Arizona’s Mental Health Laws

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The tragic shootings in Tucson have raised questions and awareness about mental illness in Arizona’s mental health laws. Medical health attorney Charles “Chick” Arnold discusses the issues.

Ted Simons: The tragic shootings in Tucson have raised awareness and questions about mental illness and Arizona's mental health laws. Here to address both is Chick Arnold, an attorney who's spent decades fighting for the rights of Arizonans with serious mental illnesses. He also serves on the board of mental health America of Arizona. Chick, good to see you here. Thanks for joining us.

Chick Arnold: My pleasure, Ted.

Ted Simons: The impact of the Tucson shootings of raising awareness for the mentally ill, talk to us about it.

Chick Arnold: Obviously the issue, the incident, the tragedy focused attention. We can't presume anything. But what we believe at this point certainly is that old Jared Loughner had symptoms of mental illness. That's a double-edged sword. It's creating additional awareness and that's a positive thing. It's also creating an opportunity for educating people about mental illness and how treatment can work. That's a good thing. The downside is it's creating an additional demand on an already stressed mental health system.

Ted Simons: I want to get to that in a second. But there's another edge. In raising awareness, you have folks that are lumping all the mentally ill into the dangerous category, don't you?

Chick Arnold: That's a part of the stigma that people with mental illness and families have been living with forever, Ted. Even people who believe that can be educated, recognizing what brain illness truly is and that treatment works. Treatment is something that can help manage the very symptoms that Jared was suffering from.

Ted Simons: Let's go ahead and talk about Arizona mental health laws, what they are and what a family would have to deal with in terms of navigating the laws, the system, the whole nine yards.

Chick Arnold: It's critical to recognize. Treatment works, Ted. None of this comes with instruction. It's difficult for families to negotiate systems that are often made inaccessible because of budget deficits and restrictions on budgets. There's medical treatment, the medications and doctors visits and then there's community support, things like housing and case management services that indeed work. Those are the kinds of things that have been dramatically cut this past year and we're looking at additional cuts this coming year.

Ted Simons: What kind of cuts?

Chick Arnold: The budget cuts proposed by the governor relating to the AHCCCS limitations would significantly reduce the university of people who qualify for title 19 services, for Medicaid services. Those folks have already been reduced from the community services. So this past July, people who were non-medicaid eligible lost their case management services, lost the benefit of brand name medications in favor of generic medications and often lost housing as well. These additional people who are in the university of people who will be reduced from the AHCCCS rolls will lose those services as well as the medical services that are critical for support.

Ted Simons: For those who lose those services, there's some who are saying there are alternatives out there. Is that a valid point?

Chick Arnold: Alternatives to services?

Ted Simons: In terms of coverage, in terms of getting those services some way, shape or form.

Chick Arnold: Public policy as defined in our state has been that community service works, community treatment works. We've determined that we have an interest in public policy in saving lives, in preserving communities and preserving opportunities for employment. Those public policy decisions are being compromised by these proposed budget cuts. Services work, but we need to strengthen our system, not reduce its valid service.

Ted Simons: You talked about the stigma regarding mental illness. Does that still exist? And what does this shooting do to that? Because that's got to be a factor there.

Chick Arnold: Of course stigma exists. I would suggest it's a lack of understanding of what brain illness truly is. Certainly everyone with mental illness is not dangerous. In fact, a very small percentage of people with brain illnesses are dangerous at all. The issues are education, this is an opportunity to understand illness, understand what our outstanding statutes enable and provide as opportunities for families to negotiate systems that are there for us.

Ted Simons: Okay. So if a family is watching right now and they're concerned, they don't know if they should be concerned, but they are concerned. Where do they go? Where do they start? How do they get involved?

Chick Arnold: Ted, the resources in the health department have been significantly reduced over the years but they do a good job of providing services. Contact our local agencies throughout the state that are available to do intakes and help assess the needs for treatment. Once again, Ted, treatment works.

Ted Simons: It does work, but there has to be patience, too, because sometimes folks get caught up in a treatment and the first or second line of treatment may not work. They have to have the patience, don't they?

Chick Arnold: Patience becomes being a family member of a person with a brain disorder, Ted.

Ted Simons: We've talked about this on this program in a variety of ways. When you look at Jared Loughner, this was someone who was deemed too dangerous to appear on a college campus without certain clearance by way of a psychiatrist, psychologist, whatever the mental health professional. How is it that that determination was made and it ended right there? That no one else seemed to know about this young man and his obvious troubles?

Chick Arnold: You know, Ted, that's what awareness have resulted in. People are wondering, how could this happen? How could this young man be as ill as he was and not be subject to mental health treatment? We have a system which he could be evaluated by a mental health professional in the public mental health system. I suggest that would have been a noble service to evaluate him from the college system to the mental health system and served our community as a whole.

Ted Simons: But again, you have to watch the dynamics about being too careful and having people who really aren't a danger all of a sudden -- I guess the question is, when does this involuntary action take place? Who decides what's going on out there in terms of making that determination?

Chick Arnold: Well, our statutes provide a three-step process. The first step of which is a full, full-scale evaluation. That's what needed to happen for Jared Loughner. At that point professionals who are trained and competent to make these calls would have determined whether there is any potential for dangerousness or whether he would have fit for any of the standards for involuntary treatment.

Ted Simons: So bottom line here, last question here, lots of folks are obviously calling a variety of services around the state with lots of questions. What do you say to them? What kind of advice do you give them?

Chick Arnold: I think hope is critical, Ted. Hope is critical. Generally, specifically for families with persons with brain disorders, keep plugging. Keep looking for treatment. Keep seeking that option that will work. Once again, treatment works. It's our job as family members to make sure that we advocate on behalf of our disabled member to get the treatment so sorely needed.

Ted Simons: Chick, it's good to see you. Thanks for joining us.

Chick Arnold: My pleasure, Ted.

Charles "Chick" Arnold:Medical health attorney;

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