for the Mentally Ill of Massachusetts (NAMI-Mass) is a nonprofit grassroots education and advocacy group dedicated to improving the quality of life for people affected by mental illness. NAMI-Mass is a vital resource for families and individuals facing the challenges of biological brain disorders. Since 1983, NAMI-Mass has been highly effective in building awareness, reducing stigma, providing support, and advocating for patient rights. We have over 220,000 members nationally with three organizational levels. Localized affiliate grassroots groups help to insure that the local area mental health needs are being met. The state office, NAMI- Mass, provides coordination for the affiliates and NAMI-National coordinates the efforts of the states. For more information, please contact us. Phone: 1-781-938-4048/Fax: 1-781-938-4069 Toll Free: 1-800-370-9085/ Web: namimass.org NAMI-Mass 400 West Cummings Park Suite 6650 Woburn MA 01801 Toby Fisher MBA/MSW Executive Director