January 24, 2011
Host: Ted Simons
Arizona's Mental Health Laws
- The tragic shootings in Tucson have raised questions and awareness about mental illness in Arizona's mental health laws. Medical health attorney Charles "Chick" Arnold discusses the issues.
- Charles "Chick" Arnold - Medical health attorney
| Keywords: health
Ted Simons: The tragic shootings in Tucson have raised awareness and questions about mental illness and Arizona's mental health laws. Here to address both is Chick Arnold, an attorney who's spent decades fighting for the rights of Arizonans with serious mental illnesses. He also serves on the board of mental health America of Arizona. Chick, good to see you here. Thanks for joining us.
Chick Arnold: My pleasure, Ted.
Ted Simons: The impact of the Tucson shootings of raising awareness for the mentally ill, talk to us about it.
Chick Arnold: Obviously the issue, the incident, the tragedy focused attention. We can't presume anything. But what we believe at this point certainly is that old Jared Loughner had symptoms of mental illness. That's a double-edged sword. It's creating additional awareness and that's a positive thing. It's also creating an opportunity for educating people about mental illness and how treatment can work. That's a good thing. The downside is it's creating an additional demand on an already stressed mental health system.
Ted Simons: I want to get to that in a second. But there's another edge. In raising awareness, you have folks that are lumping all the mentally ill into the dangerous category, don't you?
Chick Arnold: That's a part of the stigma that people with mental illness and families have been living with forever, Ted. Even people who believe that can be educated, recognizing what brain illness truly is and that treatment works. Treatment is something that can help manage the very symptoms that Jared was suffering from.
Ted Simons: Let's go ahead and talk about Arizona mental health laws, what they are and what a family would have to deal with in terms of navigating the laws, the system, the whole nine yards.
Chick Arnold: It's critical to recognize. Treatment works, Ted. None of this comes with instruction. It's difficult for families to negotiate systems that are often made inaccessible because of budget deficits and restrictions on budgets. There's medical treatment, the medications and doctors visits and then there's community support, things like housing and case management services that indeed work. Those are the kinds of things that have been dramatically cut this past year and we're looking at additional cuts this coming year.
Ted Simons: What kind of cuts?
Chick Arnold: The budget cuts proposed by the governor relating to the AHCCCS limitations would significantly reduce the university of people who qualify for title 19 services, for Medicaid services. Those folks have already been reduced from the community services. So this past July, people who were non-medicaid eligible lost their case management services, lost the benefit of brand name medications in favor of generic medications and often lost housing as well. These additional people who are in the university of people who will be reduced from the AHCCCS rolls will lose those services as well as the medical services that are critical for support.
Ted Simons: For those who lose those services, there's some who are saying there are alternatives out there. Is that a valid point?
Chick Arnold: Alternatives to services?
Ted Simons: In terms of coverage, in terms of getting those services some way, shape or form.
Chick Arnold: Public policy as defined in our state has been that community service works, community treatment works. We've determined that we have an interest in public policy in saving lives, in preserving communities and preserving opportunities for employment. Those public policy decisions are being compromised by these proposed budget cuts. Services work, but we need to strengthen our system, not reduce its valid service.
Ted Simons: You talked about the stigma regarding mental illness. Does that still exist? And what does this shooting do to that? Because that's got to be a factor there.
Chick Arnold: Of course stigma exists. I would suggest it's a lack of understanding of what brain illness truly is. Certainly everyone with mental illness is not dangerous. In fact, a very small percentage of people with brain illnesses are dangerous at all. The issues are education, this is an opportunity to understand illness, understand what our outstanding statutes enable and provide as opportunities for families to negotiate systems that are there for us.
Ted Simons: Okay. So if a family is watching right now and they're concerned, they don't know if they should be concerned, but they are concerned. Where do they go? Where do they start? How do they get involved?
Chick Arnold: Ted, the resources in the health department have been significantly reduced over the years but they do a good job of providing services. Contact our local agencies throughout the state that are available to do intakes and help assess the needs for treatment. Once again, Ted, treatment works.
Ted Simons: It does work, but there has to be patience, too, because sometimes folks get caught up in a treatment and the first or second line of treatment may not work. They have to have the patience, don't they?
Chick Arnold: Patience becomes being a family member of a person with a brain disorder, Ted.
Ted Simons: We've talked about this on this program in a variety of ways. When you look at Jared Loughner, this was someone who was deemed too dangerous to appear on a college campus without certain clearance by way of a psychiatrist, psychologist, whatever the mental health professional. How is it that that determination was made and it ended right there? That no one else seemed to know about this young man and his obvious troubles?
Chick Arnold: You know, Ted, that's what awareness have resulted in. People are wondering, how could this happen? How could this young man be as ill as he was and not be subject to mental health treatment? We have a system which he could be evaluated by a mental health professional in the public mental health system. I suggest that would have been a noble service to evaluate him from the college system to the mental health system and served our community as a whole.
