1. 1 Creating a Crisis Brochure Janet Edelman NAMI Maryland June 20, 2005

2. 2 Big Picture: Changing commitment laws is hard Compromising with others is hard Navigating the system when in crisis is hard Creating a brochure to help people in a psychiatric crisis, in comparison, is easy Benefits of a brochure to the individual and NAMI can be significant

3. 3 Background - Maryland Very liberal state – legislature very concerned about civil liberties One of 8 states with no Assisted Outpatient Treatment Law In 2000 MD Workgroup rejected any changes to the commitment law In 2002 Crisis Response System law signed, but unfunded ($19 Million price tag)

4. 4 Background – Maryland cont’d Entry to system can be difficult Services not well coordinated Service availability varies between jurisdictions Service can be good, if you can get it

5. 5 Background - NAMI Maryland NAMI surveys indicate commitment process was a concern to our members Treatment subcommittee of public policy committee created in 1998 We educated ourselves, looked at other state laws, contacted TAC In 2001 started work on bill and brochure Brochure published 2002 Emergency petition bill passed in 2003

6. 6 Research the problem Mental Hygiene Administration unable to quantify total emergency petitions in Maryland through courts or professionals. We knew that there were far more people petitioned through the police with 911 calls, but few or no statistics on petitions Statistics from hospital emergency rooms unavailable

7. 7 Survey and Tally Results We did a survey of Maryland County District Courts and Circuit Courts asking for FY2000: Number of petitions filed Number of petitions granted Hours of day/days of week filing available Only 3 counties had 24/7 court availability Only some areas have mobile crisis teams Approximately 2,000 out of 3,000 petitions filed were granted by the courts in FY2000 Ratio granted to filed varied greatly between counties Data was questionable in some cases

8. 8 Ask for Help Wrote to Chief Justice of the District Courts Included survey results Asked for changes  Petitions to be filed 24/7  Brochures available at courts and police stations  Improved statistics  Questioned quality of data available Asked for a meeting Had one hour meeting with the Judge and her aide Aide stopped returning our calls for follow up

9. 9 Develop a Plan of Action Develop a brochure to be published by NAMI Maryland on Psychiatric Crisis Determine what changes in the law would help and draft a bill

10. 10 Form a Team for the Brochure Team Roles – Subject matter experts  Family members with personal experience  Lawyers  Providers Editor Publisher Reviewers from various backgrounds

11. 11 Set Goals for the Brochure Easy to read Understandable in time of crisis Helpful to people not familiar with the system and laws in Maryland Question and answer format Accurate

12. 12 Writing Process Written by a team of NAMI members. We are the subject matter experts since we are the only ones that go through the entire process Many, many drafts – egoless writing Use e-mail for comments, Internet for research Check facts and phone numbers When we were satisfied, gave to others to review, for additional rounds of edits

13. 13 Reviewers Family Members Mental Health lawyer Psychiatrists Mobile Crisis Team Director People who know nothing about mental illness or the laws for emergency evaluation

14. 14 Decisions on Publishing Will not wait to get a grant Wanted it to look very professional, so willing to pay for quality printing First printing would be limited in volume (5,000) to see how it was accepted Will ask for donations for large orders (suggesting $.20 per brochure)

15. 15 Layout Meeting with Printer Our requirements: Make it eye-catching Should be easy to read, since may be used during a crisis We used all of his recommendations concerning: layout color font

16. 16 What We Did with the Brochures Sent out with annual fund-raising letter. We attribute increased donations to the brochure. (The first printing may have paid for itself) Sent to affiliate presidents, directing them to distribute to providers, police, etc. Distributed at conferences, fairs, etc. Placed text on our website.

17. 17 Response to the Brochures Positive comments from all who received them My local hospital, with two tragic incidents involving deaths, ordered 1,500 brochures to give to all psychiatric patients Reprinted several times Now in third edition

18. 18 In Summary: The Brochure…. Provides a public service, and shows the value that NAMI can offer to the community Improved our contacts with professionals and other organizations Was a way for us to learn about the issue Was an opportunity for NAMI to shine