Protection and Advocacy Program for
Individuals with Mental Illness
The
Protection and Advocacy Program for Individuals with Mental Illness (PAIMI) was
established by Congress in 1986. PAIMI
agencies, such as the Center are mandated to: protect and advocate for the
rights of people with mental illness and investigate reports of abuse and
neglect both in facilities that care for or treat individuals with mental
illness and in the community. The
Substance Abuse and Mental Health Services Administration, Center for Mental
Health Services administers the PAIMI program.
The
following objectives and priorities will be followed by the Center in
conducting our PAIMI activities during fiscal year 2007.
OBJECTIVE
#1: Reduce
the incidence of abuse and neglect of individuals with mental illnesses ‑
especially those in institutions ‑ (a) by improving the quality of
investigations of abuse and neglect conducted by agencies and service systems
that serve individuals with disabilities, and (b) by conducting direct
investigations of abuse and neglect allegations.
Description: Individuals
with disabilities have a right to be free from abuse and neglect. The quality of the agency/system
investigations into allegations of abuse and neglect has a direct impact on the
incidence of abuse and neglect.
Priorities:
1. Conduct direct, independent
investigations into allegations of abuse or neglect of individuals with
disabilities and advocate for policy changes when warranted. Cases will include secondary investigations
to follow up on incident or mortality reports.
2. Conduct outreach, education and/or
monitoring at jails, juvenile detention facilities or other community
placements.
3. Conduct regular outreach, education
and/or monitoring regarding seclusion and restraint, other abuse and neglect
issues, and rights violations on the psychiatric units of
4. Pursue litigation to address
constitutional, statutory, and regulatory violations related to abuse and
neglect issues, whether in the context of individual cases or class actions.
5. Review, track, and trend incident reports
from licensed behavioral health agencies furnished to the Center pursuant to
the Arizona Administrative Code.
Advocate for policy changes when warranted.
6. Review, track and trend mortality and
morbidity (M&M) reports of all individuals in
OBJECTIVE
#2: Increase
access to comprehensive and appropriate mental health care services for adults
and children with mental illnesses.
Description: Adults
and children with mental illnesses are vulnerable populations with difficulty
accessing mental health care services that allow them to be as independent as
possible, maintain their mental health, and live life to its fullest. Additionally, individuals with mental
illnesses have the right to mental health care treatment in the least
restrictive environment. A goal for
treatment should be to enable individuals to live and work in the community.
Priorities:
1. Pursue policy or system changes in the
mental health system consistent with a recovery model and the President’s New
Freedom Commission on Mental Health and coordinate with agencies to develop
client‑based practices, including case management, medication, crisis,
behavioral health, and transportation services.
2. Provide advocacy and legal services
individuals to ensure discharge from inpatient settings to appropriate and
adequate housing with appropriate and adequate supports with an emphasis on
individuals currently residing in institutions who have significant barriers to
discharge into a community setting.
3. Provide advocacy and legal services
individuals to obtain and maintain appropriate mental health services in accordance with case selection
criteria. Particular priority will be given to cases which present systemic
issues or problems, including due process and other civil rights violations, as
well as cases which concern individuals with a dual diagnosis (substance abuse
or a developmental disability), cases which involve denials of vocational
services or long term vocational support, cases which involve children at a
high risk of entry into the foster care system and children transitioning into
the adult mental health system, and those involving persons at risk of criminal
justice involvement.
4. Conduct
outreach and training.
5. Monitor the existing class action cases
for the provision of mental health services to adults and children, which
includes pursuing legal remedies to address noncompliance with the existing
orders when appropriate. Initiate class
action cases where systemic issues not covered by the existing class actions
are presented.
6. Provide technical assistance to other
agencies advocating on behalf of individuals with mental illnesses, including
regional Human Rights Committees.
7. Provide timely and accurate information
and referral, technical assistance and short term assistance to individuals and
their guardians.
OBJECTIVE
#3: Expand
access to appropriate and high quality special education services for students
with mental illness.
Description: The
overwhelming majority of children with disabilities are capable of
participating in a regular education environment with adaptations or
modifications, provided that they receive quality educational programs to meet
their individualized needs. Through this objective, the Center is attempting to
ensure that children with mental illness truly benefit from special education
and related services and have real opportunities for independence, productivity
and inclusion.
Priorities:
1.
Provide advocacy and legal services
to children with mental illness who have received inadequate or inappropriate
behavioral interventions leading to a denial of a free and appropriate public
education.
2. Provide advocacy and legal services to
children with disabilities who have been long-term suspended or expelled to
receive a free appropriate public education.
3. Conduct trainings on the educational
rights of children with mental illness.
4.
Provide timely and accurate
information and advice to families and students on special education issues and
referral to appropriate advocacy resources.
OBJECTIVE
#4: To
promote equal employment opportunity in the workplace and to increase access to
employment related services for people with mental illness.
Description: More
than 10 years after the passage of the Americans with Disabilities Act, many
employers have discriminatory practices that adversely affect people with
psychiatric disabilities in hiring, retention, promotion and termination of
employment.
1. Provide legal advocacy services for the
provision of effective and reasonable accommodations when necessary for people
with mental illness in the hiring process, employment and receipt of benefits
and privileges of employment, and advocating for employer policies that support
an interactive accommodation process between the individuals with disabilities
and employers.
2. Provide legal advocacy services to oppose
hiring and recruitment procedures that do not create equal access for people
with psychiatric disabilities and employment practices involving unlawful
disability‑related inquiries and medical examinations.
3. Provide legal advocacy services to
challenge withdrawal of job offers and employment termination of people with
mental illness based on stereotype and ignorance about disabilities.
4. Provide information and referral and self-advocacy
technical assistance to individuals and their guardians.
5. Provide
training to individuals on their rights under federal and state law.
OBJECTIVE
#5: Promote
equal opportunity to housing under the fair housing act for people with mental
illness. Bring about this awareness
through trainings, dissemination of written information, information and
referral services, and short term assistance.
Description: Since
the Fair Housing Act (FHA) was amended in 1988 to add disability as a protected
status in prohibitions against housing discrimination, people with disabilities
continue to face barriers to equal opportunity in housing. Housing providers continue to discriminate on
the basis of disability by refusing to provide reasonable accommodations,
declining reasonable modification of policies and practices, failing to provide
physically accessible housing and including discriminatory terms and conditions
in housing. Additionally, municipalities
continue to enforce exclusionary zoning practices. We wish to address these discriminatory
practices that decrease the lot of available housing for people with
disabilities and ensure that individuals with disabilities and their housing
providers know of the FHA.
Priorities:
1. Provide information and referral about
disability rights protected by the FHA and how to enforce them.
2.
Provide training about disability
rights protected by the FHA and how to enforce them.
3.
Provide short‑term assistance
to consumers whose circumstances are likely to be resolved by informal advocacy
by the Center.