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Creating a Crisis Brochure

Janet Edelman NAMI MarylandJune 20, 2005

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Big Picture:

Changing commitment laws is hardCompromising with others is hardNavigating the system when in crisis is hardCreating a brochure to help people in a psychiatric crisis, in comparison, is easyBenefits of a brochure to the individual and NAMI can be significant

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Background - Maryland

Very liberal state – legislature very concerned about civil libertiesOne of 8 states with no Assisted Outpatient Treatment LawIn 2000 MD Workgroup rejected any changes to the commitment lawIn 2002 Crisis Response System law signed, but unfunded ($19 Million price tag)

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Background – Maryland cont’d

Entry to system can be difficultServices not well coordinated Service availability varies between jurisdictionsService can be good, if you can get it

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Background - NAMI Maryland

NAMI surveys indicate commitment process was a concern to our membersTreatment subcommittee of public policy committee created in 1998We educated ourselves, looked at other state laws, contacted TACIn 2001 started work on bill and brochureBrochure published 2002Emergency petition bill passed in 2003

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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 petitionsStatistics from hospital emergency rooms unavailable

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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 availabilityOnly some areas have mobile crisis teamsApproximately 2,000 out of 3,000 petitions filed were granted by the courts in FY2000 Ratio granted to filed varied greatly between countiesData was questionable in some cases

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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 meetingHad one hour meeting with the Judge and her aideAide stopped returning our calls for follow up

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Develop a Plan of Action

Develop a brochure to be published by NAMI Maryland on Psychiatric CrisisDetermine what changes in the law would help and draft a bill

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Form a Team for the Brochure

Team Roles – Subject matter experts

Family members with personal experience Lawyers Providers

Editor Publisher Reviewers from various backgrounds

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Set Goals for the Brochure

Easy to readUnderstandable in time of crisisHelpful to people not familiar with the system and laws in MarylandQuestion and answer formatAccurate

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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 writingUse e-mail for comments, Internet for researchCheck facts and phone numbersWhen we were satisfied, gave to others to review, for additional rounds of edits

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Reviewers

Family MembersMental Health lawyerPsychiatristsMobile Crisis Team DirectorPeople who know nothing about mental illness or the laws for emergency evaluation

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Decisions on Publishing

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

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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

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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.

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Response to the Brochures

Positive comments from all who received themMy local hospital, with two tragic incidents involving deaths, ordered 1,500 brochures to give to all psychiatric patientsReprinted several timesNow in third edition

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In Summary: The Brochure….

Provides a public service, and shows the value that NAMI can offer to the communityImproved our contacts with professionals and other organizationsWas a way for us to learn about the issueWas an opportunity for NAMI to shine