April 2, 2011

Our state’s budget is in trouble, and our most vulnerable neighbors are at risk.  Unrelenting budget pressures and the heated political debates on how to relieve them are jeopardizing the care for people with serious mental illness.
States nationwide have opted for record-setting decreases in mental health agency budgets – a combined total of nearly $2.2 billion according to the National Association of State Mental Health Program Directors.  For some states, this amounts to 20 percent of their total mental health spending – even as demand for community-based mental health services is rising in our state…and nationally.

And now our state leaders are calling for “flexibility” in how they meet current requirements under the state Medicaid program.  Those calls, however, should not and cannot be used as justification to undermine the care and support for those with serious mental illness.  Medicaid often funds the mental health professionals who serve these individuals and, by doing so, keeps these people connected to their communities.

Politicians’ calls for shared sacrifice in balancing state budgets are commendable in theory.  Yet, we must turn aside actions that would essentially deliver the message:  “We can’t afford to care.”

At Hill Country MHDD Centers, we stand on the front lines of providing comprehensive mental health services to over 3,000 residents per month throughout a 19 county area of the great Texas Hill Country.

The people we serve and their families are better able to contribute productively at work, in schools and through volunteering in the communities in which they live.  Federal and state budget decisions threaten our ability and those of other mental health providers in the state to keep over 100,000 individuals each month engaged in daily meaningful and purposeful activities.

We know health care dollars are precious, and so we work to apply them in ways that build and strengthen our community’s safety net for those who are often least able to fend for themselves.  Among the keys to ensuring success of our efforts:  improving and standardizing the care for the individuals we treat.  In short, we’re determining what works best and replicating it.

As part of our efforts to advance standardized care, Hill Country MHDD Centers is one of 10 community behavioral healthcare organizations nationwide that the National Council for Community Behavioral Healthcare selected to participate in its “Advancing Standards of Care for People with Schizophrenia” program.

This program is designed to improve the daily functioning of people with schizophrenia, and to shift the understanding and expectations of what is achievable for these individuals – from their vantage point, from the perspective of the mental health professionals who work with them and from the attitudes of the general public who too often don’t understand them.

The promise of the pilot program has been evident even in its first few months.  We’ve taken a relatively basic shift in how we’ve approached treatment by using a standardized tool for how a person is functioning in his or her daily life.
We already see common ground between our medical team and patients on treatment goals, and more effective ways to benchmark progress.  At the end of the day, we expect this progress to translate into greater independence for the individual – and maybe even a reduced dependence on other areas of our health care system.  Patients in the program have truly become engaged in their treatment and have taken a greater responsibility for their personal recovery.  Patients within the program have been so receptive to the curriculum in the program that Hill Country has expanded its use to benefit other individuals. 

With one in 17 Americans suffering from serious mental illness each year, our Federal and state lawmakers need to establish budget priorities that make clear we are a society that will afford to care for those most in need.