7 ways Newtown changed Connecticut’s mental health system

The massacre at Newtown's Sandy Hook Elementary School inspired a new focus on mental health in Connecticut and across the country. State lawmakers made several changes to the system in a high-profile gun control, school safety and mental health law passed in April. Here's a look at what's changing.

1. The state now tracks people who have voluntarily committed themselves and prohibits them from owning guns for 6 months.

Hospitals must report to the Department of Mental Health and Addiction Services the names of people who voluntarily commit themselves to psychiatric hospitals. The information is also shared with the Department of Emergency Services and Public Protection, and the person is prohibited from owning a firearm or getting a permit within six months. The provision is controversial and has drawn criticism from psychiatrists and advocates for people with mental illness, who worry it could discourage people from seeking treatment. The post-Sandy Hook legislation also extended the period of time that people who are involuntarily committed by a probate court are prohibited from owning a firearm from one year to five.

Status: The tracking system, run by DMHAS, has been up and running since Oct. 1.

Funding: $645,000 per year

2. The state is getting five new teams to provide intensive support to people with serious mental illness.

Connecticut already has four Assertive Community Treatment Teams, which work with people with serious, persistentmental illness, providing support that can help them live in the community. Soon the state will have five more "ACT Teams." They're made up of people with a range of specialties -- including nurses, psychiatrists, vocational specialists, case managers and therapists -- and their responsibilities can include administering clients' medications, providing rides, connecting clients with job training, helping clients learn to grocery shop, managing clients’ budgets or addressing housing issues. They tend to work with people who have been difficult to engage in treatment. Proponents of the concept say it’s an alternative to court-ordered treatment for people with mental illness who are not hospitalized. 

Status: The state Department of Mental Health and Addiction Services is in the process of selecting agencies to operate the new teams. Bids are due next week.

State funding: $3 million per year

3. Someone from each school district must get Mental Health First Aid training.

The 12-hour training program is sometimes referred to as a mental health version of CPR: It teaches people to recognize when someone is having a mental health problem and to intervene until professional help arrives. Beginning in the next school year, every school district’s safe school climate coordinator must receive Mental Health First Aid Training, according to the law passed in response to Sandy Hook. The law also allows school boards to require teachers, school nurses, counselors and other employees to participate in the training. Experts say the program can reduce stigma by making people less afraid of mental illness. One trainer said her students typically expect to use the information in their jobs, but often end up using it more in their personal lives.

Status: Training sessions are under way. Department of Mental Health and Addiction Services staffers are leading the trainings for school personnel at no charge. Some private agencies also offer the courses.

State funding: $17,000 per year

4. The state is developing a telephone consultation system for primary care doctors to get help from child psychiatrists so they can treat patients with behavioral health problems locally.

Pediatricians say much of their time is now spent working with children and adolescents with mental health needs, and one of the biggest challenges they face is getting help for those patients. Specialists are often booked, and it can be difficult to get insurance plans to cover certain types of treatment. The law passed in response to Sandy Hook calls for the state Department of Children and Families to set up a system, modeled after one used in Massachusetts and more than 20 other states, that makes teams of child psychiatrists available by telephone to consult with primary care doctors, including pediatricians. The idea is to help primary care providers address minor and moderate behavioral health issues in their practices. Tim Marshall, DCF’s clinical manager for behavioral health services, said he expects the system to get 3,000 to 4,000 calls in its first year and more after that. “We anticipate this assisting the need that’s out there for kids and families to receive good services locally in their communities, and if we can keep as many kids within the comfort of their primary care provider, we think that’s a great win,” Marshall said.

Status: Marshall said it’s anticipated that primary care providers will be able to use the system by March. DCF recently contracted with ValueOptions, a behavioral health company that administers mental health benefits for DCF clients and Medicaid enrollees, to administer the program. ValueOptions is developing a campaign to reach out to primary care providers. The process of picking the teams that will do the consulting is also under way.

State funding: $1.8 million per year

5. More people with mental illness are receiving care coordination.

The law passed in response to Sandy Hook provided funds to expand a program called Melissa’s Project, which provides care coordination for people with mental illness who, in the words of Executive Director Michael Mackniak, are “having a real difficult time maintaining a meaningful life in the community.” Clients are often involved in multiple, fragmented systems -- including the criminal justice system, probate courts and mental health services. Melissa’s Project staff learn their client’s goals and coordinate teams of providers to help achieve them. They can also monitor whether a person’s treatment plan is being followed and address problems that arise. Before the Sandy Hook legislation, the program, which is based in Naugatuck, served 124 people.

Status: Mackniak said the agency has doubled the number of clients it serves and staff it employs. Although the reach is not statewide, Melissa’s Project now represents clients in Hartford, Middletown, New Haven, Waterbury, Torrington, Danbury, Bridgeport, Fairfield and on the shoreline.

State funding: $850,000 per year

6. There’s funding for a Peer Bridger Program intended to keep people with mental illness from cycling in and out of the hospital.

"Peer bridgers" is a program intended to serve up to 100 people with mental health disorders who are involved in the probate court system -- which can involuntarily commit someone or appoint a conservator -- and haven’t been well served by the existing mental health system. In the program, people who have been in the system or who have dealt with mental health issues will work with clients, building relationships and offering their perspective on what helped them in recovery. A key goal is to keep people from returning repeatedly to probate courts.

Status: DMHAS is selecting an agency to run the program. Bids were due last week. The agency chosen must be a peer-run organization.

State funding: $1 million per year

7. There’s work under way to address behavioral health services for young adults.

During public hearings held in the aftermath of Sandy Hook, many people spoke of particular challenges young adults face getting mental health services, especially those with private insurance. The Sandy Hook legislation established a task force to study “the provision of behavioral health services” in the state, with a focus on those involving people aged 16 through 25. It’s considering topics including insurance coverage, payment models, the mental health workforce and the capacity of the treatment system.

Status: The panel is currently meeting and is expected to issue recommendations that could be addressed during the next legislative session. 

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