Settlement is boost for mental health training in S.D.

A $2.5 million legal settlement with a drug manufacturer will support initiatives in South Dakota ranging from suicide survivor education and respite care to "mental health CPR" and training for parents of children with mental illness.

The money comes from Janssen Pharmaceuticals of Titusville, N.J., a subsidiary of Johnson and Johnson. South Dakota was one of 36 states that sued Janssen for marketing antipsychotic drugs for purposes not approved by the U.S. Food and Drug Administration. Janssen agreed in 2012 to pay the states a total of $200 million. South Dakota announced this week how it will use its share.

About $2.1 million will go to programs the Department of Social Services will oversee. Most of the other $400,000 will funnel through the attorney general's office.

"We will likely work with community mental health centers," said Amy Iversen-Pollreisz, deputy state secretary of social services.

The money also will help train police and other first responders for emergencies relating to mental health.

"It gives them the skills to know how to react and defuse a situation and get an individual to someone who can help," Iversen-Pollreisz said.

Wendy Giebink, executive director of NAMI, or the National Alliance on Mental Illness in South Dakota, said police training already proved effective in Sioux Falls and Rapid City now will expand across the state.

"There's quite a bit of interest in other communities in bringing in crisis-prevention training. This will help them take advantage of that," she said.

Her agency, based in Sioux Falls, has nine affiliates in the state. Past emergency responses often resulted in someone not receiving effective treatment, she said.

"What happened historically ... is typically, they would be arrested and taken to jail ... or to the hospital. That was not really appropriate for most of those cases. It was wasting resources and not helping," Giebink said.

NAMI estimates that 61.5 million American adults, about one in four, have a mental health issue in a given year and that 13.6 million, or one in 17, live with an illness such as schizophrenia, depression or bipolar disorder.

States argued that Janssen's marketing put both elderly residents and children at risk.

The states challenged the promotion of Risperdal, Risperdal Consta, Risperdal M-Tab and Invega as treatment for depression, anxiety, sleep disorders and elderly dementia when those drugs were off-label, or lacking FDA endorsement.

"They never admitted wrongdoing in the resolution ... but a $200 million settlement speaks volumes," said Attorney General Marty Jackley.

Tom Johnson, director of pharmacy at Avera McKennan Hospital, said such settlements are relatively common.

"Drug companies are only able to use on-label indications for use of a medication," Johnson said. "A physician may use an available product for essentially any indication as they see fit, based on other literature. However, a drug company cannot promote a drug without filing the appropriate paperwork through the FDA. For marketing purposes, they need to stick to on-label indications."