Life Working at the Mental Health Advocacy Clinic

February 21, 2014

Mental Health Advocacy Clinic student Shoshana O'Brien '14 offers this description of her work in the clinic.

Working at the Mental Health Advocacy Clinic affords me the opportunity to do actual, needed, and highly interesting work throughout many different facets of the law. Clinical Professor Mark Heyrman, who runs the clinic, is incredibly supportive, and allows students to follow their interests and to take on whatever legal projects speak to you. Also, Mark has an open door policy-if you have a question you need to ask, if you aren’t quite sure about the structure of your brief, or if you want to practice before your oral argument, or if you have a policy question, Mark will be there to help you out.

Just this week, I have had the opportunity to do a little bit of work on four different and incredibly interesting projects. Firstly, as a 7-11, I’m working on trial strategy and examinations and cross examinations of expert witnesses in a case to get our client conditionally released into the community because she no longer meets the NGRI commitment criteria after being adjudicated not guilty by reason of insanity and who is now held in a state psychiatric facility. 

Secondly, I’m working on writing comments on behalf of Mental Health America-Illinois to oppose a proposed Medicare regulation which would strip mental health drugs of their protected status in Part D and thereby deny lifesaving medications to the mentally ill. On January 6, the Centers for Medicaid and Medicare Services announced a proposed rule that would eliminate protected status for antidepressants and antipsychotics in Medicare Part D prescription drug plans. The proposed rule CMS-4159-P revises prior agency policy that required Part D plans to include on their formularies "all or substantially all" drugs within six classes, including antidepressants and antipsychotics. In the proposed rule, CMS laid out its new criteria for deciding whether a class of drugs should have protected status: 1) failure to receive the drug would result in the patient’s hospitalization within 7 days (the timeframe for the appeals process); and 2) drugs in that class are not interchangeable. CMS argued that many of the drugs within the classes of immunosuppressants and antidepressants are interchangeable and will not cause hospitalization if patients do not immediately take them upon receiving a prescription. Removal of antipsychotics and antidepressants from the protected class will have devastating effects for many patients, because while drugs have substantially the same rates of effectiveness, those drugs are effective on different persons, and doctors do not know why, or which drug will be effective for which person. Removing psychoactive medications from the protected class list will have devastating effects on the treatment of mentally ill patients.

Thirdly, I’m working on writing comments for and lobbying for the passage of Illinois’s Section 1115 waiver, which would expand access to Assertive Community Treatment (ACT) teams and Community Support Teams (CST), and access to supportive housing for persons with behavioral health conditions.

Lastly, since Mark is a long standing member of the Public Policy Committee of Mental Health America, students in the clinic have the opportunity draft the revisions of three polices: #53-Mental Health Courts; #57 the Insanity Defense and #58 Life Without Parole for Juvenile Offenders. I looked through all of the issues and called dibs on working on the team which assesses the impact of Mental Health Courts on the welfare of the mentally ill.

These are just the things I’m working on. Teammates on other projects are working on issues from large complex class actions suing the Illinois government under the Americans with Disabilities Act for not providing reasonable accommodations such as medications for the mentally ill and others leaving prison who are required to register on the sex offender registry, to appeals for individual clients!

Mark J. Heyrman