*HR 3717 addresses, or partially addresses, many of these 10 Essential Steps Toward Better Treatment:

  1. Acknowledge that serious mental illnesses, such as schizophrenia, are medical illnesses of the brain, not behavioral problems.  Treat a person who is having a "brain attack" with the same urgency as someone having a heart attack.*
  2. Acknowledge that Anosognosia exists (lack of insight).  Take it into consideration during all phases of treatment, discharge, and support. When someone does not understand they are sick, they lack the capacity to fully participate in the treatment decision making process. This is no different than someone who suffers a stroke and is incapacitated. *
  3. Ensure the transition/discharge/step down process is based on clinical readiness.  Take Anosognosia into consideration, as well as a person's cognitive abilities.  Schizophrenia, especially, has a significant, negative impact on cognitive functioning. 
  4. Reform HIPAA so that parents are not left in the dark and unable to participate in their loved ones treatment. Decisions were made on Paul's behalf by case workers. His family was often left out of the process and it had negative consequences for Paul.*
  5. Full repeal of the Medicaid Institutes for Mental Diseases (IMD) Exclusion.  End the federally sanctioned discrimination against people with serious brain disorders and drug addiction. * ((HR3717 is not fully repealed and limits acute care to 30 days)
  6. Fully enact the Community Mental Health Act of 1964. President Kennedy envisioned community based hospitals and outpatient treatment centers, but it was never fully materialized, mainly due to the Medicaid IMD Exclusion.
  7. Properly enforce the Olmstead Decision so that people who are the most disabled are not pushed beyond their capabilities.  "This Court emphasizes that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings"- 1999 - Justice Ruth Bader Ginsburg.  All too often this caveat is forgotten and people like Paul are pushed beyond their limitations, with disastrous results.
  8. Enact and fully enforce Assisted Outpatient Treatment (AOT) laws nationwide.*
  9. Ensure full insurance parity for people who have an illness in the brain so that they receive the same level of care as a person who has a serious illness in their heart, kidneys, or lungs. 
  10. Rebuild the infrastructure to make this all happen:
  • Increase funding for research into causes, diagnostic tools and effective treatments*
  • Educate Parents and Educators on early warning signs and develop better early intervention strategies*
  • Remove the "dangerous standard" from the intake process.  It is like waiting for a person to go into full cardiac arrest before finally taking them to the emergency room. 
  • Rebuild the hospitals and increase the number of beds to meet the needs of the community (50/100,000).*
  • Mental Health Courts - Jail Diversion is a must!*
  • Decriminalize drug use - Treatment works (but we need that IMD Exclusion repealed too because drug rehab facilities are IMDs!)
  • Crisis Intervention Training for all first responders, especially the police!*

Paul's Legacy Project Supports HR3717, The Helping Families In Mental Health Crisis Act of 2014

We need Treatment Before Tragedy not Tragedy Before Treatment