Formal Response to Governor Mills
We were a little surprised that the governor’s office put out three different comments about the press conference yesterday. We feel the need to elaborate on all three today.
1) They announced that the governor had increased funding for the mental health department. Yes, that’s true, but unfortunately more and more is being spent by the department clinging to their “cross your fingers policy “of releasing people with Anosognosia over and over again, which doesn’t leave enough money to keep people safely supported in the community.
2) The governor’s office announced they didn’t accept the IMD waiver, because of “public concerns”. What public? Parents and family members, medical professionals, hospitals, all wanted the governor to accept the waiver money for brain disorders, as she did for substance abuse. The only “public” we are aware of who spoke out against the waiver was Disability Rights of Maine. From our IMD Position Statement: “The state of Maine did not apply for the SMI/SED waiver based on Disability Rights of Maine’s argument claiming it was “in violation of the ADA, Olmstead, and the Settlement Agreement.” Their arguments are misguided as proven elsewhere in this position statement. It’s time to end this layer of bureaucracy and eliminate the IMD exclusion.”
It is also a grave mistake to not recognize that so many with SUD’s also suffer from SBD’s. You can’t treat one without treating the other. Also from our IMD Position Statement: “It is estimated that 18.7 million adults battled a SUD in 2017. 8.5 million of those had a co-occurring disorder or COD (a brain illness and a co-occurring SUD). SAMHSA determined that fewer than 11.8% of those with COD were receiving treatment for both disorders and 36% received no treatment at all. Successful treatment of their CODs requires treating both their SUD and their SBD.
SAMHSA has identified that there is only about a 5‐year window of opportunity for the prevention of co-occurring substance abuse after the onset of a brain disorder. Untreated SBD leads to more severe and treatment-resistant illnesses and the development of CODs. By far, the most common connection between untreated brain illness and substance abuse is self-medication. In many cases, the SUD is a symptom of the SBD and would not have developed had the patient received prompt, consistent care for their illness.”
These monies do not necessarily go just for hospital beds, they can go for transitional housing, for ACT teams in the community – all things that would be so helpful to keep those with anosognosia in a community setting! Accepting the waiver would allow for increased reimbursement for inpatient care and all facilities at various levels of care, including access centers and longer term #HousingThatHeals.
Having higher levels of reimbursement will enhance services in all of these levels of care, including more work with psychologists, and multidisciplinary teams so that the models can move away from just a pill and a bed to more comprehensive care. We absolutely do still need many other things, including comprehensive community based care.
3) The most unbelievable comment was the last one: that the PTP program was supported, but it was a last resort option! Just how last resort is it when the hospitals are so clogged up with people there, over and over and over again so people like Mr. Butterfield could not be admitted or people are waiting for 2 to 3 weeks in an emergency room, inappropriately, for a hospital bed? It is well documented that there is a much poorer prognosis for those with SBD who do not receive prompt, early intervention and treatment. Every episode causes further deterioration of the brain and other organs resulting in irreparable damage, making this population wait for beds and the PTP Program. This worsens their long-term prognosis as well as their health and safety, and the safety of the community.
4) We would also like to know why, when we have statutes that allow for those to get help based on grave disability and an inability to care for themselves, we must wait for them to become dangerous before even attempting to access treatment? Again, it is well documented that there is a much poorer prognosis for those with SBD who do not receive prompt, early intervention and treatment.
We would very much like the opportunity to meet with Governor Mills at her earliest convenience to discuss this humanitarian crisis and how we can finally bring treatment before tragedy for those suffering from serious brain disorders here in Maine and their loved ones who suffer right along with them.
With Gratitude and Hope,
Coordinator & Co-Chair Steering Committee
National Shattering Silence Coalition
Senator John Nutting
Joe Pickering, Jr.
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