Requiring mentally ill to get treatment isn’t always the right answer

Sister Claire Graham, who attended St. Francis High with Genevieve Lucchesi, holds a picture of her at a memorial service in June.
Sister Claire Graham, who attended St. Francis High with Genevieve Lucchesi, holds a picture of her at a memorial service in June.

Last month, we read the heartbreaking story of Genny, a homeless Sacramento woman who tragically passed away on the streets. Genny’s story and the many stories like hers stir emotions and spark public debate on the need for mental health reform in our country. We can and should be doing more to address mental illness.

Some may contend that Genny should have been forced into treatment since she refused to accept available services offered to her. Assisted outpatient treatment, as administered through Laura’s Law in California, is designed for patients consistently failed by the system. I know that when families are facing a crisis, this may be their only option. These programs, when paired with a high level of community services and support, can be an effective tool to help a very narrow subset of patients.

However, I am sincerely concerned that mandating outpatient treatment at the federal level would divert resources from other options that should be there for patients and families, and would limit our communities’ ability to make local decisions.

I am focused on crafting policy that helps patients at whatever stage they are in their mental illness, by increasing services and funding and working to eliminate stigma. On Wednesday, a House subcommittee will take up the Helping Families in Mental Health Crisis Act, legislation that could be a step forward.

We must have the resources to ensure that it is common practice to help people like Genny when they experience their first psychotic episode, not just after their condition has deteriorated. Mental illnesses are diseases that can be treated, and it’s time our policies and approach to patients reflect that reality.

To that end, I was one of the chief architects of the Excellence in Mental Health Act, signed into law in April 2014. This law will finance an array of intensive community services – including crisis services and coordination with physical health services – delivered through Community Behavioral Health Clinics. Just weeks ago, California was one of 24 states to be awarded a planning grant for participation in this exciting demonstration project.

In situations like Genny’s, we must look at the whole picture. What is not being discussed is the lack of available treatment for Genny long before she became homeless. Genny was a young mother raising children when she began hearing voices and showing signs of a mental illness, but didn’t get the help she needed. We know her story could be anyone’s: a friend showing signs of depression, or a young adult who is struggling with substance abuse.

We all understand the importance of prevention when it comes to our physical health and dealing with diseases such as cancer, but it is time we apply that same thinking to mental health. We would never say that we should not research or treat cancer, but we would also never focus solely on the end stage of the disease, without putting resources into prevention, early intervention and education on how to recognize the first signs of illness.

We will have many more victims like Genny unless we find common ground around mental health reform that focuses on strengthening both prevention and crisis programs, increasing funding, and supporting states and cities. I have hope that we can change our system’s current trajectory if we work together in a bipartisan way. As Congress attempts to address the challenge of mental health reform this week and in the future, I will continue to fight for the resources that communities need to better serve all patients and their families who struggle with mental illness.

Doris Matsui, a Sacramento Democrat, represents California’s Sixth Congressional District.