Democratic and Republican lawmaker are focusing on three reforms to address glaring problems in the state’s behavioral health system.
Senators Catherine Miranda and T.J. Shope:
The Arizona State Hospital provides critically important inpatient psychiatric care to people with mental illnesses who are under court order for treatment.
Treatment at our state hospital is considered “the highest and most restrictive” level of care. Patients are admitted because of an inability to be treated in a community facility.
Over the last couple of years we’ve become increasingly concerned about shortcomings in Arizona’s behavioral health system, especially the system of care for folks with a serious mental illness.
Arizona State Hospital needs reform. Here’s how to do it.
After studying the problems and examining best practices, we’ve concluded that there are three major areas that need to be fixed during the upcoming legislative session:
- Better oversight and governance of the Arizona State Hospital.
- Improved community reintegration resources.
- More secure residential treatment options.
State hospital needs better oversight
As we pointed out in an opinion piece back in July, we need to fix oversight of our Arizona State Hospital. A lack of independent oversight is putting lives at stake.
A root cause of the poor oversight (and resultant substandard care) is that the same agency runs and “regulates” the hospital — the Arizona Department of Health Services.
That’s a classic example of the fox watching the henhouse.
A top priority for us this upcoming legislative session will be to permanently fix this flawed oversight model by separating the state hospital from ADHS.
Under our bipartisan plan, the superintendent of the facility would report to an independent, appointed governing body composed of people with experience overseeing complex psychiatric facilities. ADHS would then be free to regulate the facility without the conflict of interest that has compromised oversight and care.
Hospital patients need better transitions
The state hospital doesn’t have a way to successfully discharge many patients, meaning many patients get stuck at the hospital even though they really should be transitioning to live more independently.
We propose developing a small “community reintegration” unit to serve as a transitional unit for patients who are approaching discharge from the state hospital but who still need structured care.
How a 1981 lawsuit: Changed mental health care in Arizona
This unit would be similar to the hospital but would offer more of a community-based treatment environment with physical and psychosocial health services and substance use disorder treatment.
We applaud the state hospital for highlighting this critical gap in its recent legislatively-mandated Clinica
Secured facilities must be built, staffed
Another critical gap is the lack of secure facilities where folks can receive more intensive care than they can get in Arizona’s existing residential behavioral group homes.
Some persons with a serious mental illness need a safe place to receive treatment but with more structure and better qualified staff than are available in existing residential behavioral health group homes.
The bipartisan budget that former Gov. Doug Ducey signed in 2022 included funds to build three such secure residential treatment facilities, including funding to staff them.
Sadly, those funds were swept out of the current budget.
We believe these facilities are critical and will insist that the funding is restored in next year’s budget.
We look forward to the Joint Legislative Psychiatric Hospital Review Council meetings this fall. We’re eager to share what we’ve learned about the shortcomings in Arizona’s health care system — and the importance of these three key interventions.
We hope the council meetings will serve as a springboard for bipartisan support to do right by folks with a serious mental illness, and their families.
Let’s do this.
Sen. Catherine Miranda is a Democrat representing Arizona Legislative District 11 in central and south Phoenix, and is a member of the Joint Legislative Psychiatric Hospital Review Council. Sen. T.J. Shope is a Republican representing Arizona Legislative District 16 in Pinal County and is chair of the Senate Health and Human Services Committee. On X, formerly Twitter: @CatherineSenate and
@TJShope.