Mental health system in jeopardy

The message sent to Olympia last week was loud and clear: Without some sort of help from the state, the cracks in Island County’s mental health system will become craters.

Sounding the alarm for a regional mental health system increasingly devastated by budget cuts and patient slippage, a handful of Island County officials, along with their cohorts in two surrounding counties, are asking that lawmakers take strong action in stopping the gaps in public mental health coverage.

In a 4-point position paper delivered late last week by the ad hoc Community Stakeholders Work Group, officials and community leaders from Island, Skagit and San Juan counties implored state legislators for better funding of mental health services, parity in insurance coverage, increased public awareness of mental health issues and, in general, a more comprehensive system of mental health care.

The letter comes on the heels of Gov. Gary Locke’s proposal to cut nearly $40 million in community health funding from next year’s state budget. Island County Human Services Director Jackie Henderson, who was one of several Island County representatives to co-sign the letter, said Thursday that it’s too early to tell how the cuts will play out locally, though there’s little doubt an impact will be felt.

“That’s a bunch of money,” Henderson said of the proposed cuts. “A lot of family-support kinds of programs are getting axed. These cuts are going to hurt real people. This isn’t hurting government. This is hurting real people.”

Henderson said the letter to the Legislature originated from a full day work session in early October, attended predominantly by members of Community Mental Health Services (CMHS), the largest public mental health agency serving Island, Skagit and San Juan counties. In January, CMHS will merge operations with Compass Health of Snohomish, effectively expanding the organization’s reach into four counties.

The meeting also was attended by various community leaders from such organizations as United Way, senior centers, church organizations and numerous law and justice officials, all of whom hatched a collective message to send state lawmakers.

“We came together and talked about all the issues facing mental health these days,” Henderson said. “The outcome we wanted was to come to some kind of agreement that we could pass on to the Legislature which represented our joint concerns.”

One of the major points to arise from the these talks was the issue of mental illness and the legal system. According to jail representatives at the workshop, many inmates passing through the system — many over and over again — have mental health problems that could be more appropriately treated in community mental health programs. A recent Coalition for Juvenile Justice report submitted to Congress indicated that up to 75 percent of juveniles arrested for crimes suffer from mental illness.

“One of the biggest concerns is that, as other treatment services dwindle, so many folks with mental illness end up in jail,” Henderson said. She pointed out that the costs of processing mentally ill individuals through the legal system likely is much more expensive that getting such people help through mental health programs.

“In the long run, we’re going to pay for it one way or another,” she added. “It’s way more expensive to keep that person in jail.”

According to Henderson, cuts to mental health services only shift the cost to these more expensive legal alternatives, while also imprisoning “folks in the system that really shouldn’t be there.”

On this front, officials implored legislators to advocate more strenuously for adequate funding of community mental health services, rather than allowing cuts to direct services.

Henderson said another important aspect of the 4-point paper was the need for increased public awareness and understanding of mental health issues and treatments. Obviously, prejudice and misunderstanding hurts those suffering from mental illness, but it also creating obstacles to those attempting to lobby for better funding of community programs.

Henderson said it’s wrong to believe that anyone who receives government help — whether it be for mental illness or unemployment — is simply lazy or a criminal.

“Ninety-nine percent of the people I know that get some kind of assistance are in that position through no fault of their own,” she said. “They’re hard working people who just need some support now and then.”

As the gap between rich and poor widens, more and more folks classified as “working poor” are being neglected by the system, including many who may suffer from mental illness, Henderson said. “A growing number of people in the middle don’t qualify for low-income help,” she said. “That segment is growing.”

Henderson said one of the problems facing community mental health systems is the way they are funded. Rather than receiving general funding, health programs are receiving money earmarked for specific uses, with the result that prevention and education based programs often fall to the wayside.

“Mental health is kind of in a crisis model,” Henderson said. “That’s how the funding comes right now. There’s nothing in there for prevention. What would be really nice is a little more flexibility in how we can spend money.”

Prevention programs appear to be hit hardest by budget cuts and lack of state or county funding. “Everybody’s so concerned about our lack of being able to do anything in the early prevention area,” Henderson said, especially, she added, those programs targeting youth. “We do have mental health professionals in each of the local school districts, but it’s very part time,” she said. “It’s not even nipping the need.”

Recent tax-limiting initiatives essentially have crippled many community mental health centers. At budget time, the axe often falls on programs that, comparatively at least, are perceived as expendable.

Though circumspect when speaking about the recent passage of I-747, which limits property taxes, Henderson obviously feels that many voters who support “trimming the fat” through reduced taxation have misunderstood how county governments function, where the money goes and what departments get hit the hardest with cuts. Too often, it’s the so-called safety net, including many mental health programs, that are adversely affected when county government tightens its belt.

“It’s almost like the citizens of this state need to decide what’s important to them,” Henderson said. “We can’t have it all and not pay for it. It’s getting tough.”Despite shrinking revenues, Island County’s mental health services continue to do a good job, Henderson said, though the future of public health care doesn’t look exactly promising right now.

“Given what they’re able to do, they do an excellent job,” Henderson said. “The problem is, there’s a lot of people falling through the cracks. The cuts that we’re going to have to make are really short sighted.

“These programs were created for a reason,” she added, speaking of local mental health services. “Some families will literally just fall apart.”

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