Confronting the Standard of Neglect in Severe Mental Illness
and Establishing the Right to Be Well
NSSC Massachusetts (NSSC MA), a chapter of the National Shattering Silence Coalition, is bringing to light the broad treatment gap that too often begins after the first 911 call, emergency department visit, or discharge from acute care. Our goal is to help establish a true Standard of Care for people living with severe mental illness—one that provides timely, appropriate, and continuous treatment rather than leaving families to navigate a fragmented system on their own.
We believe access to mental health care should never be a roll of the dice. By shifting the focus from the “imminent danger to self or others” standard to a practical standard recognizing High Clinical Need, we are working toward a system where severe mental illness is treated as the medical condition it is—with care delivered in clinical settings whenever possible, rather than only after an emergency crisis, often reaching the point of police involvement.
We are a community of families, peers, and professionals working together to educate, support, and empower those affected by severe mental illness. From the front lines of the “trenches” to the halls of Beacon Hill, we bring our decades of lived experience and professional expertise together to help families find their way through a difficult system.
We are committed to building a Commonwealth where people living with severe mental illness receive the care they need, when they need it; where families are supported as caregivers; and where every person has the Right to Be Well.
The Path Forward: The Continuum of Care Act
Documenting the failures of our current system is only the first step. To improve lives, we bring to light policies that too often leave people with severe mental illness without the care they need.
While the Continuum of Care Act (S.2973) did not advance out of the Senate Ways and Means Committee this session, we are deeply grateful for the legislators, families, professionals, peers, and advocates who helped bring this issue to the forefront. That support continues to grow, and we are carrying that momentum forward.
The Continuum of Care Act will be refiled in January as we continue working to educate on the need for Continuum of Care; a more responsive pathway of care for people with severe mental illness. The legislation would create a clinical pathway to Assisted Outpatient Treatment (AOT), providing civil court-ordered, community-based treatment for individuals with a demonstrated history of serious illness and a high clinical need—before an emergency escalates to the point of a 911 call, crisis or police involvement.
By recognizing Grave Disability and the realities of severe mental illness, including the impact of anosognosia, we can move beyond a system that waits for imminent danger before meaningful intervention is possible. The goal is not forced treatment but creating pathways to appropriate medical care when someone is too ill to recognize the need for it.
Massachusetts can do better. It is time to move from crisis response to continuity of care—and from the Standard of Neglect to the Right to Be Well.
Real change begins with people who are willing to speak about what they have experienced in treatment gaps.
As we prepare to refile the Continuum of Care Act in the next legislative session, we are asking families, peers, professionals, and supporters to reach out to their own state Senator and Representative. Start a conversation. Share your personal experience with severe mental illness and the challenges you have faced trying to access appropriate, timely care.
Tell them why establishing Assisted Outpatient Treatment (AOT) in Massachusetts matters to you, your family, and your community. Help them understand what happens when the system waits until someone is in imminent danger before meaningful mental health care becomes possible.
Your stories matter. Your experiences matter. Your voice can move hearts and change minds.
Take Action: Share Your Story
You don't need to be a policy expert or know exactly what to say.
Simply sharing what you have lived through can help legislators understand why Massachusetts needs a better continuum of care for people with severe mental illness.
Find your legislators. Start the conversation. Share your story. Help us bring the Right to Be Well to Massachusetts.
Download our legislative fact sheet to share with your representatives and join us in demanding a National Standard of Care.
For the most up-to-date legislative tracking, expert data, and national progress on Assisted Outpatient Treatment,
please visit our partners at: AOTNOW.org.
The Cost of Mental Health Abandonment
Too often, someone living with the most severe mental illness cannot recognize that they are ill. Families are left watching their loved one deteriorate while being told there is nothing that can be done until they become an “imminent danger.”
We call this the 911 Gap—the dangerous period when a mental health emergency goes untreated until it becomes a crisis in the community or even a police matter.
The impact on families is devastating. They live with fear, trauma, isolation, and the constant uncertainty of whether the next crisis will bring treatment, hospitalization, incarceration, homelessness, or tragedy.
NSSC Massachusetts has documented more than 150 tragedies across the Commonwealth through publicly available records and news reports. Each tragedy occurred after premature release from psychiatric care, into the community.
Behind every number is a person, behind every person is a family, behind every crisis is community impact by multiple First Responders.