Celebrate Wellness from Co-occurring Disorders Join the Walk for Wellness on October 7

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1 Volume: V Issue 2 September/October 2012 Celebrate Wellness from Co-occurring Disorders Join the Walk for Wellness on October 7 There are many bills before the New Jersey Legislature that affect both individuals with an addictive illness, individuals with a mental illness and, individuals with both. Issues related to criminal justice, criminal records, homelessness all become relevant to people with co-occurring disorders when their illness goes untreated or the treatment is not integrated or adequate. And, issues related to recovery, treatment, civic responsibility, employment, expungement, and discrimination become relevant to those who were able to access treatment and found the road to wellness. Many of these individuals, their families and communities will join together to walk for wellness and recovery on October 7, 2012 at Johnson Park, Piscataway, NJ. To join NCADD-NJ S team, please copy and paste the following link: There are many pieces of legislation that affect those with co-occurring disorders (COD). Not only does legislation related to mental illness and addiction become relevant, but, individuals with untreated co-occurring disorders are over represented in our criminal justice system, the homeless population, and emergency rooms. When the mental and addictive illness is not adequately addressed, social costs escalate. Approximately 39 percent of people who are homeless have a mental disorder, and an estimated 50 percent of adults with serious mental illnesses who are homeless have a co-occurring addictive disorder. Among detainees with mental disorders, 72 percent also have a co-occurring addiction disorder. In the juvenile justice system two-thirds of the youth have one or more addiction disorders and mental disorders. (see the previous issue of Capital Talks for bills addressing criminal justice, criminal records, expungement, alcohol and drug use, all of which affect individuals with a co-occurring disorder). Treatment of co-occurring mental and addictive disorders requires state and local agency action, in collaboration with state legislators, who can play a role in monitoring, financing and evaluating co-occurring treatment services. The Task Force on co-occurring disorders recommended: We urge the state s lawmakers and officials to set an example by incorporating the primary goals of this reform and to begin with the most basic, albeit tedious, task of reconsidering the way our mental health system is run. We must re- visit the manner in which services are provided, contracts are issued, and performance is monitored we must review and overhaul the existing set of rules and regulations and, collectively and at all times, we must ensure a focus on Treatment, Wellness and Recovery. This report represents a blueprint for reform, categorizing the best and most promising practices call for an integrated treatment approach. Individuals with co-occurring substance abuse and mental illnesses must be treated at the same time, at the same place, with the same treatment team. Outcomes are improved when integrated prevention, intervention and treatment strategies are applied.

2 2 Capitol Talks Legislation plays a significant role in creating a system that meets the needs of individuals with co-occurring mental and addictive disorders and is necessary to improve systems of care. For example the Budget bill created the merger between the Division of Addiction Services and the Division of Mental Health in 2011, which is an integral step in treating co-occurring disorders. In addition to the related legislation mentioned above, legislation that is currently being considered that will have an impact on individuals with a co-occurring disorder includes: - A745 - which requires correctional facilities to provide inmates with prescription medication that was prescribed for chronic conditions existing prior to incarceration. These chronic conditions include medications used to treat mental illness, addiction, and co-occurring disorders; - S2135/A The New Jersey Healthcare Exchange Act, which includes on the advisory committee a provider of mental health and addiction services; - S2224/A Removes pejorative terminology referring to mental capacity of individuals. The prevalence of co-occurring disorders is not well known despite the fact that consumer peers believe it occurs in about 40 percent of New Jersey residents. One study found that 42.7 percent of individuals with a 12-month addictive disorder had at least one 12-month mental disorder. The Epidemiologic Catchment Area Survey found that 47 percent of individuals with schizophrenia also had a substance abuse disorder (more than four times as likely as the general population), and 61percent of individuals with bi-polar disorder also had a substance abuse disorder (more than five times as likely as the general population). Providers are beginning to understand that co-occurring disorders are not a limited subgroup of the client population, but that co-occurring symptomatology is to be expected in the population of persons seeking addiction and/or mental health services. Co-occurring disorder are both common and highly complex. It affects 7 to 10 million adult Americans in any one year. Forty-one to 65 percent of individuals with a lifetime addiction disorder also have a lifetime history of at least one mental disorder, and about 51 percent of those with one or more lifetime mental disorders also have a lifetime history of at least one addiction disorder. Individuals rarely experience only two disorders. Rather, they have multiple interacting disabilities, psychosocial problems, and disadvantages. Sixty-five percent of individuals who contact primary care for a health issue, actually have a behavioral health issue. Individuals with co-occurring addictive and mental disorders have high rates of other health problems and often present for care in the primary health care system. In fact, many individuals with mental disorders seek and receive care exclusively through the primary health care system. There is little evidence that these disorders are identified or treated, or that the primary health and behavioral health care systems collaborate to deliver care effectively. Primary care physicians often do not detect the presence of addictive disorders, mental disorders, or both. Even when they do recognize the problem, often it is not addressed. Some of this may change with health care reform, which encourages the integration of behavioral health care and physical health care through the use of health homes and accountable care organizations. However much needs to be done to reduce the stigma associated with these illnesses within the health field for true integration to occur. The vast majority of people with co-occurring addictive and mental disorders do not receive care for a broad range of reasons. For one, severe under-funding of the public addictive and mental health treatment delivery systems. Additionally, private insurance often excludes or severely limits coverage for services, which is a significant issue as both disorders are chronic, and require long-term treatments, not dissimilar to the long-term needs of people experiencing diabetes, heart disease or stroke. Finally, the discrimination and stigma of addictive disorders and mental disorders may be isolating, making people with these disorders less likely to seek care in the first place. Data from the Healthcare for Communities Survey, conducted by UCLA and RAND, found that among people with co-occurring disorders, 72 percent did not receive any mental health or addiction treatment over the previous year. Fewer than 25 percent of individuals with co-occurring disorders received appropriate mental health services, and only 9 percent received supplemental addiction services. Reducing the stigma and discrimination of people with co-occurring disorders is imperative because individuals do recover if appropriate treatment is accessible. In fact, when compared to other chronic diseases such as diabetes, and hypertension both mental health and addiction recovery are more successful than other chronic diseases. These numbers may not provide the full extent of co-occurring disorders. The stigma associated with addictive and mental disorders cause many individuals with co-occurring disorders not to seek treatment or to seek treatment in primary care settings.

