6/1/16
Proposed PAIMI 2017 Targets
Advance the right of people with disabilities to transition out of institutions into the least restrictive community setting appropriate to their needs
Rationale:Too often, people with mental illness who could successfully live in the community with sufficient services and supports are stuck in institutional settings in violation of their right to receive services in the least restrictive environment under the Americans with Disabilities Act and the Olmstead decision.
Target Populations
People with mental illness in institutions who could be more appropriately served in home and community-based settings.
People without adequate information to enforce their rights to home and community-based services.
Promote the right of self-determination
Rationale: Self-determination, the ability to make decisions and take actions to shape one’s own life, is fundamental to our purpose as the P&A.. Guardianship, which allows for the substitution of one person’s decision-making for another, can be the most egregious denial of self-determination.
Target Populations
People with mental illness who would like to restore their competency.
People with mental illness who have public or institutional guardians.
Advocate for children and adolescents between the ages of birth to 21 with complex mental health needs and co-occurring intellectual and or developmental disorders so that they receive medically necessary, community based mental health services and supports in their homes, family setting or the most homelike setting appropriate to their needs.
Rationale:Parents of children with co-occurring mental illnesses and intellectual or developmental disabilities struggle to find appropriate services for their children. For these children with complex needs, mental health services and intellectual disabilities services are separately administered, ineffective, time limited or waitlisted. Requests for the few services that are available are frequently denied by the Medicaid Managed Care Organizations. Because of these barriers, most of this population cycle in and out of institutions, acute care units and are sent to institutions out of state far away from their homes.
Target Population
Children under 21 who have mental illness and intellectual and other developmental disabilities who are not receiving appropriate services and supports.
Ensure appropriate treatment for people with mental illness in North Carolina prisons
Rationale: There are more North Carolinians with severe mental illness in our prisons and jails than in our psychiatric hospitals. For those with mental illness in prison, the outcome is usually harmful; sometimes, sadly, it is tragic.Through Protection and Advocacy system monitoring and investigation of abuse and neglect Disability Rights NC has identified significant deficiencies in our prison mental health service system resulting in on-going harm to people with mental illness. Disability Rights North Carolina can impact how people with mental illness are treated in our correctional facilities and increase the chances that people can be successful upon release.
Target Population
People with mental illness in prison who are not receiving appropriate treatment.
Investigate and Report on the Safety of People with Mental Illness Admitted to OurJails Including Examples of Best Practices in Jails
Rationale: Jails are neither designed nor funded to provide mental health treatment, yet with the erosion of public mental health services they have increasingly become de facto mental health facilities.Detention facilities are not equipped to provide the support and services that this population needs. Without appropriate treatment inmates with mental illness decompensate, are vulnerable to abuse and are disproportionately segregated in solitary confinement. Our preliminary research indicates suicide is the leading cause of death in N.C. jail inmates (34% of the deaths in N.C. Jails between 10/12 – 10/14 were suicides).From January 1, 2013 through June 30, 2015 there were at least 58 deaths in North Carolina jails; at least 26 of the deaths (44.8%) were the result of suicide.
Target Population
People with mental illness confined in N.C. Jails.
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