Olmstead Plan Brief .pdf
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Make Minnesota a place where all people have meaningful choice and fair opportunities for a good life.
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Supporting People with Mental Illness to Lead
Meaningful Lives in their Community:
Choices and fairness for all citizens
Policy Brief – February 2014
Authors: Jeni Kolstad, Rojina McCarthy, Ann Przybilla, Abby Sharp
Executive Summary
Minnesota’s state leadership values the health and
well-‐being of all its citizens. This is demonstrated by
Governor Dayton’s Executive Order establishing a
sub-‐cabinet to develop and implement a
comprehensive plan supporting freedom of choice
and opportunity for people with disabilities –
referred to as the Olmstead Plan.
People who are diagnosed with serious and
persistent mental illnesses (SPMI) are Minnesotans
with disabilities that struggle for many of the ideals
outlined in the Olmstead Plan:
•
•
•
•
•
Opportunity and freedom for meaningful
choice, self-‐determination, and increased
quality of life
Opportunities for economic self-‐sufficiency
Employment options
Choices of living location and situation
Supports needed to realize these choices
Unfortunately, Minnesota has largely left out
people with SPMI from the Olmstead Plan.
Minnesota’s Olmstead Plan is a work in progress.
The time is now to voice concerns about the lack of
attention to people with SPMI in the plan. It is
imperative that the Olmstead Plan address the
unique needs and challenges of people with SPMI
and ensure that the approaches taken are designed
to meet their needs.
The Americans with Disabilities Act
defines a “disability” as a person who:
•
Has a physical or mental impairment that
limits one or more major life activities
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Has a record of such impairment
•
Or is regarded as having such impairment1
What is Minnesota’s Olmstead Plan?
•
A way for the state to document its plans to
provide services to individuals with disabilities
in the most integrated setting appropriate to
the individual.
•
Goals are related to employment, housing,
transportation, supports and services, lifelong
learning and education, healthcare and
healthy living, and community engagement for
people with disabilities.
• It aims at “achieving a Better Minnesota for all
the Minnesotans, and strives to ensure that
Minnesotans with disabilities will have the
opportunity, both now and in the future, to
live close to their families and friends, to live
more independently, to engage in productive
employment and to participate in community
life.” 2
People who live with a serious and persistent mental illness
are citizens with disabilities who deserve support.
This policy brief was developed & disseminated in collaboration with the Department of Social work at Minnesota State University, Mankato
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Make Minnesota a place where all people have meaningful choice and fair opportunities for a good life.
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Understanding Mental Illness
Mental illness is a medical condition that
interferes with a person’s thinking, feeling, and
mood. Mental illness can greatly affect the daily
functioning of people. Just as physical medical
conditions can be relieved through medical
treatment, so can mental illnesses. Mental
illness can affect anyone regardless of age,
gender, race, or income. The symptoms of
mental illness can be disabling, in particular for
people with a SPMI, where people may not be
able to work or take care of themselves without
support. Unfortunately, there just is not enough
support for people with SPMI to live healthy
lives within the community. The Olmstead plan
was developed in Minnesota to provide
additional supports for people with conditions
that result in a disability.3
When Mental Illness is a Disability
People who have serious and persistent mental
Illness (SPMI) can qualify as having a disability
due to:
•
Frequent inpatient care
•
Psychiatric hospitalizations
•
Impairment in functioning in major life
activities
•
A diagnosis of schizophrenia, bipolar
disorder, major depression, schizoaffective
disorder, or borderline personality disorder
Services That Support People with SPMI
to Live in their Community
•
Adult Rehabilitative Mental Health Services
(ARMHS)
•
Intensive Residential Treatment Services
(IRTS)
•
Assertive Community Treatment (ACT)
•
Community Behavioral Health Hospitals
(CBHH)
•
Crisis Response Teams (CRT)
•
Crisis Residential
About 320,000 adults in Minnesota each year have a mental illness,
with 167,000 adults having a Serious and Persistent Mental Illness.
It is estimated that less than 50% of people with SPMI receive the
treatment they need. 4
This policy brief was developed & disseminated in collaboration with the Department of Social work at Minnesota State University, Mankato
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Make Minnesota a place where all people have meaningful choice and fair opportunities for a good life.
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Limitations of the Olmstead
Plan for People with SPMI
While the Olmstead Plan provides
recommendations for individuals with a disability,
it does not appropriately address the needs of
people with a serious and persistent mental
illness. Time and again we have seen services and
supports designed from the perspective of serving
people with developmental or physical disabilities,
as a result, failing to meet the needs of people
with SPMI, often with detrimental effects. People
with SPMI have unique needs and challenges that
require services designed to meet their specific
needs, not to be grouped with others using a “one
size fits all approach.”