Ted Simons: But again, you have to watch the dynamics about being too careful and having people who really aren't a danger all of a sudden -- I guess the question is, when does this involuntary action take place? Who decides what's going on out there in terms of making that determination?
Chick Arnold: Well, our statutes provide a three-step process. The first step of which is a full, full-scale evaluation. That's what needed to happen for Jared Loughner. At that point professionals who are trained and competent to make these calls would have determined whether there is any potential for dangerousness or whether he would have fit for any of the standards for involuntary treatment.
Ted Simons: So bottom line here, last question here, lots of folks are obviously calling a variety of services around the state with lots of questions. What do you say to them? What kind of advice do you give them?
Chick Arnold: I think hope is critical, Ted. Hope is critical. Generally, specifically for families with persons with brain disorders, keep plugging. Keep looking for treatment. Keep seeking that option that will work. Once again, treatment works. It's our job as family members to make sure that we advocate on behalf of our disabled member to get the treatment so sorely needed.
Ted Simons: Chick, it's good to see you. Thanks for joining us.
Chick Arnold: My pleasure, Ted.
- For the first time in state history, Independent voters out-register Democrats. If the trend continues, the number of registered Independents could exceed Republicans by the 2012 elections. Bruce Merrill of Arizona State University discusses the trend.
- Bruce Merrill - ASU Political Scientist
| Keywords: vote
Ted Simons: For the first time in state history, independent voters outnumber registered Democrats. That's according to the Arizona secretary of state's office, which says that if the trend continues, the number of registered independents could exceed Republicans by the 2012 election. Here to tell us what the numbers say about Arizona politics is ASU pollster and political scientist Dr. Bruce Merrill. Bruce, always a pleasure. Good to see you.
Dr. Bruce Merrill: Always good to be here.
Ted Simons: What are the numbers? Are they increasing? Is a trend increasing?
Dr. Bruce Merrill: They've been trending for at least 15 years. The same as with the nation. We do expect the number of independents to exceed Republicans or Democrats by 2012, maybe 2014. So the trend has been going on for awhile, will continue.
Ted Simons: Who are these people?
Dr. Bruce Merrill: Well, one of the sad things is that we know that a disproportionate number of people that are registering for the first time as independent are young people under the age of 30. They're turned off from both political parties. Actually, once you have a party identification, particularly a strong party identification, it's hard to change it. There is some change going on, but a lot of it is the new, younger people coming into the political system for the first time.
Ted Simons: For those who are changing, where are they coming from, Republicans, Democrats, a little bit of both?
Dr. Bruce Merrill: In Arizona it's been a little bit of both. It's a mistake to look at independents as a homogenous group. There are about a thirst lean republican, about a third lean democrat, and about a third or more libertarian or real independent that never really had any identification with any political party. They really come from both political parties.
Ted Simons: This is the kind of group, generalizing here, the kind of group that will go back to a political party?
Dr. Bruce Merrill: Not very likely. Although in the history of American political parties, there's been a tendency for once the number of independents begins to grow, kind of like water behind a dam, once the dam breaks, those independents in the past have tended to go to one party or another. But parties are so dysfunctional and people are so turned off to political parties today, that some of us feel that that may not occur. That we just may be entering a period of tremendous volatility and change.
Ted Simons: So if someone in the Republican party or in the democratic party says, we need to get more of those folks, do they even try? Do they know where to go?
Dr. Bruce Merrill: No. It's going to be very hard for the parties to do that. For one thing, the research I've done here in Arizona, but it's no different nationwide, people have increasingly become concerned about the partisanship. So they don't like the bickering between the two parties, so they're not likely to be attracted to a party. The other thing that's had a tremendous impact on the number of independents is the level in the type of negative advertising. In this last election, people told us they were sick and tired of the negative advertising. So, I think what you're going to see and one of the main significances of this increase is the electorate is simply going to be much more volatile. In other words, one election the independents may go for a particularly attractive candidate. Two years later they could go if the other party has a better candidate or better issue, they’re going to go for that candidate. So it's just going to be very volatile for awhile.
Ted Simons: Not a chance of a third party coming from these folks?
Dr. Bruce Merrill: No. In America, the way we've structured our electoral system is single member districts, it's almost impossible for a third party to exist.
Ted Simons: Same reason we don't see -- there are so many independent voters out there, how come there are no independent legislators in the statehouse?
Dr. Bruce Merrill: Because independents can only vote for a Republican or Democrat. There really isn't an independent party.
Ted Simons: Some criticism of independent voters, particularly they're party is not identified. What they'll say is this is engagement not identified. That independents are simply not as engaged as party members are or anyone who identifies with a party. Is that a valid criticism?
