Budget cuts create more crises for mentally ill
Published September 29, 2015
Editorial by Fayetteville Observer, September 28, 2015.
From the day the state started moving mentally ill people out of the hospitals and back into their home communities, our mental-health system has failed.
With the passage of each year, and each new state budget, problems appear to grow. The coming fiscal year doesn't shape up to be any different.
The embrace of community-based care began in former Gov. Mike Easley's administration, in 2008. The concept sounded appealing - in principle, it was. Far better, the experts reasoned, to treat the patients closer to home, so they can be near their friends and families and not isolated in a hospital many miles away. Bring the services to the patients.
Trouble is, the state never budgeted enough money to provide adequate services. So people fell through the cracks. They showed up in emergency rooms and police holding cells instead of in places where trained mental-health professionals could care for them.
The only real virtue of the new approach was that individual communities were drawing up plans to serve their own residents. At least there was some effort made to tailor the service to local needs.
But even that went away, as the state began moving toward larger regional groups overseeing mental-health services.
In Fayetteville today, those services are managed by one of eight regional offices - Alliance Behavioral Health Care, which cares for patients in Wake, Durham, Johnston and Cumberland counties.
The state budget just passed makes a $110 million cut in funding for mental-health services statewide, and projects another $152 million cut next year. The Senate wanted even deeper cuts; the House wanted a slight increase. Lawmakers say the mental-health providers have surpluses and should be spending that money to make up for the cuts.
The reserves, the CEO of Alliance told the News & Observer, were earmarked for filling in the gaps in the system, including more crisis services. That was the way the managed-care process was designed to work.
But now, those gaps will remain, and people will fall through them. They'll land in jails or emergency rooms, where guards and doctors may not have the training they need to help. They'll be part of another chapter in the shameful saga of mental-health reform, which has failed those afflicted with mental illness on an even grander scale than warehousing them in mental hospitals.
