March 1st, 2013

Task force working on mental health legislation

State and national lawmakers are mulling legislation on gun control, mental health care and benefits for first responders in the wake of Connecticut’s Sandy Hook shootings.

Connecticut legislators created a Bipartisan Task Force on Gun Violence Prevention and Children’s Safety. The task force designated three working groups to focus on gun violence prevention, school security and mental health. The groups will review current law and make recommendations to the overall committee, which will provide recommendations to Senate and House leadership. The goal is to produce a bipartisan emergency certified bill that had not been filed at press time.

During a Jan. 29 public hearing, the mental health working group took written and oral testimony. Sen. Toni Harp (D-New Haven), working group co-chairwoman, says it’s reviewing issues including commitment laws, concerns that parity laws are not working for the privately insured and possible assessments for children and adolescents to determine gaps in the system.

“We’ve got to begin to build capacity in our state, particularly for adolescents,” Harp says, noting an inadequate number of child psychiatrists and other providers for youth and young adults.

“There are a lot of things we have to consider. We are in an economic downturn; our revenues are not producing, so we’re not in a good place to do a lot of elaborate things. But we are committed to doing some adjustments that I think will help.”

Traci Cipriano, J.D., Ph.D., licensed clinical psychologist and director of professional affairs for the Connecticut Psychological Association (CPA), testified at the hearing, asking legislators to resist supporting a law that would require mental health professionals to report to the local government and/or police any patient who might be a danger to themselves or others, such as legislation recently passed in New York.

“Such a proposal would put a lot of psychologists in a legal and ethical bind,” Cipriano says. “We asked the legislature not to support such a bill because first of all, it’s so broad we think it would stigmatize and criminalize mental illness.”

Cipriano says such a statute could deter people from seeking mental health treatment or expressing their feelings or impulses freely to mental health professionals. It could also decrease access.

“It may make psychologists less willing to take on cases that are perceived to be risky, because they do not want to be put in that dilemma,” Cipriano says.

Cipriano says she hopes legislators proceed carefully. “I’m concerned that the legislature will rush to do something to make everyone feel safe.” Such a rush, she notes, could have consequences, such as those who most need treatment being least likely to access it.

Resources would be better used by improving mental health services overall, Cipriano adds. “One thing we need is more public education about what mental health services are available, whether they are public or private. I’d like to see more resources for families in terms of getting evaluations. One thing I heard repeatedly at the hearing was that people don’t know where to get an evaluation.”

The CPA sent a letter to the working group asking legislators to consider establishing “Regional Consultation Centers,” to be run by a clinical psychologist and minimal staff, to serve as a resource for school staff and parents – providing phone and in person consultations and comprehensive diagnostic evaluations of children and adolescents. “We think this is a relatively low-cost way to begin to address a recognized need,” Cipriano says.

H. Thomas Brant, M.A., CAS, certified school psychologist and vice president of the Connecticut Association of School Psychologists, submitted written testimony urging school districts to adhere to National Association of School Psychologists recommendations, which include increased access to mental health services and supports in schools, improved screening and threat assessment procedures, establishing trained school safety and crisis teams and assigning one school psychologist for every 500 students.

“School safety should not just encompass building safety measures, but have a focus on addressing the needs and services that improve the safety, well-being and learning of the children through a continuum,” Brant wrote. “The challenges that we face are great and we should not let increased anxiety obscure the development of policies that support what schools can do effectively, which in turn support our primary mission of learning.”

Nationally, Katherine C. Nordal, Ph.D., executive director of the American Psychological Association (APA)’s Practice Directorate, says that organization is optimistic there will be traction around mental health issues in Congress, but watchful of proposals that could lead to more stigma for seeking mental health treatment. “We are certainly looking at legislation with an eye on that,” Nordal says.

Nordal notes that a reasonable approach is needed, one that continues to provide a safeguard that psychologists have been able to give their patients in regard to confidentiality issues.

“Certainly we believe if people can get help earlier and the access to care is there, hopefully we can have some impact from the mental health side in beginning to curb violence, although we certainly recognize – and the point we are very clear about – is that people with mental health are no more prone to violence than other people. We certainly do not want this to result in hysteria and stereotyping that all mentally ill people are violent,” Nordal says. “We want the mental health issues in the country highlighted but we don’t want that to be an excuse for the country to not appropriately address gun violence issues, many of which have nothing to do with mental health.”

The APA supports key components of President Obama’s plan, and endorses his call to ensure statutory parity provisions mandated by the Affordable Care Act are fully implemented in both private and public health insurance plans.

The APA released its own Recommendations to Prevent Gun-Related Violence, which include the enhancement of access to services, in part by providing broader access to health care under Medicaid by rendering behavioral health and substance use services offered by psychologists and social workers mandatory (rather than optional services).

By Pamela Berard

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