|National Alliance on Mental Illness
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For immediate Release
April 6, 2005
Report Released on Washington State Mental Health Crisis, with Specific Recommendations
NAMI Washington Praises Recent Budget Actions; Joins With Law Enforcement, Physicians, Educators to Present Cost-Effective Approaches and Launch Statewide "Campaign for the Mind of America"
April 6, Olympia, WA -- At a Capitol press conference, NAMI Washington and partners from law enforcement, medical, education and social service communities released a new report, "Can Crisis Beget Opportunity? Washington State’s Response To The Mental Health Funding Quandry," presenting a cost-effective plan to reduce financial and moral costs of untreated mental illness to individuals, families, and taxpayers.
The report includes support for current legislation; five new ways that Washington can pay for services based on examples in other states; and five specific recommendations for turning the state's current fiscal crisis into opportunity. It also urges expansion of proven, cost-effective "evidence-based practices"
Over 450,000 of Washington State’s 4.4 million adult residents have a severe mental illness. The full report is available on-line at www.nami.org/report/wa. See Executive Summary below.
"The Evergreen State is due to lose more than $80 million in federal Medicaid revenues over the next two years, a cut that could be devastating because Medicaid funds almost 90% of State community mental health services," said Gordon Bopp, president, NAMI Washington-- the Washington chapter of NAMI (National Alliance for the Mentally Ill).
"Governor Gregoire's proposed increase in mental health funding and the budget increases passed by the Senate are terrific first steps toward closing the gap, but we need to do more."
"Every emergency room physician knows first hand the price we pay for cutting mental health services," said John Milne, M.D. an emergency physician from Swedish Medical Center in Seattle, and board member of the Washington chapter of the American College of Emergency Physicians.
"Denied the help they need, people with mental illness must seek treatment in community emergency rooms. Not only is the ER an ineffective environment in which to provide long term mental health services, it also increases the burden on already overcrowded departments, thus limiting access for those with more emergent conditions."
The press conference marked the state launch of the "Campaign for the Mind of America," a multi-year national and state-level initiative to increase access to mental health treatment and services and show the effects of untreated mental illness on every community.
"The Campaign for the Mind of America is working in Washington State to ensure that as state leaders face tough fiscal choices, they make smart decisions." said Mike Fitzpatrick Executive Director, NAMI National. "Every study shows that while cutting mental health services and treatments may result in short term budget savings, the long term costs of untreated mental disorders is much greater."
Untreated mental illness costs the nation more than $100 billion annually in lost productivity. Major additional costs also are shifted on to other sectors of society, such as law enforcement, education, and emergency rooms---making them unfairly and inefficiently the front lines of mental health treatment.
Can Crisis Beget Opportunity?: Executive Summary
Washington State’s Response to the Mental Health Funding Quandary
I. INTRODUCTION: THE CRISIS FACING WASHINGTON STATE
Public sector services for children and adults with serious mental illnesses are at grave risk in Washington State, in part because the state of Washington has relied more heavily on Medicaid dollars to fund these services than almost any other state. State and Federal Medicaid accounts for 89% of the $750 million spent by the State on community mental health services. The Evergreen State will lose approximately $82 million in federal Medicaid revenues over the next two years.
The impending Medicaid reductions threaten to exacerbate already critical shortages in treatment and services for people living with mental illness. NAMI-Washington believes more state resources must be targeted for services to youth and adults with severe mental illnesses. Without them, the state will have to pay the much higher costs that accrue when people do not receive the services they need: more homelessness, more people with severe mental illnesses in jails and prisons, and ultimately, more cost-shifting to non-mental health systems that historically are left to "pick up the pieces" when mental health services fail. Moreover, people will suffer needlessly.
II. RESPONDING TO THE CHALLENGE -- LEGISLATION
In 2004, the Joint Legislative and Executive Task Force on Mental Health Services and Funding was convened to review the status of public mental health services in Washington State and to consider strategies for overcoming lost Federal revenues resulting from changes in Medicaid funding. For the 2005-2007 biennial budget, the Task Force recommended that lost federal funds should be replaced with state funds, and called for changes in mental health care policy and priorities. In reaction to the recommendations of the Task Force, two bills have been introduced and are pending in the state legislature, HB 1290 and SB 5763.
NAMI-Washington supports HB 1290 but believes that more improvements in the delivery of mental health services and supports are needed to truly the address the needs of people with severe mental illnesses across the State.
NAMI-Washington enthusiastically supports most of SB 5763.
III. RESPONDING TO THE CHALLENGE -- EVIDENCE-BASED PRACTICES
"Evidence-based practices" (EBPs) are clinical and administrative practices that have been proven, through randomized clinical trials and "real-world" observations, to consistently produce specific, positive results.
Available data indicate that overall, Washington State has been moving to implement evidence based services in the community for people with severe and persistent mental illnesses. However, the Mental Health Division must do a better job of collecting information on the services provided and must collect information on outcomes achieved through these services.
IV. RESPONDING TO THE CHALLENGE -- FINDING NEW WAYS TO PAY FOR SERVICES
In a time of tough choices, Washington should learn from other states that have developed innovative ways to generate revenues for services for vulnerable populations. These include:
- Illinois -- a hospital tax levy will allow the state to capture $450 million in extra federal Medicaid money.
- Michigan --passed a 75 cent-a-pack increase in the state’s cigarette tax to generate an additional $300 million annually for the state’s Medicaid program.
- Vermont-- finances two-thirds of its Medicaid spending through a trust fund supported by tobacco revenues, provider taxes and general funds.
- Kentucky -- court fees collected in DUI cases are be used to provide mental health services in local jails.
- California-- 1 percent tax on all income in excess of $1 million is expected to generate $800 million for services to people with severe mental illnesses by 2006-2007.
V. RECOMMENDATIONS: TURNING CRISIS TO OPPORTUNITY
The following actions would enable Washington State to address the needs of its most vulnerable citizens with severe mental illnesses.
- Washington State must significantly increase its investment in the public mental health system to ensure that youth and adults with severe mental illnesses receive the treatment and services they so desperately need. NAMI Washington applauds Governor Gregoire’s recent budget which increases mental health funding by 8.6%. The Washington State Senate also deserves credit for increasing mental health funding in their budget proposal.
- Now is the time to increase efforts to facilitate the adoption of evidence based and emerging best practices for youth and adults with severe mental illnesses on a statewide basis.
- There should be no further reductions in inpatient and residential bed capacity until there is adequate capacity in the community to address the needs of individuals receiving these services.
- Pre and post-booking jail diversion services, including Mental Health Courts, should be established on a statewide basis.
- Washington State’s law pertaining to civil commitment of individuals with mental illnesses or chemical dependency should be amended to allow interested parties to petition for initial detention based on a good faith belief that a person presents a likelihood of serious harm or is gravely disabled.
The crisis precipitated in mental health funding is an opportunity for Washington State to make changes in its mental health system that will improve access to appropriate services for youth and adults with severe mental illnesses. Changes and improvements in the delivery of services will succeed only if adequate dollars are invested by the State into these services. Governor Gregoire’s proposed increase in mental health funding represents a significant first step towards achieving the promise of better services for Washington’s citizens with severe mental illnesses.
Read the full report (PDF file)
More about Campaign for the Mind of America in Washington