|C||onsumers||The Alaska "Mental Health System" has decided that it is going to downsize
API to 54 beds, which is fewer patients than it has virtually ever had
since it opened in 1962. The idea is that instead of
hospitalizations, people should be treated in the community whenever
possible. This is, of course, something everyone wants. The
original plan to go along with the downsizing was: (1) a Single
Point of Entry (SEP) that would evaluate all entrants into the emergency
mental health services system and determine the most appropriate place for the
person, and (2) a local hospital operating a Designation Evaluation and
Treatment (DET) facility to handle people who need short
term evaluation and stabilization. Neither of these services were achieved as a result of a bid solicitation process.
In order to overcome this difficulty, the State proposed that a PACT team be created in Anchorage. Consumers around the country are very opposed to PACT Programs as they have been extremely coercive in many cases. See,
Academic research is also beginning to agree with this position. See:
Consumers are saying that the biggest problems with the mental health system are (1) the coercive nature of the "treatment" and (2) the lack of choice. Therefore a consumer-driven, choice oriented approach to achieving inpatient-reducing community services that looks something like the following is being proposed:
It turns out that an experimental program for homeless people suffering from mental illness in Florida, also called "Choices" has yielded interesting results. See, Addressing Self-Defined Goals Improves Psychiatric Status of Homeless People.
The original PACT Discussion Draft Proposal calls for an approximately $1.8 million annual budget, which all goes to and in support of (e.g., rent, mileage, etc.) the 12 full time position team members. We propose instead a system built around independent case management. Thus, $500,000 of the $1.8 million would be used on and in support of the independent case management, in which a high percentage would be for peer specialists. The other $1.3 million would be used to purchase independent services for 130 people to be in the program. To do this, $10,000 would be available to each person in the program to purchase psychiatric, psychotherapy, vocational training or other other services, or to meet physical needs such as the security deposit on an apartment, eyeglasses, dishes, etc. The CHOICES Program would have an arrangement with its own psychiatrist and services could be made available from that psychiatrist, but people in the program would be free to choose a different psychiatrist.
Last modified 12/2/2000