Mental health crisis looms on Whidbey Island

Federal cuts could leave many without help

Oak Harbor resident Patricia Little knows how hard it can be to find help for children or adults in the midst of a mental health crisis.

Her 32-year-old daughter, Fawn, is both developmentally delayed and has severe behavioral disorders. The woman had a crisis — an outbreak of acute or dangerous behavior — about a year ago when doctors put her on the wrong type of medication. Fawn found out, for example, that banks gave out money and went to one, demanding money from a teller. She didn’t understand that a person has to have an account with funds to get cash.

Little said her daughter became angry when the teller didn’t give her money, so she reached through the window and hit the woman.

Fawn visited the emergency room almost every day and eventually ended up in a “blue room” at the Everett jail. During this time, Little said she tried to find some sort of help for her daughter, but found “closed doors” everywhere she looked. She was literally on the phone eight hours a day.

“Nobody seemed to help in any way,” Little said. “It wasn’t until a month and a half of her crisis that I finally rattled enough cages.”

Little, who is now a member of the North Sound Mental Health Regional Advisory Board, said her experience is not unusual at all. She said many, many families have had to battle to get help for their loved ones with mental health problems. And it’s only going to get worse.

Under the Bush Administration, the Center for Medicaid and Medicare Services has proposed new rules that will cut all funding for mental health services to only card-carrying Medicaid-eligible folks, which would affect possibly thousands of Washington state residents each year.

“It’s put our system into a real state of turmoil,” said Island County Commissioner Mike Shelton, who’s a member of the state’s mental health task force. “It’s a very bad thing because people need services when they are having mental health problems. Otherwise they may end up in the criminal justice system, which is the most expensive system.”

Now more than ever, a group called the National Alliance for the Mentally Ill, or NAMI, can offer vital help for assisting families with mentally ill loved ones to navigate through the confusing world of public and private mental health services.

“Finding your way through is like a maze,” Little said. “It’s almost impossible unless you know someone who’s gone through it.”

Molly Houlihan of Oak Harbor is the president of the Whidbey Island chapter of the organization. The group holds monthly family support meetings on a drop-in, self-help basis. Group members help each other by sharing tips about what local services are available and how to receive them; giving each other emotional support; educating each other and the community about mental illness; and advocating for appropriate treatment, housing and funding.

One message that Houlihan hopes to spread to the public is that mental illnesses are medical illnesses like any other, whether it’s heart disease or cancer. She said there’s still an unfortunate stigma attached to many mental illnesses, even though severe and chronic disorders like schizophrenia have been proven to be “neurological brain disorders,” not a defect in character.

“There’s still an attitude out there that these people somehow deserve what they are getting,” she said. “It’s critical that people understand that these are no-fault brain disorders.”

Both Houlihan and Shelton said that private health insurance in this country doesn’t do a very good job of covering mental health issues, which leads many families to seek help from governmental and non-profit agencies. While Little testified that it can be a confusing maze to find help, in the future the help might not be there at all for the majority of families.

According to Shelton, in 1993 the federal government told the state to convert the community mental health system to a managed care system. Under a waiver granted by the Center for Medicaid and Medicare Services, the state could use savings to treat patients not eligible for Medicaid.

But now the federal government have taken away the waiver, which Shelton said will “put the system in a real state of turmoil.” It may mean that hundreds of people who need services each year simply won’t get any.

“It’s frustrating and sad. Very, very sad,” said Jackie Henderson, the Island County Health Department’s director of human services. “These are programs people have spent so many years building up, and were so helpful, and they are just gone overnight.”

State-funded programs may not have been perfect, Little said, but they are better than absolutely nothing. In Island County, Shelton explains that Compass Health, a non-profit organization, provides mental health services. The North Sound Mental Health Administration, a division of the Department of Social and Health Services covering five counties, contracts with Compass Health for the work.

To be eligible for Medicaid, an adult living alone, for example, must make less than $7,000 a year and he or she must go through a bureaucratic, paperwork-laden process to become enrolled. It can take up to a year to become Medicaid eligible, Shelton said. Which means there may be plenty of people who may be eligible but aren’t signed up.

“To me it’s criminal in this country, with all its riches,” Houlihan said, “to make them into throw-away people.”

Henderson said another critical problem with the state’s mental health system is that so little money goes toward prevention.

On the other side, the North Sound Mental Health Administration officials point out that while there are a plenty of negative impacts to the change — which they have no choice but to follow — there are also a few benefits to the change. Medicaid consumers may see improvements in service since case managers may have reduced caseloads and they will received increased frequency and intensity of services, according to Charles Benjamin, executive director of the North Sound Mental Health Administration.

Yet advocates warn that a change in the state mental health system won’t only affect the mentally ill and their families. Shelton said it will be much more expensive to communities in the long run to deal with the mentally ill since they will inevitably end up in hospital emergency rooms or the criminal justice system.

Even now, Shelton said, many inmates in the Island County Jail have mental health problems and probably shouldn’t be there.

Houlihan agrees. “If people can have access to services in a timely manner, it’s more effective and saves everyone time and money,” she said.

Little also pointed out that more mentally ill people will end up harming themselves and others if they don’t get appropriate help. And more people may end up on the streets.

“One of the impacts on Whidbey is having a lot more homeless,” she said. “There’s already been an influx of homeless to Whidbey Island. The mentally ill are living in woods, in abandoned buildings.”

Shelton said the state task force is working on solutions to the problem and will release recommendations early next year. While the details haven’t been worked out, Shelton said the outcome of the task force’s work is already obvious: “The solution is money,” he said.

But in a time of economic trouble and budget deficits, Shelton said he has his doubts about whether politicians will see the wisdom of funding early-intervention mental health services.

Little said Fawn is one of the lucky ones, for now. Little finally got her daughter the help she needs after she talked to an aide of state Sen. Mary Margaret Haugen. Fawn is on the right medication and living in a facility in Everett.

“My daughter needs to be protected from the public,” Little said, “and the public needs to be protected from her.”

Find mental health support on Whidbey

Join the National Alliance for the Mentally Ill, Whidbey Island. The group is one of the 1,000 affiliates of the national organization, which is family-based support group for relatives and friends of the mentally ill. The group’s goals are to educate the community, support members, advocate for services, inform members about services and lobby the government.

The North End group generally meets the first Monday of each month, from 9 a.m. to 11 a.m. at the Coupeville Methodist Church, at 608 North Main. The meetings are confidential. People are welcome to drop in or call Molly Houlihan at 675-7358.

The South End group meets, as of Sept. 1, on the second Monday of each month at 6:30 p.m. at the Freeland Library. Call Ann Sullivan at 360-331-6774.

As a non-profit organization, NAMI also takes donations.

You can reach News-Times reporter Jessie Stensland at jstensland@whidbeynewstimes.com or call 675-6611.