In mid-September, North Carolina state legislators passed a budget that cut $110 million from the eight regional mental health agencies, such as the North Carolina Correctional Facility for Women, Alliance Behavioral Healthcare and the North Carolina National Association on Mental Health. These agencies were simply instructed to fill that budget cut with “money from savings,” savings that were to come from efficient management and fed back into improving local service programs.
Instead, the budget asks the agencies to spend their savings to maintain, rather than improve, those services. With this horrendous cut in funds, which are used to help people who are mentally ill, patients relying on government-funded mental health care programs will not see new or expanded services to help with the already existing strain on programs.
It is expected that next year’s budget will be cut an additional $152 million this time next year, according to the News and Observer. That means services, like the support groups created by the Mental Health Association of Greensboro, will likely disappear.
Many people who are mentally ill can become violent and impulsive when they are not being properly treated, which means it is not crazy to assume that our prisons will see an increase in prisoners as these programs are cut and more and more people do not receive the help they need.
Rob Robinson, the CEO of Alliance Behavioral Healthcare, an organization that pays for public mental health in Wake County, Durham County and Johnston County, says the company can handle the cut for a year, but after that, the services will be cut monumentally.
North Carolina and its respective counties use Medicaid to pay for counseling, mobile crisis units and desperately needed programs for children, like therapeutic foster care.
The state regional mental health agencies mentioned above are honestly lucky that more money was not cut: the state Senate wanted to cut a horrifying $185.6 million from a group of companies that is already struggling to make ends meet and provide the services that mentally ill people need. Conversely, the state House wanted to increase money for mental health urgent care by $2 million. The $110 million budget cut was the compromise.
Republican Chris Malone of Wake Forest desperately tried to justify the decision by stating, “It’s not taking money from them. It’s not giving them as much.”
I say that explanation is ridiculous. This decision is robbing these agencies of money that could help so many people who are struggling. Mental illness is as equally debilitating as physical ailments, yet no one is proposing cuts from public health agencies.
These regional health agencies were set up as managed care organizations in a 2011 law, based on the premise that each facility would receive a set amount of money and savings.
Jack Register, executive director of the National Association on Mental Health-North Carolina, a mental health advocacy group says, “This is a big concern for us [because] the whole reason why the [savings] existed was for improvements,” such as increasing crisis services and increasing provider rates that are below market rates.
Last spring, the state sold the Dorothea Dix hospital property to Raleigh for $52 million. This year’s budget took about $50 million from the sale into something called the “Dorothea Dix Hospital Property Fund.”
The budget looks to add 150 hospital beds for mentally ill patients needing short-term treatment, using a portion of the money from the sale of the Dorothea Dix hospital property. The state Department of Health and Human Services must come up with a plan by April 1, 2016 to spend up to $25 million from the fund to produce 150 new mental health inpatient beds scattered throughout the state. It’s not hard to realize that $25 million is not nearly enough for 150 beds; it’s not like that money is just paying for the bed itself. With state mental health hospitals already overflowing with patients, where are those beds supposed to go?
Dorothea Dix was a crusader and the prime source of motivation behind the creation of the Raleigh psychiatric hospital, which opened in 1856. The last patients left that campus in 2012. Malone said that the budget chose to proportion money from Dix’s Property Fund to stay in line with Dix’s principles. But I contend that the decision was actually the legislator’s covering their mistakes and trying to rebuke some of the anger that was a reaction to the budget cut.
Register said that instead of looking to create more inpatient beds, a commission should have been established to consider ways to use the Dix money to expand community-based mental health services. Not all mental health patients who need help need to be hospitalized. Programs such as community support groups or the mobile crisis hotline are so helpful to some people. Even more important services would ideally be a package deal providing comprehensive clinical assessment, a treatment plan, a psychiatric evaluation with prescriptions, and a referral to the proper level of care.
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