In a forum held a few weeks ago for local candidates for the Missouri House of Representatives, mental health authorities pleaded with incumbents and candidates to consider the state of mental health programs in Missouri.
But were they really listening?
In a state that has less and less money to spend on programs, our state leaders seem to push mental health to the back of the policy pecking order year after year.
It’s not as if unworthy causes are hogging all of the attention. Funding for education and the state’s Medicaid program gobbles up more than half of Missouri’s $23 billion budget every year.
In the upcoming legislative session, state lawmakers — many of them expected to be newcomers to the Missouri General Assembly — will be forced to determine who gets what with a smaller pot of cash, and they will likely be preoccupied with finding ways to put unemployed Missourians back to work. Given this scenario, it would be hard to foresee any sharp increases in state support for mental health providers.
In terms of job cuts in state agencies, the Missouri Department of Mental Health has seen the biggest bloodletting since Gov. Jay Nixon took office last year, according to figures provided by Linda Luebbering, the state budget director. Of the roughly 2,500 jobs cut from Missouri state agencies, more than 850 came from the Department of Mental Health.
In the last three years, state funding appropriated for the Department of Mental Health has fallen more than $41 million, while the federal funding for the department increased more than $80 million within the same period, when accounting for temporary stimulus funds. In the 2010 legislative session, total approved funding for the department fell by more than $20 million, and in July Nixon withheld an additional $6 million to account for revenue shortfalls.
The cost of dealing with mental illness for all states combined is an estimated total of $200 billion, according to a study released in 2008 and funded by the National Institute of Mental Health.
Disorders ranging from depression, drug addiction and attention-deficit disorder to more complex psychological disorders, such as schizophrenia, can be classified as mental illnesses. Mental illness affects an estimated one in four Americans every year, according to the National Institute of Mental Health.
With the state cutting back on its contribution to mental health programs, greater strain is placed on local mental health authorities to provide services to this sector of the population, said Boone County Public Administrator Cathy Richards in an e-mail.
The Boone County public administrator, an elected position, is responsible for serving as a public guardian in a court of law for those who have a mental illness. Richards said 90 percent of her approximately 400 clients suffer from a mental illness.
“You see, mental illness just doesn’t go away because there isn’t money available,” Richards said. “What the public needs to understand is that there is a definite need in our community for greater, not fewer, mental health services. With mentally ill patients, little problems that are left untreated can quickly become major problems.”
For one, the schools in our communities must deal with a student population in which 16 to 22 percent of students are suspected of having a mental illness, said Lou Ann Tanner-Jones, a supervisor for the Columbia Public Schools Special Services Department.
Students could be suffering from internally manifested illnesses that affect an individual student’s performance in class, Tanner-Jones said, or externally manifested illnesses that affect classroom order. She said these students are faced with a “significant barrier” to learning.
“These kids sit in the class every day, but they’re not really there,” said Tanner-Jones at the candidate forum. “They’re just not connected.”
A reduction in state support to mental health programs, she said, passes the burden of providing services to these students onto the shoulders of local school district officials.
Missourians who have a mental illness have also become more of a concern for public safety officials.
At the forum, Columbia Police Captain Dianne Bernhad said dealing with citizens suffering from mental illness has become “one of the most important issues” for law enforcement.
The Columbia Police Department has worked with the Boone County Sheriff’s Department and the MU Police Department to provide officers with special training to help them recognize and deal with citizens who have a mental illness.
Bernhard said roughly 50 Columbia officers are given this training, which requires 40 hours of instruction.
In an e-mail, Bernhard stressed to me that citizens who have a mental illness are not inherently dangerous to police officers or other citizens, despite the public’s mindset.
“Yes, there are a few that are dangerous and those individuals need to be identified quickly and taken to treatment,” Bernhard said in the e-mail. “The consequences of not recognizing the difference could be tragic.”
I do not envy the workload that awaits legislators, both veterans and newcomers, in the upcoming session. They are going to have to make tough choices about our state’s budget that are not going to make everyone happy.
But if legislators can emphasize the importance of sound mental health for all Missourians, and that it is an issue that cuts through so many more of the state’s concerns, they might be able to drum up the popular support they need to prioritize mental health issues for our state budget writers.
If funneling more revenue to mental health programs means new taxes — such as taxes on Internet sales transactions from out-of-state and an increased excise on tobacco, as some legislators have proposed — it will be a tough sell to Missourians. They are long known for an independent streak, in terms of political issues, and — like the residents of most states — they are feeling uncertain about the economy.
Richards said Missourians who suffer from mental illnesses “don’t make good poster children” for a political cause, like those who suffer from other disabilities, and that “no one stands up for the mentally ill.”
“Since no elected official that I know of strongly advocates for additional funding for mental health programs, funding is easily cut and mental health issues are easily swept under the carpet,” Richards said.
If this issue is seen by voters as a problem that causes strain in other policy areas, then constituents could get behind plans that have been politically risky in the past. They could argue that Missourians cannot perform at their best in school and at their jobs unless they are of sound mental health, and thus, it could be more difficult for Missourians to obtain and maintain work.
Reframe the issue in this way, and Missouri lawmakers could make the case that more funding is needed. In turn, they could stand up for a group of Missourians who truly need help.
Or they could maintain the status quo and continue to let the state’s contribution slip. Perhaps local governments, school districts and police departments will find a way to foot the bill themselves.
Richards seems willing to hold up her end of the bargain. She said it is the responsibility of governments to provide “necessary services to its people.”
“To provide little or no services to this group just means that the mentally ill will receive their services through some other venue, like in jails or emergency rooms,” Richards said. “These services are much more expensive than governmental funding and a completely ineffective way to manage the mentally ill.”
Andrew Denney is a senior at the Missouri School of Journalism and a political science major at MU. He is also a copy editor for the Missourian. He is set to graduate in December.