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Mothers of the Mentally Ill (MOMI) is a grassroots effort to improve treatment access and care for individuals impacted by severe psychiatric conditions. We welcome all family caregivers, friends, community members, and individuals who have lived experience with brain-based illnesses. 

Our efforts are focused on legislation and policy to improve care for individuals impacted by the most severe illness conditions, particularly schizophrenia, bipolar one with psychotic features, and schizoaffective disorder. We are based in Washington State and work at the state and national level to promote system change.

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• Recovery is expected when care is prompt and appropriate.
• Mental health care must be compassionate, humane, comprehensive, and on parity with health care for other disabling and life-threatening conditions. 
• Treatment laws and service systems must acknowledge anosognosia, a symptom of severe illness that can disable a person’s ability to see and understand they are sick. 
• Involuntary treatment should be used sparingly but may be necessary for a person too ill to engage with treatment independently.
• Misinformation about the true nature of severe brain-based disease has contributed to a system that withholds life-saving care from individuals who are the most vulnerable, leading many into homelessness, involvement with law enforcement, and early death. 
• Advocacy against involuntary care and inadequate resources have combined to create a system that criminalizes illness. 
• Appropriate quality of life should be tracked, measured, and required as a treatment outcome.

Support Assisted Outpatient Treatment (AOT)

AOT is a team-based, court-supported protocol for individuals who need assertive help to maintain recovery in an outpatient setting. When done well, AOT incorporates a whole life approach to treatment, housing, vocational help, and more. An AOT team has agility to alter the level of care based on a person’s psychiatric symptoms, not only threat of harm. With support and advocacy from MOMI, Washington State in 2022 passed legislation (HB 1773), to establish new standards and procedures for AOT access. Treatment Advocacy Center (TAC) is providing technical assistance to Washington and other states for AOT expansion nationwide. 

Washington State’s  2023 Legislature failed to pass SB 5130 to improve the law, but this failure is not a deal breaker for AOT. The state's Health Care Authority is hiring coordinators with an ambitious goal of rolling out AOT across the state this summer! 

If someone you love may benefit from AOT in Washington State, read the petition and consider if there is a provider who may be willing to file one with the court. If a petition is filed, the court must respond. If you have history to support a petition, share it with the provider. There are no HIPAA barriers to you sharing information with a provider.

ADVOCACY ACTION: Let your elected officials know that you support AOT and hope they can come to agreement next year about a bill to improve the law and increase funding for AOT programs. For example, this year's bill would have added to the list of people qualified to petition for AOT, making it more agile for complicated circumstances.  Use the District Finder to find contact information for your elected officials.  

Monitor rollout of 988 

On July 16, 2022, the 988 Suicide & Crisis Lifeline went live nationally as a number to call for a mental health or substance use crisis.  MOMI testimony supported passage of HB 1477, which endeavors to enhance and expand crisis response and follow-through within a more functional continuum of care. Various committees support Washington's Crisis Response Improvement Strategy (CRIS). 

ADVOCACY ACTION: Hop online to look at the CRIS committee schedule and consider attending one of the public meetings online. If you have a 988 story to share, request an opportunity to present your story to the CRIS committee.

Improve the ITA system

MOMI provided testimony in 2020 when Washington passed SB 5720 to amend the Involuntary Treatment Act (ITA). The law enables initial hospitalization of an individual who meets psychiatric criteria for up to 5 days/120 hours. The law includes criteria for danger to self/others and amends criteria for someone “gravely disabled” due to psychiatric deterioration. With new language, a person who "manifests severe deterioration from safe behavior" may be hospitalized. The law includes an explanation: “Severe deterioration from safe behavior would be defined to mean that the person will, if not treated, suffer or continue to suffer severe and abnormal mental, emotional, or physical distress associated with significant impairment of judgment, reason, or behavior.” The new language doesn’t apply until more specialized psychiatric beds are available and the system is less reliant on “single bed certifications” for emergency placements. Advocacy is needed to support more inpatient beds so the rest of this law can be implemented.

ADVOCACY ACTION: Let your elected officials know why involuntary care supports a person's human right to be cared for and not abandoned. Request actions that will add inpatient beds. Use the District Finder to find contact information for your elected officials.  

MOMI  supports a national agenda:

• Remove the federal exclusion to Medicaid reimbursement for hospital care in a psychiatric facility with more than 16 beds. The “IMD Exclusion” that prohibits payment for Institutions for Mental Disease—IMDs—is a form of institutionalized discrimination and has contributed to massive bed shortages.  Advocates, please contact your federally elected officials to voice your support for repeal of this discriminatory aspect of Social Security law. 

• Spread awareness about anosognosia and why understanding this symptom of illness is critical for policymakers. At times they are most ill and needing care, individuals experiencing anosognosia (pronounced uhnah-suh-no-zhuh) are least likely to seek help or willingly engage with treatment. See Seattle Times, Jan. 3, 2022: Why people often can’t recognize their own mental illness. 

• Reduce HIPAA barriers to family engagement. The U.S. Department of Health and Human Services has proposed modifications to the rules around patient privacy to remove barriers to coordinated care. MOMI is among many grassroots efforts across the country to submit public comment related to the proposals. Meanwhile, the Washington State Hospital Association (WSHA) provides this  resource: Permitted disclosures of mental health information and substance use disorder information without patient consent. Families: Learn the law so you know what to do if a provider is shutting you out inappropriately. Sharing medical history with providers does not violate HIPAA; if you fax history to a facility, staff have a responsibility to read it and file it within the medical record.

• Spread information and training about the Mental Health Advance Directive (MHAD). In partnership with Chad’s Legacy Project, begun by another Washington family who lost a son to severe mental illness, MOMI helped to support passage of SB 5370 to improve the MHAD law and format. Work is underway to improve its usage. Reach out if you want to get involved. A form for sending an email to MOMI is on our home page.

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