3 Capitol Talks 3 The National Institute of Mental Health has shown that success rates of treatment for disorders such as schizophrenia 60 percent, depression (70-80%) and panic disorder (70-90 percent) surpass those of other medical conditions (heart disease, for example, has a treatment success rate of percent). If we look at the relapse rates for other chronic diseases such as diabetes (30-50 percent), asthma (50-70 percent), and hypertension (50-70 percent), addiction (40-60 percent) we see similar rates of relapse and success. Although nearly half of all public and private facilities that provide addiction treatment reported that they offer services to individuals with co-occurring mental disorders, most individuals receive treatment first from one provider, then another or, receive treatment from two separate providers at the same time. Despite evidence in support of integrated treatment for addictive and mental disorders, only 4 percent of individuals in the Healthcare for Communities Survey reported receiving sequential care. Another 4 percent reported receiving parallel treatment. Fragmented and uncoordinated services create a service gap for persons with co-occurring disorders. Treatment for people with co-occurring disorders should be integrated, where both the mental health services and addiction treatment are provided by the same clinician or group of clinicians. With adequate treatment people do recover and lead full and productive lives: JOIN US ON THE WALK FOR WELLNESS AND RECOV- ERY TO CELEBRATE THE WELLNESS AND RECOVERY OF THOSE WITH CO-OCCURRING DISODERS, MENTAL ILLNESS AND ADDICTIVE DISORDERS CELEBRATE WELLNESS AND RECOVERY WITH THE SHORE BLUES BAND Listen and Dance to Great Blues The Mental Health Association in New Jersey & The National Council on Alcoholism and Drug Dependence-NJ Live Music, Walk For Wellness T-shirts, Raffle, Prizes Information Tables When: Sunday, October 7, 8:30 AM Where: Johnson Park, Piscataway, NJ BILLS THAT ADVANCED IN THE PAST 90 DAYS CRIMINAL JUSTICE Bill: A3175 Aca (1R) Watson Coleman (D15) Summary: Supplemental appropriation of $2 million to fund mandatory drug court. 09/24/2012 2nd reading in the Assembly History: 06/28/2012 Introduced and referred to Assembly Appropriations 09/24/ Reported out of committee Bill: S851/A578 Aca (1R) Vitale(D19), Weinberg (37); Wagner (D38); Chivukula (D17); Fuentes (D5); Giblin (D34); Gusciora (D15) +24 Summary: Good Samaritan Emergency Response Act ; eliminates criminal liability for persons who seek medical assistance in response to drug overdose. Governor 08/20/2012 Passed in both houses History: 01/10/2012 Introduced and referred to Assembly Judiciary 05/21/2012 Reported out of committee with committee amendments, 2nd reading in Assembly. 05/24/2012 Passed in Assembly /31/2012 Received in Senate and referred to Senate Judiciary 06/21/2012 Reported out of committee, 2nd reading in 08/20/2012 Substituted for S 851 (1R). Passed in Senate and sent to Governor Bill S881/A2302 Lesniak (D20); Scutari (D22); Watson Coleman (D15); Johnson (D37); Quijano (D20); Schepisi (R39) +5/ Mainer Summary: Eliminates prosecutorial objection to admission to drug court program; expands eligibility and provides for phased in mandatory drug court program. Pamphlet Law 07/19/2012 Bill or Resolution Signed by the Governor History: 01/10/2012 Introduced and referred to Senate Judiciary 02/16/2012 Reported out of committee with committee amendments, 2nd reading in Referred to Senate Budget and Appropriations 05/03/2012 Reported out of committee with committee amendments, 2nd reading in 05/24/2012 Amended on Senate floor, 2nd reading in Senate 27 0 (Lesniak). 05/31/2012 Passed in Senate /07/2012 Received in Assembly and referred to Assembly Judiciary 06/18/2012 Transferred to Assembly Appropriations Reported out of committee with committee amendments, 2nd reading in Assembly.

