What would you do about mental health and substance abuse if you were the next Governor?
This Website is based on the idea that mental health and substance abuse affects everyone. If you're reading this, you already know this and don't need to be convinced. But the politicians and policymakers do -- not that they don't have loved ones who suffer from mental illness or substance abuse, not that they don't have friends who do. But somehow this realization is divorced from their daily work of campaigning and policymaking. And they have learned that this blind spot is shared by the electorate at large.
This Website strives to change that. If enough people join us by saying their vote is strongly influenced by MH/SA issues, politicians will have to take notice.
Why is this important?
Because we have learned since 2001 that it is the attention or inattention of the Governor that determines what happens in MH/SA. And because of what the current administration has done, we now have a mess that will take a lot of work and a lot of money to fix.
It seems to me that as the enormity of the current crisis has become apparent, the state government has been limited in what it can do. And, all things considered, this is understandable. The General Assembly has been reluctant to invest new money in a situation where it seems appropriated money has not been fully spent and, apparently, fraud has come into play. The new DHHS Secretary, an able and honorable man, is doing the best he can with the situation he has inherited. I think everyone realizes that only a new Governor can bring the new start that is needed.
What I would say to the next Governor is this:
1. This is a big problem. Fixing it will not be cheap.
2. The first thing that needs to happen is to restore the safety net. This means that everyone in the state must have access to a full-service clinical home where assessment and treatment services are available.
3. For this to happen, policymakers must stop trying to make the clinical needs of sick people match the contortions required by multiple funding streams. The design of the mental health / substance abuse system must be based on clinical needs, with funding flows supporting that.
4. Substance abuse treatment capacity, including medical detox, needs to be expanded dramatically throughout the state. (This should be very attractive to politicians, given the high returns of money invested in substance abuse treatment -- in human terms, in mental health system terms, and in terms of reducing criminal behavior.)
5. The clinical home must be designed so that the clinical workforce can be restored. The current Administration's policy could not have been better designed if it had explicitly wanted to drive dedicated professionals out of public mental health. This needs to be reversed.
The next Governor needs to understand that the imperatives of privatization and the imperatives of a safety net are mutually exclusive. You cannot have a safety net in an unfettered "any willing provider" environment. You have to have a clinical home where patient care is coordinated and provided.
And, to repeat, it won't be cheap.
Is anyone who wants to be Governor able to do this?
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1 comment:
No, it won't be cheap. But all ramifications of the current approach considered (negative financial and other impact on agencies such as medical hospitals, psychiatric hospitals, law enforcement, LME inefficiency, faith based organizations, emergency departments, etc., and multiple hidden hidden costs in many other areas), the current approach is far from cheap. And my strong suspicion is that the current chaos is far more expensive than doing it correctly would be. Thomas E. Maultsby, M.A., L.P.A.
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