Dr. Bruce Merrill: It is valid. It never used to be. Independents 10, 15 years ago actually had more information and participated higher than some of the party people. But today so many of the people that have come in as independents really are alienated. They don't want anything to do with the parties or the political system and that's one reason voting turnout has been so low.
Ted Simons: Again, is there anything that just in general the political environment can do to get these folks more engaged?
Dr. Bruce Merrill: Well, you know, Obama certainly had a short-term effect. He brought some people in, but you saw what happened. When he wasn't on the ballot, two years later, they went back to how they had been before. So the thing that is going to attract people without strong party ties is personality or a very strong issue. 1070, for instance, we know in Arizona, the research that I was doing, showed that independents went for 1070 about 65 to 35. So that was an issue that really did pull independents towards the Republicans and helped the Republicans have this big election in Arizona.
Ted Simons: Last question. What do these numbers say now about the future of Arizona?
Dr. Bruce Merrill: Well, again, Ted, there's no question in my mind that the number of independents is going to continue to increase, and I think what it says more than anything is we're going to have a big disconnect between the electorate in places like the legislature. The legislature tends to be much more conservative, for instance, than the rank and file. Keep in mind, the turnout in the primaries is so low, that who is elected in the primaries sets the public agenda, independents have no input into that process.
Ted Simons: All right. Bruce, always a pleasure. Thanks for joining us.
Dr. Bruce Merrill: Good to be here.
- We kick-off National School Choice Week with a discussion about Arizona’s experience with school choice. Guests include Lisa Graham Keegan, a former Arizona Schools Superintendent and Founder of the Education Breakthrough Network, and ASU Professor David Garcia, director of the Arizona Education Policy Initiative for the Mary Lou Fulton Teacher’s College.
- Lisa Graham Keegan - former Arizona Schools Superintendent and Founder of the Education Breakthrough Network
- David Garcia - director of the Arizona Education Policy Initiative for the Mary Lou Fulton Teacher’s College
| Keywords: education
Ted Simons: This is national school choice week. We mark the occasion by taking a look at Arizona's record on school choice. In the early 1990s, Arizona established one of the strongest charter school laws in the nation, and the state's pursued a variety of market-driven alternatives to public education ever since. Here to talk about the Arizona's successes and shortcomings with school choice is Lisa Graham Keegan. She's a former state lawmaker and superintendent of schools who helped craft much of Arizona's school choice legislation. More recently, she founded the education breakthrough network, a one-stop shop for education choices everywhere. Also joining us is ASU professor David Garcia, a former assistant superintendent of public instruction. He now directs the Arizona education policy initiative for ASU's Mary Lou Fulton teacher's college. Good to see you both. Thank you for joining us.
Ted Simons: What does school choice mean in Arizona?
Lisa Graham Keegan: Well, in Arizona, first of all, school choice is simply parents choosing the school their children go to. In Arizona we have private schools the parents choose if they can afford them. We have tuition-tax credits which provide scholarships for parents who might want a private school. We have public charter schools which we talked about 120,000 students in charter schools. We have on-line schools. Sometimes those are private, sometimes they're public. It's a pretty wide spectrum of what we offer in terms of choices in Arizona.
Ted Simons: How do you see school choice as being defined in Arizona?
David Garcia: I think our parents in Arizona have about more choice than any other state in the country. In tuition-tax credits, in open enrollment and that phenomenon has been in place for at least 20 years. We've had a whole generation go through the public education system with choice and having many choices available to them. So there have been very few states that have pushed school choice like Arizona.
Ted Simons:With that in mind, is school choice working? Are kids being educated better now than they were then?
David Garcia: The interesting paradox of school choice is school choice is for individual parents an opportunity to choose the best school for their child. I'm taking advantage of school choice. My daughter does not go to the neighborhood school. She goes to another school I've chosen. The paradox is that always doesn't lead to overall achievement and gains for the entire system. It isn't that parents choose individual schools that the entire system will benefit as a result of those individual choices.
Ted Simons: How do you work that dynamic?
Lisa Graham Keegan: Because I think it's so small as a result of public education. That over time what is happening, the longer we do this, the better choice the choice schools get and we attract the people who do great things break through. In Arizona, the top 15 High Schools, the significant percentage of those, maybe ten are probably charter schools. That's an interesting phenomenon, High Schools we struggle with in Arizona. I think David is absolutely right. We don't have data yet that says, look, a choice system, all of the kids in that system are doing better than the kid in the assigned system. That's not what you want to look at. You want to look at who is getting better faster. What are parents choosing. This year in Arizona we grew by 1%. District enrollment was down, choice schools are up. I think that crossover is indicative of the fact that choice is probably where we're headed in the future. More and more parents are going to start to make this choice. We're going to quit kind of assigning kids to schools and choice is sort of going to become the wave of the future.
