May is Mental Health Awareness Month, a time when the National Alliance on Mental Illness (NAMI) Connecticut and advocates across the country are bringing awareness to mental health. Each year we fight stigma and discrimination, provide support, educate the public and advocate for equal care.
Connecticut has been seen as a leader in mental health services and initiatives for many years and has been acknowledged as such. Therefore, it is sadly ironic that we are now standing on the precipice of setting ourselves back years from what we have worked so hard to build, by deeply and devastatingly cutting mental health and other human services.
While we understand the complex difficulties policy makers face to address this budget crisis, it is clear that we need to make better choices. Cutting human and social services, and specifically community-based mental health and substance use services, will not save money, whether in the short term or long term. Rather, these cutbacks will leave individuals stranded without vital and essential services forcing them into higher-cost, higher care services, such as emergency rooms, that oftentimes don’t address their underlying needs.
The real tragedy here is that advocates, legislators, administrators and others have worked tirelessly over the years to build up our mental health system to where it is an example of what can be done. Moreover, we know that the programs and services that have been adopted here in Connecticut produce better outcomes: Crisis Intervention Teams, mental health services for individuals who experience homelessness, including young adults, supportive housing, peer supports and others – and keep people from emergency rooms and deeper end, higher costs involvement. These services were designed to not only help people but to reduce costs.
The cuts are not thoughtful or forward thinking — they are reactionary and potentially very harmful. For example, when mobile crisis programs get cut and have to reduce services and hours of operation, the proven life- and money-saving Crisis Intervention Team (CIT) approach breaks down. When CIT officers encounter individuals in a mental health crisis, they link these individuals to clinicians (who are most often part of mobile crisis teams) who help them get access to needed services and supports. When this access gets curtailed, people will end up having to use emergency rooms, hospital stays, or worse get caught up in the criminal justice system, thwarting their recovery and costing considerably more in state services.
Similarly, defunding homeless outreach programs and transitional residence programs that support individuals with mental health or substance use issues who are experiencing homelessness will only exacerbate individuals’ situations and increase use of crisis services such as emergency rooms or interactions with law enforcement, without addressing the person’s real underlying needs.
Additionally, cutting off more parents from their medical insurance through HUSKY by lowering income eligibility, will result in these struggling families losing their health care coverage because even with federal subsidies, they still cannot afford the required out-of-pocket costs. Families will need to go without and eventually use high-cost emergency and crisis health care.
Proposed cuts to children’s mental health services are equally a harmful step backward. For example, School Based Health Centers (SBHCs), which provide integrated physical and mental health for 96 schools in Connecticut, are one of the best places for children to receive needed mental health services and yet SBHCs have been repeatedly cut with additional cuts being proposed.
ACCESS Mental Health for children is a successful model for integrated behavioral health care and tele-health within primary care—where the state is headed in healthcare—but the Governor once again chose to go with austerity rather than sustaining and growing this program.
One question we should all ask is what about revenue building measures? As noted in a recent publication by CT Voices for Children, what’s needed from leadership is “. . . a balanced approach that includes revenue, rather than a cuts-only approach that threatens an already fragile economic recovery.”
In other words, we can’t just cut our way out of this. Furthermore, cutting important safety net services for people with little money is essentially a tax increase on low-income individuals and families.
We are still hopeful that as we go into Mental Health Awareness Month that Gov. Dannel Malloy and the legislature can come to some kind of compromise that permits the state to carry on its signature mental health and substance use programs, thus maintaining what has been gained over the years, and provides a long-term direction for a budget that is not at the expense of some of the most vulnerable people in the state.
Connecticut deserves no less.
Kate Mattias, MPH, JD, is the Executive Director of NAMI Connecticut.