mmunity Psychiatrist

Volume 39, Number 1

Innovative Community Program for Children with Autism Spectrum Disorder

Continued

In conclusion, the MAP is a unique community program deserving of further investigation as a potential replicable model in other university and academic centers across the nation. Studying the effectiveness of community programs like the MAP ensures program adequacy for the enrolled children and families. Determining effectiveness is important for acquiring program funding, restructuring and quality improvement projects, and examining the potential feasibility of duplicating the program design in similar communities. Innovative techniques, such as incorporating undergraduate students, may be worth considering as we search for solutions to the medical, social, and public health challenges of providing care for those with ASD.

Acknowledgements

I would like to recognize my mentor, Dr. Sue Tolleson-Rinehart, at the University of North Carolina School of Medicine, for her steadfast, uplifting guidance. The sincerest thank you to the families, children, and staff of the Meredith Autism Program, including Hilary Wilkinson, Crystal Lester, and Dr. Mark O’Dekirk.

For questions regarding this topic or ideas for collaboration please reach out to Kelly Chase Greeson chasegresson21@gmail.com. Complete list of references available upon request.

Part One:Introduction and Background

Part Two:The Basics: The Pillars of Community Psychiatry

Part Three: Core Competencies for Community Psychiatrists

Part Five:Creating Healthy Communities

Part Six:Supportive Services for Community Living

Part Seven: Special Populations

Part Eight: Development and Administration of Services

Part Nine:Shaping the Future

Links to purchase: Springer or Amazon)

Spring 2023

Volume 39, Number 1

Voting is Recovery

Nicolas K Fletcher MD, MHSA Psychiatry Resident Authority Health Consortium

APA/APAF Public PsychiatryLeadership Fellow

For much of this country’s history, the intersection of voting and mental illness has been discussed and debated in various forums in respect to how best to accommodate individuals deemed “idiots,” “lunatics,” “insane persons,” or some variation on “not having full control of one’s mind.” However, not until the passage of the Americans with Disabilities Act of 1990 (ADA), arguably the most critical piece of legislation against discrimination for persons with disabilities (including mental illness), were protections codified at the federal level in the public and private sector.

This landmark legislation was later reinforced by the Americans with Disabilities Act Amendments Act of 2008 (ADAAA) which served to explicitly broaden and make more inclusive the definition of “Disabilities” following several rulings by the US Supreme court which used a narrowed definition and thus left many Americans with disabilities, especially those with severe mental illness (SMI), without protections. The ADAAA qualified SMI and psychological impairment as substantial limitations in brain function, whether episodic or in remission, to now easily qualify as disabilities (i.e., depression, bipolar, schizophrenia...). As an aside, this makes individuals with SMI eligible for Social Security Disability (SSD) benefits and income.

Despite the intent of the ADA and similar legislation, persons with mental illness continue to experience discrimination that limits their participation in the electoral process partly because the general public and some lawmakers may hold the opinion that the diagnosis of a mental illness renders a person incompetent to vote. Coupled with the fact that states have the authority to establish who is or is not competent to vote through constitutional provisions, statutes, or regulations, means that while most individuals with SMI appreciate the significance of voting, the barriers to voting vary across state lines. In addition to competency, barriers include homelessness, registration status, lacking proper identification, history of incarceration, access to a polling location, and ballot information. As a result, individuals with mental illness experience social and political exclusion, and community psychiatrists arguably should do the practical work needed to address their disenfranchisement.

Spring 2023 www.communitypsychiatry.org