SCR1019 - 532R

Whereas, families of persons with mental illness are usually the first to recognize that their loved ones need help dealing with the symptoms of their illness: and

Whereas, mental illness can be successfully managed with long-term compliance with treatment in the form of proper medications and appropriate therapy; and

Whereas, adults with mental illness, although often functioning under a worldview distorted by delusions, can be very intelligent and articulate, and are sometimes very capable of fooling or manipulating others who do not know them well; and

Whereas, adults with mental illness are often impaired by "anosognosia," which prevents them from understanding their illness and need for treatment; and

Whereas, families of an adult with a mental illness often find it difficult, if not impossible, to convince their loved ones to seek and stay in treatment and often must resort to seeking involuntary treatment provided by the state to get the treatment needed; and

Whereas, families of an adult with mental illness who has become incapacitated by the illness to the point that the person cannot make reasonable decisions can apply for and obtain a court order appointing a family member or someone else as guardian to make treatment decisions for the adult with mental illness; and

Whereas, guardianship is typically not discussed with families by those in the mental health system from whom they seek help, and the expense and trauma associated with obtaining a court-appointed guardian is not something that many families are able to bear; and

Whereas, the State of Arizona has a publicly funded, statutorily authorized mental health system that allows the state to force persons to get needed treatment who are mentally ill and who are either a danger to self or others as the result of the mental illness or who, without treatment, will likely become dangerous or more seriously mentally ill, and who are unwilling or unable to voluntarily accept treatment. However, the system with which families and patients are forced to deal in order to get needed treatment is confusing and unnecessarily complex, is not always responsive to the needs of the mentally ill person and is sometimes resistant to listening to or helping those who know the person best; and

Whereas, a growing number of families in Arizona can attest to the mental health system's lack of responsiveness when they seek treatment for an adult family member with mental illness. Often the situation is not perceived to be an emergency if no harm has yet occurred or been seriously threatened, or if forms were not filled out properly and the intake persons are not willing to talk with the family members to get more information to clarify the situation or to assist the family member with finding help elsewhere in the community; and

Whereas, even when the system appears to be initially willing to help, the person for whom treatment is sought is too often provided only brief treatment in the form of counseling and a prescription for medication without any follow-up to determine whether the person has been compliant with the treatment prescribed and whether there has been any significant change in symptoms or behaviors; and

Whereas, the State of Arizona is mandated to provide a system to screen and evaluate those in need of court-ordered mental health treatment and to provide a community-based residential treatment system with a wide range of treatment alternatives to institutionalization, including an effective case management system. However, the evaluation agencies in the largest county in Arizona, with the largest number of people at risk, do not have sufficient capacity to efficiently perform evaluations. There are not sufficient resources in the community to meet the needs of mentally ill persons, requiring them to stay in inpatient settings that are not appropriate for their treatment. Further, appropriate case management designed to effectively monitor and ensure patient compliance with mandated treatment is available to only a select few; and

Whereas, far too many preventable tragedies have resulted from the present state of Arizona's mental health system, including the tragic death of Reyna Isabel Estrada Ramirez on July 14, 2017 at the hands of her older brother, who suffered from an untreated mental illness; and

Whereas, known for her passion for sports, her long, dark braided hair and her contagious laughter and smile, Reyna packed a great deal of life into her sixteen years. Whether participating in a beauty pageant, camping in the forest, playing in the snow, enjoying recreational activities in the desert, vacationing in Hawaii, Mexico, California or Las Vegas, attending a game of her beloved Redskins and Red Sox, swimming with giant turtles in the ocean, or amusing her family with stories, Reyna lived her life to the fullest and impressed others around her with her intelligence, kindness and humor. She will be greatly missed by all who knew her; and

Whereas, Reyna Estrada's premature and senseless death is a tragic reminder of the horrific and life-altering consequences that can result from ignoring the symptoms of mental illness in our communities.

Therefore

Be it resolved by the Senate of the State of Arizona, the House of Representatives concurring:

1. That the Members of the Legislature recognize that the publicly funded mental health system in this state exists to benefit not only the patient but to protect the public by providing needed mental health treatment to those who cannot or will not voluntarily accept treatment.

2. That the Members of the Legislature recognize that families of a person with mental illness have the right to be treated with respect and compassion when seeking the appropriate care and treatment for their family member.

3. That the Members of the Legislature recognize that the mental health system is confusing and complex for persons who seek help for a family member who has, or appears to have, a mental illness, and that families have the right to receive help navigating the system and information about what the system can and cannot do and what other resources or support services are available in the community to help them and their family member.

4. That the Members of the Legislature recognize that it is their responsibility to ensure that the mental health system in Arizona works to benefit the patients and to protect the public, including ensuring that the system is adequately funded to deal with the growing number of untreated mentally ill persons in this state and that those agencies accountable for the public funding provided to run the system use the monies appropriately.