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New bill for mentally ill should help prison overpopulation

In a recent report, the Government Accountability Office found 112 federal programs meant to support people with serious mental illness in 2013. Overcrowding and staff shortage at mental health facilities in the 60s contributed to views that hospitals were ineffective. It also drove communal thinking that care should be community-based. Abuse and neglect at the institutions have been cited as another reason for changes. The number of beds in the country dropped from half a million to about forty thousand, according to the oversight committee. The committee says that it needs at least 140,000 beds to function. That shortage can also be contributed to overcrowded jails, the homeless population, and emergency room visits. Basically, hospital beds have been traded for prison cells. A new bill would change Medicare and Medicaid billing rules to make inpatient beds more accessible. Many community-based programs that are supported by state and federal governments are supposed to help people avoid homelessness, imprisonment, and emergency room visits. Some community-based mental health advocates say the programs need more money and more beds to work like they should. The Pennsylvania Mental Health Consumers Association (PMHCA) is advocating for closing state mental hospitals and redirecting the money to community-based programs, according to the association’s executive director. She says that community-based programs are more effective than putting patients in hospitals and giving them drugs. The president of the American Psychiatric Association says hospitals are better equipped than community-based programs to treat people with mental health issues. The new bill would change Medicare laws to require hospitals to help mentally ill patients gain access to community-based programs after being discharged. The new bill includes grants for assisted outpatient treatment in which judge-ordered patients would have to complete treatment as a condition of letting them stay outside institutions. Forty-five states, including our own, would use the treatment. Although voluntary treatment is better than involuntary treatment, assisted outpatient treatment can help some people avoid prison and repeated hospitalization, according to one source. Another area disagreed upon is a provision in the bill that allows physicians to share patients’ information with family members and caregivers when the doctor think it is better for their health. Information sharing is not currently permitted under federal guidelines and restricts parents of adult children with mental illnesses from information that would help. Opponents believe patients should be allowed the same privacy rights as people with other illnesses. The new proposal would eliminate the federal Substance Abuse and Mental Health Services Administration-the group that is currently tasked with coordinating mental illness programs-and it would form an assistant secretary for mental health and substance use disorders to take over coordination. The bill will dedicate money to explore ways to screen, diagnose, and treat mental illness.

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