4 4 Capitol Talks 06/21/2012 Substituted for A 2883 (1R). Amended on Assembly floor, 2nd reading in Assembly (Watson Coleman). 06/25/2012 Passed in Assembly Assembly vote reconsidered (Watson Coleman). Amended on Assembly floor, 2nd reading in Assembly (Watson Coleman). Emergency resolution (Watson Coleman). Passed in Assembly /28/2012 Received in Senate, 2nd reading in Senate to concur with Assembly amendments. Passed in Senate and sent to Governor /19/2012 Signed by the Governor P.L.2012, c /24/2012 Reported out of committee with committee amendments, 2nd reading in Assembly. HEALTH CARE REFORM Bill S3186/A2171 Gill (D34); Vitale (D19) / Conaway (D7); Singleton (D7); Chivukula (D17); Ramos (D33); Wisniewski (D19) +1 Conaway (D7); Singleton (D7); Chivukula (D17); Ramos (D33) +4 Summary: New Jersey Health Benefit Exchange Act. 10/01/2012 2nd reading in the Senate History: 06/28/2012 Introduced and referred to Senate Commerce 07/30/2012 A3186 Introduced and referred to Assembly Health and Senior Services 10/01/2012 Reported out of committee with committee amendments, 2nd reading in Scheduled: 10/04/2012 Senate, 12:00p Party Conferences; 2:00p Voting Session. (Revised 10/03/2012) IMPAIRED DRIVING Bill: A1015 Mainor (D31); Benson (D14) Summary: Increases penalties for drunk driving with a minor as a passenger. 09/24/2012 2nd reading in the Assembly History: 01/10/2012 Introduced and referred to Assembly Law and Public Safety 09/24/2012 Reported out of committee, 2nd reading in Assembly. Bill: A3225 Angelini (R11) Summary: Establishes pilot program requiring certain first time drunk drivers to install ignition interlock device. 1st House: Referred to Committee 07/30/2012 Assembly Law and Public Safety Committee History: 07/30/2012 Introduced and referred to Assembly Law and Public Safety MENTAL AND CO-OCCURING HEALTH Bill: S2224/A3357 Weinberg (D37)/ Vainieri Huttle (D37) Summary: Changes pejorative terminology referring to mental capacity of individuals. Proposed for introduction 09/27/2012 A3357 Proposed for introduction 10/01/2012 Proposed for introduction History: 10/01/2012 Proposed for introduction. UNDERAGE DRINKING AND DRUG USE Bill: A638 Aa (1R) Rumpf (R9); Conaway (D7); Gove (R9); Albano (D1) +22 Summary: Establishes Hooked on Fishing Not on Drugs Program in DEP and appropriates $200,000 therefor from Drug Enforcement and Demand Reduction Fund. Pamphlet Law 09/18/2012 Bill or Resolution Signed by the Governor History: 01/10/2012 Introduced and referred to Assembly Agriculture and Natural Resources 02/02/2012 Reported out of committee, referred to Assembly Appropriations 03/12/2012 Reported out of committee, 2nd reading in Assembly. 03/15/2012 Amended on Assembly floor, 2nd reading in Assembly (Rumpf). 05/24/2012 Passed in Assembly /31/2012 Received in Senate and referred to Senate Budget and Appropriations 06/07/2012 Reported out of committee, 2nd reading in 06/21/2012 Substituted for S 178 (1R). Passed in Senate and sent to Governor /18/2012 Signed by the Governor P.L.2012, c.46. Bill: S64/A2574 Codey (D27); Oroho (R24) +1/ Vainieri Huttle (D37); Coutinho (D29) Summary: Establishes measures to deter steroid use among students. 10/01/2012 2nd reading in the Senate History: 01/10/2012 Introduced and referred to Senate Education 10/01/2012 Reported out of committee, 2nd reading in

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