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Better behavioral health screening in the public schools. Greater access to mental health services for adolescents and young adults. And a new look at the state's controversial policy barring involuntary outpatient commitment for people with mental illness.
Those are some of the sweeping policy changes that Connecticut lawmakers may consider this session in response to the massacre in Newtown.
The shooting of 20 children and six educators at Sandy Hook Elementary School on Dec. 14 already has sparked a broad-ranging policy discussion on mental health, both in Washington and in state capitols across the nation, just as it has prompted debate on gun control and school security.
President Barack Obama is calling for a national dialogue on mental health. He also promised better access to behavioral health services in schools: his plan would allocate $15 million for training for teachers and other adults to detect and respond to mental illness in children and young adults.
Sen. Beth Bye praised the president's plan, and said she plans to make her own proposal for more social workers in the state's public schools.
"We need people in the schools to be more aware of kids who are dealing with social and emotional issues,'' said Bye, a Democrat from West Hartford who is a member of the newly formed legislative task force examining post-Sandy Hook proposals. "Early intervention does make a difference."
Jim Siemianowski, spokesman for the state Department of Mental Health and Addiction Services, said treating people early generally produces better outcomes. "We endorse anything that is focused on early identification and screening,'' he said.
While bolstering mental health screening and services in schools may find broad support, other potential proposals could prove more contentious.
Sen. Joseph Crisco, D-Woodbridge, who also sits on the task force, said he expects lawmakers to take a close look at legislation enacted this week in New York. In addition to some of the nation's strictest gun laws, the package of bills signed into law by Gov. Andrew Cuomo includes several provisions related to mental health, including a measure that aims to keep people with mental illness away from firearms.
"People who are mentally ill should not have access to guns, that's common sense," Cuomo said this week. "That's probably the hallmark of this bill, coming up with a system that allows for mental-health screens."
The new law requires psychiatrists and social workers to report to county mental health officials patients who are deemed a danger to themselves or others. The names of those individuals will be placed in a statewide database, which could be used to pull gun licenses.
That provision of the new law has drawn criticism from some mental health experts, who say it could violate long-held tenets of patient-doctor confidentiality and discourage people from obtaining treatment.
"I think it would put a big damper on people seeking mental health care,'' said Dr. Carolyn Drazinic, president-elect of the Connecticut Psychiatric Society and an associate professor at the University of Connecticut School of Medicine.
Drazinic notes that 20 percent of the general population has experienced a mental health issue at some point in their life. "Are we going to be putting all these people in databases because they went and saw a psychiatrist?'' she said.
Another provision in the New York legislation expands the state's Kendra's Law, which allows judges to order people with mental illness to obtain outpatient treatment.
Connecticut is one of six states that does not permit involuntary outpatient treatment, but that could change.
"In light of Sandy Hook, we're cognizant of the fact it needs to be further evaluated,'' Siemianowski said.
Supporters of changing the state's policies on outpatient treatment for patients with severe forms of mental illness say the Newtown shooting could be the catalyst for change.
"In Connecticut and the rest of the country, the mental health system is broken and oftentimes the civil commitment laws are part of the problem,'' said Kristina Ragosta, senior legislative and policy counsel for the Treatment Advocacy Center, a national nonprofit group that supports court-ordered treatment in some cases. "I hate that this discussion is the result of a tragedy, but the reality is this has now become a focus. ... I'm hopeful that Connecticut follows the lead of other states like New York."
But Drazinic cautioned that civil commitment isn't a quick fix, or a substitute for additional resources.
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