David Garcia: I think in Arizona we have assigned schools. I'm not sure parents look at assigned schools. They look at all schools. That's very common in Arizona. With the admin of choice, we look at parents as wise chosers, repeat customers. Because of our failing schools in Arizona, 86% of parents of students reenroll. In excelling schools, it's only 91. There's only a 5% difference. Something that happens that I'm not sure we're appreciating in the school choice debate, once parents choose a school, they're not ready to move again. They want that school to work. They do something that no other consumer does in a market, they stay and help the school improve. A good example is no child left behind made school principals announce to their parents that the school was failing and they could go anywhere in the district on the district's dime. Only 3.8% of eligible parents took advantage of it. Most of them turned and tried to improve the school.
Lisa Graham Keegan: A bunch of reasons for that I would argue, David. The schools were really not forthcoming with telling parents, not only in Arizona but across the country. A lot of what happened there, because I addressed this in Los Angeles, the school districts weren't giving the parents the information to use the opportunity to go to another school. I think to sort of set this up as a dichotomy is a false one. We're emerging in the way we provide education to our kids. On-line learning is making a huge difference. One of the best schools in Arizona called carpe diem, it's a very different delivery, hugely performing out in Yuma, really fun to see. You have the traditional schools, like the basis charter school, named the best school in the country. It looks like a classroom you or I would remember, I would remember. I'm older. It really hasn't changed that much, just a fabulous school. All of these different models, they're the best they can be within their own models. It isn't a matter of looking for the best thing. We're looking for a lot of models that can serve a lot of parents and we give them the information about what is available.
Ted Simons: For those who are waiting for the rising tide to lift all boats, you're saying it may not necessarily be the best way to measure this.
Lisa Graham Keegan: No, I don't think it is.
Ted Simons: Some folks were looking for that and some folks thought that was promised originally. Talk to us about that.
Lisa Graham Keegan: That's true. For sure if everyone around you is doing a great job and your reputation is you're not doing a very good job and that reputation can only come if we provide information how kids are doing like assessments, once that gets out there, the school that is not doing a great job does better. That's sort of a competitive environment. That we know that is true. Yes, that was promised. But the point should not be, we've got this larger system and what we want to do is we just want to use these sort of schools as though they're marginal or peripheral or unimportant. We're just trying to make this thing in the middle better. No, everything is important. There's a child in every school.
Ted Simons: How do you see that, the lifting of all boats, rising tide?
David Garcia: That hasn't turned out to be. In the best cases the folks that have looked at this, the gains have been modest. It hasn't been the kind of radical improvements people promised. But then again, the comparisons that were made off were made off of product goods, things like mail service, stuff that is easier to pick and fix. Education is much more complex. The choices of an education are much more complex. Like I mentioned, interestingly, once people choose a school, they get invested in that school like no other business. It's not like if a product isn't working for me, I turn to the company and say let's improve it. What we find, once the parents choose, they want it to work. A good example, a student of mine told me the principal had to tell the parents the school is failing. They didn't leave. They said, what do we do? We need a more sophisticated choice of parents in the environment.
Lisa Graham Keegan: We have 20,000 parents that would like to be in the scholarship program in Arizona. We have a significant, 55% of the charter schools responded to a survey that said yeah, we have a waiting list that parents would like to get in that school. So yes, parents would love for the school they're in to be great. They would also love to be in a great school and lots of them are sitting on active waiting lists. Arizona has all of that going. I think what is important is, when a school really breaks through, I mean, I don't want this conversation to lead people to believe that choice schools are schools that are great for kids, you kind of get a marginal improvement. Phoenix collegiate academy where we kicked off national school choice this week, students and teachers right in the middle of the school district and they about doubled those kids scores. When a school is getting it absolutely right, the difference in the child's life is absolutely enormous.
Ted Simons: How do you get that right and make a difference for more kids? People will listen to this conversation and they'll say, all I hear is negative information about Arizona kids. It's ranked 40th something if not 50th. We have 20 years of this now, what is going on?
David Garcia: Public school --there's a High School in Tempe, desert vista whose students routinely passing S.A.T.s. It doesn't mean that you are going to get it right in choice schools. One of the things you need to look at here, what we're asking some of our charters to do is different from the public school systems. In what respects, we have a bigger standards movement that I think sometimes thwarts innovation with the ideas the charter schools would be more innovative. They haven't been. I would argue we may not have given them the chance to be innovative. If you look at why parents choose charter schools, the number one reason is class size and school size. Yet we're not learning from that. We continue to build traditional public High Schools that are much bigger than they should be. Most parents choose schools because they want to be in front of teachers and they want the closed environment.
Lisa Graham Keegan: The great thing is we're learning better things of innovative school choice.
Ted Simons: That's where we'll stop the conversation. Good stuff. Thanks for joining us.