HOUSE BILL REPORT

HB 1804

BYRepresentatives Brekke, Moyer, Sayan, Dellwo, Lewis, Winsley and Anderson

Revising definitions of mental illness.

House Committe on Human Services

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (9)

      Signed by Representatives Brekke, Chair; Scott, Vice Chair; Anderson, Leonard, Moyer, Padden, H. Sommers, Sutherland and Winsley.

House Staff:Jean Wessman (786-7132)

AS REPORTED BY COMMITTEE ON HUMAN SERVICES FEBRUARY 2, 1988

BACKGROUND:

In 1982 the Legislature enacted the definitions of who constituted the priority populations to be served within the Community Mental Health Services Act.  Those definitions included the acutely mentally ill, chronically mentally ill and the seriously disturbed person. The last changes to the definitions were in 1986 when children's specific conditions and situations were added to the definition of chronically mentally ill in order to ensure their inclusion in services provided.  This occurred because of the limited ability to serve those classified as seriously disturbed which is characteristically where children and other groups who don't fit the acute or chronic definition end up.  One of those other groups who has remained underserved because of the specific debilitating conditions common to their group is the elderly population.  Many of their specific situations are not currently included in the definition of chronically mentally ill.

To attempt to serve more fully the special needs of the geriatric population, it is suggested that the definition of chronically mentally ill be expanded to include their special situations and conditions.  Since there continues to be discussion on all of the various definitions constituting the categories of mental illness, it is suggested that the House Human Services Committee examine this area during the interim.

SUMMARY:

SUBSTITUTE BILL: The House Human Services and Ways and Means Committees are charged with an interim study on community mental health to include examining the definitions of mental illness in regard to various populations including but not limited to such groups as children, young adults, minorities, those who have used neuroleptic drugs for two months or more,  the elderly, and the general adult population.

SUBSTITUTE BILL COMPARED TO ORIGINAL:  The expansion of the definition of chronically mentally ill to include the specific conditions and situations applicable to the elderly is deleted. The implementation date of the expanded definitions is deleted. The House Committee on Ways and Means will also conduct the study on community mental health along with House Human Services.  The population of those who have used neuroleptic drugs for two months or more is added to those groups who will be included in the study.

Fiscal Note:      Available.

House Committee ‑ Testified For:    Thelma Struck, Department of Social and Health Services; Pat Thibaudeau, Washington Council on Community Mental Health; Chris Piatt, Geriatric Mental Health Association of Washington; and Fred Mills, American Association of Retired Persons. Favors study: Frank Winslow, Alzheimer Society of Washington and Elizabeth Muktarian, Pierce County.

House Committee - Testified Against:      Carroll A. Hernandez, King County, Human Services Division.  Oppose definitions: Frank Winslow, Alzheimer Society of Washington and Elizabeth Muktarian, Pierce County.

House Committee - Testimony For:    It has been almost seven years since the Community Mental Health Services Act was enacted.  It is time to re-examine the definitions of what constitutes mental illness to encompass the needs of special groups such as the elderly, minorities, mentally ill offenders and users of neuroleptic drugs.  Many of these groups are underserved because they don't currently fit into the definition of either acutely mentally ill or chronically mentally ill.  The underlying problem is the lack of adequate funding to meet the mental health needs of those currently classified as seriously disturbed.  The definitions need to be changed since they are inadequate and out-of-date.  An interim study on the definitions is an excellent idea and many of us would like to participate.

House Committee - Testimony Against:      Do not make piecemeal changes to the definitions.  Adding groups one by one does not solve the real problem and only serves to shift other needy persons out of the upper priority levels. The definitions need to be examined as a whole.