Mental health care faces lean future as state struggles with funding

May 03--More residents will be committed to institutional facilities already at capacity, more children will be taken from their families and placed in group homes and former homeless residents will be forced to return to the streets.

That's some of the local consequences of proposed state budget cuts to mental health, said Chris Van Dyke, executive director of Mental Healthcare of Cullman. Last year, the state cut the Department of Mental Health's funding and shuttered state hospitals, funneling individuals with mental illness to smaller residential facilities.

"That was supposed to be the fix," Van Dyke said, "but now here we are again."

Van Dyke said his agency is looking at an 11 percent cut, or $250,000, in state funding, but when every dollar of its state money is leveraged as matching funds for Medicaid money, that cut actually becomes closer to $500,000.

"There was a sense of trust when we closed the state hospitals last year, that it would take care of the situation," he said. "We're doing the state's job for them."

Locally, the direct impact of the cuts being discussed in Montgomery include:

-- 11 jobs lost at Mental Healthcare of Cullman

-- 20 children placed in detention facilities or group homes

-- 70 more adults committed to institutional facilities

-- 1,000 fewer psychiatric visits

-- 18 former homeless residents will losing housing

-- 300-plus lose other community services

Van Dyke said his agency provides services and counseling to families, which allow children to stay in their homes instead of being moved into detention centers or group homes. Adults currently being treated for mental issues would have to be committed to either Reid House in Cullman or Bryce Hospital in Tuscaloosa -- both of which are at capacity.

"The state should prepare to bring in portable housing at Bryce because there's just no room," he said. "Bryce would have to double or triple in size for all the patients coming from all across the state. Sending someone to the state hospital cost two to three times as much than the services we can provide here with Reid House."

Mental Healthcare of Cullman built Reid House, a 16-bed residential facility on Mitchell Road, and opened it this past year to house patients that would otherwise be treated at state hospitals. In June, the North Alabama Regional Hospital in Decatur will close its doors, leaving Bryce, Taylor Hardin Secure Medical Facility where the criminally insane are housed and the Mary Starke Harper Geriatric Psychiatry Center as the remaining state-run hospitals, all located in Tuscaloosa.

Van Dyke contends the privatization of mental health care has saved the state millions of dollars annually. His agency routinely keeps those with mental illness out of state facilities by purchasing beds in private hospitals with state funds.

He described a recent case where a local woman was charged with disorderly conduct and taken to the county jail.

"She told them she was hearing voices," he said. "We were able to get her out of jail and the psychiatric care she needed eventhough she was uninsured. If the cuts go through, people in situations like that are going to be affected first. She would still be sitting in jail, waiting to go to Bryce."

Leaving the mentally ill in jail presents additional costs and burdens to the county, he said. Not funding mental health could likely see the return of federal oversight.

"There's going to be lawsuits," he said. "The Wyatt case went back to the 1970s and didn't get settled until 2002. We could be going right back there."

The federal court case involved patient Ricky Wyatt whose attorneys argued his treatment at Bryce suffered due to layoffs at the hospital. At that time, state mental hospitals were often under-staffed and left in deplorable conditions.

The outcome of Wyatt v. Stickney caused a drastic deinstitutionalization of committed patients, with the population of Alabama's hospitals dropping by nearly two-thirds between 1970 and 1975. However, as Alabama spent millions to upgrade its obsolete facilities to comply with the federal court's ruling, the hospitals were releasing patients en masse.

Van Dyke attended Gov. Robert Bentley's visit to Cullman Monday and said he liked the tax plan he pitched.

"It is time to fix it. I think the only way you're going to fix the general fund is by putting some of the growth taxes toward it so both the education budget and the general fund get those funds," he said. "If we don't change anything, we're going to be in the same place next year. The consequences of these proposed cuts are going to wind up being more costly in the end."

* Tiffeny Owens can be reached by email at towens@cullmantimes.com or by phone at 256-734-2131.

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