Mental health panel makes four recommendations

The bipartisan panel examining mental health issues agreed Tuesday to four recommendations that could become part of legislation intended to respond to the mass shooting at Newtown’s Sandy Hook Elementary School.

Legislative leaders are crafting a bill to address mental health, gun violence and school security. It’s expected to be taken up in the coming weeks.

The mental health panel also released 21 recommendations that didn’t get support from the full group, including changes to insurance regulations and gun permit applications, expanding school-based health centers, allowing outpatient commitment, and moving responsibility for children’s mental health from the Department of Children and Families to the Department of Mental Health and Addiction Services.

Here are some details on the items that won full agreement from the subcommittee:

Mental Health First Aid: The panel recommended that the state “promote” training for teachers, nurses, school counselors and other community members. The training sessions, originated in Australia, are aimed at giving people basic knowledge of mental health issues and ways to offer help for people who need assistance. Instructors liken it to CPR: It won’t make a person a professional, but it will allow him or her to help until assistance arrives. The committee didn’t recommend ways to fund the courses, but President Obama has proposed offering federal funds for the training, and Rep. Terrie Wood, a Darien Republican, who co-chairs the panel, said municipalities could look to local nonprofit groups to help with funding.

Read more about Mental Health First Aid training here.

Case management for people with serious mental illness: The group recommended promoting programs that provide case coordination or case management for people with mental illness, ideas that are considered alternatives to allowing court-ordered treatment. Two of the programs named in the recommendation are:

Melissa’s Project: The program, based in Naugatuck, provides care coordination for people with mental illness. It began as a collaboration between the state mental health department and probate courts, which can commit people to a hospital or assign them a conservator.

Executive Director Michael Mackniak, an attorney who developed the concept, said the systems involved in care for a person with mental illness — which can include the criminal justice system, probate courts and mental health services — are often fragmented and don’t coordinate well with each other. Melissa’s Project staff members find out their client’s goals and coordinate a team of providers to help achieve them.

The Melissa’s Project staff also monitor whether the person’s treatment plan is being followed, and address problems that arise. Mackniak said the program is for a small portion of people with mental illness who are “having a real difficult time maintaining a meaningful life in the community.” The program currently serves 124 people as part of a contract with the state Department of Mental Health and Addiction Services.

Assertive Community Treatment Teams: The model offers intensive supports for people with serious, persistent mental illness who live in the community. Teams include therapists, nurses, psychiatrists, case managers and vocational services. Connecticut currently funds three ACT Teams, each of which costs about $1 million. They handle routine issues, like providing medication, job training, therapy, transportation, housing, and help handling finances, as well as addressing psychiatric emergencies or other issues that arise.

Read more about an ACT Team operating in New Britain here.

Collaboration between pediatricians and psychiatrists: The panel recommended implementing a program similar to the Massachusetts Child Psychiatry Access Project, which funds teams of child psychiatrists who consult with pediatricians and primary care doctors about how to address mental health issues in their patients.

It’s aimed at addressing some major problems: There aren’t enough child psychiatrists to address the need. And pediatricians often don’t have the training to handle mental health issues in their own practices — or the wherewithal to get their patients appointments with the right specialists.

The Massachusetts program includes a hotline that pediatricians can call to talk with a child psychiatrist or therapist who might be able to help them address problems within their practices. They can also talk to care coordinators with expertise in linking kids to outside services. The child psychiatry team can also see patients to perform evaluations within two weeks, far shorter than the three to six-month wait that it can take to get an appointment outside the program.

In Massachusetts, 92 percent of pediatric practices with 2,000 or more patients used the program at least once in 2011. It’s funded with $2.5 million a year in state money. In addition to Massachusetts, 23 other states have similar programs in place.

Mental health task force: The panel suggested creating a task force to do a comprehensive study of the state’s mental health system and recommend ways to improve the system for people aged 16 to 25, a group that’s often not well-served by the existing system.

Topics for the task force to address include improving early intervention and treatment, closing gaps in private insurance coverage, improving case management and follow up, addressing the shortage of psychiatric professionals and specialized services, and developing alternate service delivery and payment models.

Wood said the task force would begin meeting after this legislative session ends in June, with the goal of making recommendations for next year’s session. Sen. Jason Welch, R-Bristol, said the process had made clear how much of a problem there is with mental health in the state, and how complicated the answers are.

“I’m usually loathe to have a task force but I think this is just so very necessary,” he said.

Read more about problems facing young adults in the mental health system here.