Report Illustrates Disintegration Of States' Mental
Health Systems
Washington DC, December 21, 2001—Most public mental health systems "have
all but disintegrated" and, given rising pressure on state budgets, may
be headed for total collapse, warns the Bazelon Center for Mental Health
Law. This is the thrust of a new report by the national legal-advocacy
center that describes "the unraveling of the nation's public policy for
meeting the needs of people with major mental illnesses."
The 24-page report, Disintegrating
Systems: The State of States' Public Mental Health Systems, quotes
extensively from state-based documents to illustrate its assertion
that "what is needed is a different way of doing business-a new vision
for public mental health."
The authors reviewed recent materials from 35 states, produced primarily
by independent commissions or task forces but also by investigative journalists,
advocacy organizations and states' own mental health authorities. Although
the excerpts in the report document problems in particular states, "the
same themes were found, variously worded, in documents from all of the
states." For example:
- The 2001 action agenda by Ohio's Mental Health Commission acknowledges
that "statewide, the supply of mental health services does not meet
current demand and will not meet increasing demand in the future."
- Louisiana's 2002 mental health services plan states that "there is
simply not enough money invested for acceptable mental health services
in Louisiana."
- "California explicitly rations care to only those with the most extreme
needs-and even then we turn people away," according to a report commissioned
by the state.
The reports and investigations cited in Disintegrating
Systems were produced in the recent period of economic prosperity.
In the face of today's downturn, Bazelon Center executive director
Robert Bernstein warns, many states are poised to make decisions that
would all but destroy their capacity to address the needs of children
and adults with serious mental illnesses.
Some of the states planning cuts in their mental health budgets are
the very states quoted by the Bazelon Center as having dire problems
already. For example:
- In New York, funds for the community reinvestment program will end
and overall mental health funding may be cut by $26 million.
- Massachusetts is discussing $20 million in cuts for the Department
of Mental Health.
- Georgia has recently reduced payment for community services by $60
million; expectations of restoring those cuts through increased Medicaid
billings have not been realized.
- Many Maryland outpatient clinics have closed recently due to lack
of resources.
- In Michigan, large cuts in the health budget will lead to cuts in
programs for people with mental illnesses.
- Oregon's Governor has proposed budget cuts that would eliminate mental
health services to 1,000 uninsured children who are not eligible for
Medicaid, drop 50 clinical therapist slots from schools and reduce
spending for juvenile offenders with mental disorders.
The report calls on national and state policymakers "to make good on
their promise of humane and effective public mental health care in the
community for the children and adults who rely on our public mental health
system." Bernstein expressed the hope that advocates and state officials
will use the information in Disintegrating Systems to educate state legislators
and other policymakers, laying the groundwork for a new approach.
Disintegrating Systems is available online from the Bazelon
Center bookstore, or send $4 plus $2 postage/handling to Publications
Desk, Bazelon Center for Mental Health Law, 1101 15th Street NW,
Suite 1212, Washington DC 20005; fax 202-223-0409.
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The Bazelon Center for Mental Health Law is the leading national
legal-advocacy center representing people with mental disorders, working
to protect and advance the legal rights of adults and children with
psychiatric or developmental disabilities and ensure their equal access
to the services and supports they need for full participation in community
life.
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