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Healthcare Journal of Baton Rouge
| July / August 2008 Issue | healthcarejournalbr.com
So, in addition to the budget recommendation, Jindal and
DHH have proposed a package of bills which will create stan-
dards for local behavioral health agencies, allow for the use of
telemedicine in assessment and treatment to compensate for
a shortage of mental health professionals, create a mental
health safety net for those in crisis, and provide a mechanism
to ensure that those exhibiting high risk behavior receive the
treatment they need. While the bills will have the most imme-
diate impact in New Orleans, they are designed to address
access issues statewide. “Right now we are responding to a
crisis, but we certainly don't want to put all of our resources in
New Orleans,” said Kopke. “The budget increases are enough
to allow us to address other parts of the state.”
DHH's legislative package includes:
•SB 182 (Gray), dubbed Nicola's Law, which came in direct
response to the deaths of Nicola Cotton and LaToya Johnson,
two New Orleans police officers who were killed by mentally ill
suspects. The Nicola's Law bill provides treatment profession-
als and the courts another tool to compel treatment and
enforce treatment protocols, when necessary, and to ensure
intensive care management is provided. The bill mirrors a sim-
ilar law in New York, Kendra's Law. Officials there report that
Kendra's Law significantly reduced crime, incarceration, and
hospitalizations linked to mental illness in a very short period
of time.
•SB 228 (Heitmeier), which establishes gateways to facilitate
access to mental health care for those in crisis. The bill will
allow for the establishment of crisis receiving centers not just
in New Orleans, but across the state.
•HB 930 (Mills), which creates readiness criteria for human
service districts across the state; establishes ongoing review
and oversight of established districts, and provides for cre-
ation of additional human service districts across the state, in
addition to the four currently in existence. The first of these,
the Jefferson Parish Human Services Authority was estab-
lished by the Louisiana Legislature in 1989 to provide local
control in the management and delivery of mental health,
addictive disorders, and developmental disabilities services.
Prior to its formation, these services were managed by the
State of Louisiana. The success of this authority resulted in
the creation of other human service districts in Baton Rouge,
greater New Orleans, and in the Florida Parishes. Two other
such districts are already in the planning stages.
•HB 653 (Labruzzo), which uses cutting edge telemedicine to
address the ongoing shortage of mental health professionals.
The bill creates a 24/7 hotline for those in crisis to receive
evaluation, counseling and instructions for further care espe-
cially in areas where there are not enough doctors on the
ground.
DHH has also proposed some long-term initiatives which,
while focused initially on the New Orleans area, may eventu-
ally be expanded to other parts of the state. Some are already
in place. DHH's long-term initiatives include:
•Enhancement of the existing 24/7 crisis phone service. The
211 system is a toll-free, live answer link to behavioral health
and social services. It will have multi-line and multi-lingual
capacity.
•Crisis Intervention Teams made up of law enforcement offi-
cers that have received specialized training to be first respon-
ders to mental health emergencies.
•A regional receiving and triage center providing a uniform
system of entry and immediate assessment. This may be free-
standing, hospital based, or may be established at an existing
facility.
•Mobile Clinical Treatment Teams consisting of a psychiatrist,
nurse, and four mental health practitioners to provide services
at community, home, or school settings as an enhancement to
existing clinical services in the greater New Orleans area.
•Mental health staffing assistance to the Orleans Parish
Prison. Necessary treatment and the potential for rehabilita-
tion are hampered by minimal staffing and oversight.
In the meantime, initiatives like the Louisiana Spirit Hurricane
Recovery program, which offers assistance to those impacted
by the storms continues statewide. “This program has had a
tremendous impact, particularly among the elderly, for those
People are finally beginning to understand
that behavioral health issues are part of pri-
mary care issues, that physical health and
mental health go hand in hand.
-Jennifer Kopke, DHH
Right now we are responding to a crisis, but
we certainly don't want to put all of our
resources in New Orleans. The budget
increases are enough to allow us to
address other parts of the state.
-Jennifer Kopke, DHH
400 BC:
Hippocrates considers mental illness
to be more like other ailments, a problem in
the balance of the humors, than a reflection of
the gods' displeasure.
387 BC:
Plato posits that mental reasoning
occurs in the brain. In Plato's
Republic
,
Socrates recommends sending the deformed
and the offspring of the inferior away to a
mysterious place.