Fighting Institutional Bias for Mental Health Treatment in New Jersey

Bren Pramanik, J.D.

Historically, mental health treatment has had a bias towards institutionalization. Advocates often cite Willowbrook as the impetus to changing public perception of mental health treatment in the United States. Passage of civil rights laws throughout the second half of the 20th century also rose awareness about the treatment of mental health disabilities in the country. The changing landscape culminated in the seminal case, Olmstead v. L.C., which held that people are entitled to treatment in the least restrictive setting. While mental health treatment and the public perception of mental health disabilities has certainly evolved in the last century, there remains a bias towards institutionalizing mental health treatment.

Like many other states across the country, New Jersey serves as an example of this institutional bias. This presentation will look at New Jersey through the institutional bias lens. New Jersey serves as an example of the difficulty in meeting mental health needs in the community, particularly for individuals with complex needs. The learning goals for this presentation will include:

  1. Looking at the history and public perception of mental health treatment
  2. Understanding the implications of Olmstead on mental health treatment
  3. An overview of mental health treatment and institutional bias in New Jersey
    a. State psychiatric hospitals – CEPP status
    b. Nursing facilities - Woodland
  4. Challenges presented by dual diagnoses
    a. Developmental centers
  5. Challenges in providing mental health services in the community
    a. Bellwether
    b. BH stabilization units at developmental centers and in the community
  6. Emerging institutional bias in New Jersey
    a. Behavioral Health Units in New Jersey nursing homes
    b. Rise in Involuntary Outpatient Commitment
    c. Passage of Involuntary Commitment Law
    d. Specialized Treatment Units
  7. Looking ahead towards community integration