Thursday, July 9, 2009

New York's assisted outpatient treatment revisited


The publication of a Duke University Study on assisted outpatient treatment in New York, known as Kendra's Law, and the June 30 report from the New York Office of Mental Health (OMH) has put the law back in the spotlight. WSJ blogger Shirley Wang tackled the issue today, asking "Does Court-Ordered Treatment for Mental Health Work?" So does it?
The answer, from Duke Univerity researchers and New York's official report, is a resounding yes. The OMH reported that the process resulted in a "substantial reduction in the number of psychiatric hospitalizations and in days in the hospital if a person is hospitalized." Their report also found that, "AOT reduces the likelihood of being arrested."
The New York report also found, "AOT recipients are far more likely to consistently receive psychotropic medications appropriate to their psychiatric conditions. Case managers of AOT recipients also report subjective improvements in many areas of personal functioning, such as managing appointments, medications, and self-care tasks."
One emotionally charged issue has been the racial disparities between blacks and whites in court-ordered treatment. In 2005, New York Lawyers for the Public Interest presented demographic data which demonstrated that African Americans were overrepresented in the AOT program. The OMH report acknowedged this, stating, "We find that the overrepresentation of African Americans in the AOT Program is a function of African Americans’ higher likelihood of being poor, higher likelihood of being uninsured, higher likelihood of being treated by the public mental health system (rather than by private mental health professionals), and higher likelihood of having a history of psychiatric hospitalization."
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Tuesday, July 7, 2009

Feds want Medicaid money back


When needing mental health treatment, many of the nation's poor have been turned away at the door. A new move by the federal government may lock them out entirely, at least in Texas.
According to a story in today's Houston Chronicle, the feds have required the state to repay them $1.67 million in Medicaid reimbursements for inpatient psychiatric care. Medicaid does not provide for adults living in psychiatric institutions.
About 200 psychiatrists and institutions in the state received notices from the Texas Health and Human Services Commission in June requesting the return of reimbursements from 2001 to 2007. A few individual practitioners received bills for $40,000 and one medical group was hit with a $130,000 demand, according to the article.
Will other states be next?
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