Missing from the Olmstead Plan, which would
better address the needs of people with mental
illness, are services such as:
•
•
•
•
Adult Rehabilitative Mental Health Services
(ARMHS)
Intensive Residential Treatment Services (IRTS)
Assertive Community Treatment (ACT)
Crisis Residential
The Plan makes mention of the need to offer
supports in an integrated way, although none of
the recommendations fully provide the supports
necessary for this population. Mental health
providers and advocates are aware of the need
for readily available psychiatric services; however,
the Olmstead Plan does not include a strategy for
shortening wait times.
Real People: Real Costs
The story of “Tony” epitomizes the unique set of
challenges he faces each day just to live
independently in his apartment; an integrated
setting. Tony receives services from ARMHS on a
weekly basis and has also received care from
facilities such as the CBHH and IRTS. He has also
had two previous stays at the crisis center in his
community. In order for Tony to continue to live
successfully in his apartment, he requires these
services, which are designed to assist him to cope
with the many challenges he faces including:
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Isolation
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Low motivation
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Energy loss
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Feelings of hopelessness and helplessness
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Thoughts of self-‐harm
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Engagement in self destructive behaviors
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Challenges maintaining relationships
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Flashbacks from his tragic past
Tony experiences minor relapses in his symptoms,
just like many others. However, with the
supportive mental health services he receives, he
is able to cope with his disability and live a good
quality of life. Tony often comments that without
the help he receives, living independently would
not be a realistic goal and his ability to live a
meaningful life as a member of his community
would be impossible.
Finally, the Plan does not address the need to
expand service options, including Evidence Based
Practices (EBP). The Olmstead Plan does not
include any EBP approaches to reach their goal of
moving “consumers” to an integrated setting.
Integrated community services has been demonstrated to reduce
psychiatric hospitalizations by more than 70% 5
This policy brief was developed & disseminated in collaboration with the Department of Social work at Minnesota State University, Mankato
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Make Minnesota a place where all people have meaningful choice and fair opportunities for a good life.
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Recommendations
In order to improve Minnesota’s Olmstead Plan
to better meet the needs of people with SPMI,
the following changes are needed in the Plan:
•
Explicitly discuss and address the needs of
people with serious and persistent mental
illness.
•
A clear definition of “Serious and Persistent
Mental Illness” as a disability.
•
Add specific services such as ARMHS, IRTS,
ACT, CBHH, CRT, and Crisis Residential
•
Include information about “mental illness”
and “SPMI” in the demographics data.
•
Address the lack of psychiatric care,
especially in rural areas.
•
Provide transitional housing supports.
•
Address the number of people with SPMI
incarcerated due to lack of services.
Minnesotans with disabilities
should “live with dignity, be valued
members of their communities, and
make choices to improve the
quality of their own lives.”
Minnesota Governor Mark Dayton
November 1, 20136
Your Call to Action.
The Time is Now!
The Olmstead Plan is not static. A revised
version will be released in July 2014. The time
is now to voice concern that the needs of
people with SPMI are not adequately
addressed in the plan. The Olmstead Planning
Committee acknowledged that there are areas
they could not address due to lack of
knowledge, so they need mental health
providers, advocates, and consumers of mental
health services to share their knowledge,
expertise, and experiences with the committee.
What you can do:
• Learn more about the Olmstead Plan by
going to: www.dhs.state.mn.us/Olmstead/
Sources
1. Americans with Disabilities Act 1990, P.L. 110-‐325, Section 10102.
2. Olmstead Planning Committee, Putting the Promise of Olmstead
into Practice (2013).
3. NAMI, Mental Illnesses (n.d.).
4. SAMSHA, Behavioral Health Monitor: Minnesota (2013).
5. Treatment Advocacy Center, Eliminating Barriers to the Treatment
of Mental Illness (2011).
6. Office of Governor Mark Dayton, Statement from Governor Mark
Dayton on Minnesota’s Olmstead Plan (2013).
For more information, email the authors of this brief at
abby.sharp@mnsu.edu
• Notify the Olmstead Implementation Office
about these recommendations by emailing
them at opc.public@state.mn.us
Contact your local legislators and inform
them of the gaping holes in the plan
http://www.leg.state.mn.us/leg/districtfin
der.aspx
•
This policy brief was developed and disseminated in collaboration with the Department of Social Work at Minnesota State University, Mankato 4
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