On Saturday, September 20, Howard County candidates for the General Assembly participated in a forum hosted by the Howard County chapter of the National Alliance on Mental Illness. The uniqueness of this issue prompted candidates to "do their homework" on the issue, review position papers put out by NAMI, and provide specific answers on complex subjects such as Outpatient Civil Commitment and Crisis Intervention Teams. I will say that from all the forums I've participated in, I learned the most from this one.
Introduction
In my opening minute, I noted that when you talk about allocating resources for mental health, you are commonly talking about dollars that are already being spent somewhere else. If we aren't funding early detection and preventative care at the front end, we will end up having to spend more on prisons, institutions, and homeless shelters at the back end. I also highlighted the fact that this issue requires collaboration and cooperation across multiple stake-holders. One of the greatest frustrations you can expect would be that of a parent who is forced to operate across "silos of care and treatment" that do not connect or speak to one another. Many times government doesn't have to create a new program, but instead can provide the "webbing" between already existing programs to make them work better together.
Protect and Expand Mental Health Services
Candidates were asked to address if, and how, they would protect and expand mental health services. I told they audience that I would support the Safety Net Act, which would provide some of the "webbing" noted above and implement significant portions of the Service Arrays advocated for by NAMI. Although not asked directly, I said later on that the funding for these programs should come from what we already spend on warehousing the mentally ill. More specifically, I think we can find front-end resources in the decriminalization of marijuana passed last year, which should result in lower costs from imprisoning non-violent criminals.
Outpatient Civil Commitment
This issue seemed to engender some confusion across the candidates and attendees. As opposed to inpatient civil commitment that we see on movies and television shows wherein an individual will be committed to an institution or hospital, outpatient civil commitment requires that person to participate in treatment outside of the hospital, such as medication or therapy. Maryland is one of only five states that has not adopted Outpatient Civil Commitment (OCC). In my remarks, I observed that this presents an opportunity to identify best practices and challenges in implementation from those other states who have had an OCC system for a number of years. I think it is clearly time for Maryland to adopt this system so long as we can also make sure the treatment network is sufficient to accept additional capacity.
Crisis Intervention Teams
Crisis Intervention Teams include first responders from an array of specialties who respond in times of crises, particularly when the issue may be more complex than what law enforcement alone may be able to address. In implementation, these teams also work to train law enforcement on how to respond for these unique circumstances. Howard County is on the fore-front of using CIT's, in great thanks to our County's partnership with the Grassroots Crisis Intervention Center. I suggested that we identify what makes this partnership so successful and augment it further rather than try to reinvent the wheel through state bureaucracy alone in other states. I have some concern about hoisting unfunded mandates on other jurisdictions, particularly the police, and to supplant additional training hours for real solutions.
There were some additional questions from the audience, but I did not take detailed enough notes to include them here. I would recommend Amanda Yeager's coverage of the event, which did a good job of capturing the general sentiments of all the candidates. This was a great forum with mostly civil, intelligent, and genuine comments by everyone who participated. It is interesting to me that some candidates can spend their entire campaign talking about cutting spending and decreasing taxes, but once in front of an underfunded constituency spend the next hour and a half pulling money out of a hat.
Have a great Monday doing what you love! Sorry for the long absence. I can honestly say that between work, campaign, and baby, I am the most busy I have ever been in my life. But I'm still having fun!
