What about fixing the mental health system in Arizona?

4 ways to fix Arizona’s disturbing mental-health care

My Turn Sun Dec 15, 2013 7:11 PM

Arizona has disturbing facts when it comes to treating mental illness:

— Only one in four people with depression receives treatment.

— Sixteen percent of jail and prison inmates suffer from mental illnesses.

— Crisis-intervention teams are not obtainable in most cities in Arizona. In fact, they are only available in Phoenix, Tucson and Mesa.

— There is still a lot of stigma and discrimination directed against people with mental illnesses.

There are ways to improve mental-health care in Arizona. Here are my four strategies:

First, integrate mental health and physical health. Encourage primary-care physicians and psychiatrists to work together so mentally ill individuals can receive comprehensive health care.

Studies have shown that at least 30 percent of patients seen by primary-care physicians suffer from a mental illness.

Mandate that primary-care physicians be required to take continuing medical-education courses that focus on mental health to renew their medical licenses. This will help people with mental illnesses obtain earlier diagnoses and better treatment.

Second, jails and prisons have become the largest providers of mental-health care in Arizona. In fact, more mentally ill individuals are housed in jails and prisons than at the Arizona State Hospital.

Police and courts should focus on violent crimes and dangerous felons and divert non-violent mentally ill offenders into the behavioral-health system where they can receive better treatment. Phoenix and Tucson have implemented jail-diversion programs for individuals with mental illnesses charged with non-violent crimes. A system of mental-health courts in each county should be instituted in order to reduce the number of people with mental illness who are incarcerated.

Third, increase police awareness and sensitivity training about mental illness.

Hardly a month goes by in which an apparently violent mentally ill individual is confronted by the police and, at times, the mentally ill individual gets Tasered, shot or killed and/or there is injury to the police officer.

A great model includes the use of specially trained Crisis Intervention Teams, which has been adopted in Phoenix, Tucson and Mesa but needs to be more widely available. The regional behavioral-health authorities should make it a priority to work with the police departments to establish CIT in their communities.

Fourth, provide community education about mental illnesses. We still have a long way to go to end the stigma, fear and discrimination against those with a mental illness. The public needs to understand that mental illnesses are no-fault, biologically based brain disorders that should be viewed no differently from cancer or diabetes.

Recently, mental-health first aid has been instituted in Arizona. It is an evidence-based public-education program that is now being offered in 20 countries. It demystifies mental illness and gives participants the capacity to obtain, process and understand the health information and services needed to make appropriate decisions and seek care.

If these four strategies were adopted, it would lead to dramatic improvements in Arizona’s mental-health system. Arizona could then become a model for the nation.

Dr. Max E. Dine is a longtime advocate for improving mental-health care in Arizona.