Care Management
Every Person With SMI
Deserves Real Treatment
Arizona's behavioral health system is failing the people it was built to serve. We are fighting for real care — not warehousing, not neglect, and not fraud.
The System Is Broken
Four Failures That Kill People
Arizona spends billions on behavioral health — and still, people with serious mental illness end up homeless, incarcerated, or dead. Here's why.
Behavioral Health Residential Facilities (BHRFs)
Most BHRFs in Arizona provide non-hospital housing without nurses or doctors. Staff are Behavioral Health Technicians — generally high school graduates who are not state-licensed. Most facilities are unsecured, meaning patients can walk out even during active psychosis.
Insufficient Secure Facilities
Arizona lacks sufficient secure treatment facilities for people with SMI. The result? Incarceration or homelessness become the default outcomes — not treatment.
Behavioral Health Fraud
Billions of dollars flow through Arizona's behavioral health system with inadequate oversight. Facilities collect Medicaid payments while providing little to no actual treatment. Residents are warehoused, not helped.
Medication & Treatment Gaps
Many SMI individuals cycle through emergency rooms and short hospital stays without access to consistent, skilled psychiatry. The medications that work — including clozapine — are dramatically underused.
The Hidden Crisis
What Is Treatment-Resistant Mental Illness?
Treatment resistance occurs when a person with a serious mental illness — most commonly schizophrenia — does not adequately respond to at least two different antipsychotic medications given at proper doses for sufficient time (typically 6–8 weeks each).
Approximately 1 in 3 people with schizophrenia are treatment-resistant. They cycle through medication after medication, hospitalization after hospitalization — while families watch their loved one deteriorate.
For these individuals, standard antipsychotics simply do not work. The voices don't stop. The delusions don't lift. The psychosis persists. And without the right intervention, the outcome is predictable: homelessness, incarceration, or death.
But there is a medication that works — and almost nobody is prescribing it.
Signs of Treatment Resistance
The Gold Standard
Why Clozapine?
Clozapine is the only FDA-approved medication for treatment-resistant schizophrenia — and the most underused lifesaving drug in psychiatry.
~30%
of schizophrenia patients are treatment-resistant
60–70%
of treatment-resistant patients respond to clozapine
<5%
of eligible U.S. patients actually receive clozapine
#1
most effective antipsychotic according to research
✅ Why Clozapine Works
- ✓Works when all other antipsychotics have failed
- ✓Reduces suicidality — the only antipsychotic proven to do so
- ✓Dramatically reduces hospitalization rates
- ✓Reduces aggression in treatment-resistant patients
- ✓FDA-approved specifically for treatment-resistant schizophrenia
❌ Why It's Underused
- ✕Requires regular blood monitoring (WBC counts)
- ✕Psychiatrists unfamiliar with prescribing it
- ✕Pharmacies often don't stock it
- ✕REMS program created bureaucratic barriers (now removed by FDA in 2025)
- ✕Liability fears and misinformation among providers
The bottom line: Clozapine saves lives. In 2025, the FDA removed the burdensome REMS program that had restricted clozapine access for years. There are now fewer barriers than ever. If your loved one has tried multiple medications without improvement, ask their psychiatrist about clozapine. If the psychiatrist won't consider it, find one who will. Arizona Mad Moms can help you advocate for access to this life-changing medication.
Legislative Victory
SB 1630: A New Level of Care for Serious Mental Illness
A Major Step Forward for Arizona Families
In 2026, Governor Katie Hobbs signed Senate Bill 1630 into law, creating a new path toward enhanced residential treatment for adults living with the most severe forms of Serious Mental Illness (SMI).
The law directs AHCCCS to develop an Enhanced Level of Care Pilot Program that will provide intensive residential treatment for adults whose needs cannot be safely met through traditional community behavioral health services.
Why This Matters
For many years, Arizona families have faced a significant gap in the behavioral health system. Individuals with Serious Mental Illness who require more support than outpatient services can provide often have few appropriate treatment options outside of short-term psychiatric hospitalization.
As a result, many experience repeated psychiatric crises, emergency room visits, homelessness, or involvement with the criminal justice system.
SB 1630 begins to address this gap by creating a new level of residential behavioral health care that includes:
Who May Benefit?
The Enhanced Level of Care is intended for adults with Serious Mental Illness whose needs exceed what traditional community services can safely provide, including individuals who may:
What SB 1630 Does — and Doesn't Do
SB 1630 creates a new residential treatment option for individuals with the highest behavioral health needs.
The law does not expand Arizona's involuntary treatment laws or change the legal standards for Court-Ordered Evaluation or Court-Ordered Treatment. Instead, it establishes a new level of care that can be made available to eligible individuals as the program is implemented.
Implementation Is the Next Step
The law now directs AHCCCS to develop the Enhanced Level of Care program, obtain any necessary federal approvals, establish eligibility criteria, license providers, and implement the pilot program.
Arizona Mad Moms will continue to educate families, share updates and resources, collaborate with AHCCCS, providers, policymakers, and other stakeholders, and monitor implementation as the program is developed.
We look forward to providing Arizona families with timely information as opportunities become available and this important new level of care moves from legislation to reality.
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