We are a society that believes in justice and equality. So why have some government policies forsaken thousands of people who have the most devastating illnesses? We would never abandon a man with cancer to live on the street, but we do this every day to people living with mental illnesses.
We, the Bernalillo County Forensic Intervention Consortium, know that the Medicaid expansion is the right choice for Bernalillo County. It will reduce the need for crisis intervention in emergency rooms and for inpatient hospitalizations; it will reduce the need to have law enforcement, courts and jails absorb the impact of an underfunded mental health system; and most importantly reduce the burden of homelessness on society.
Improving Mental Health services instead of filling jails is a more cost effective use of our taxes. Expanded Medicaid will increase coverage to over 170,000 people in New Mexico, which includes a large number of people with mental illnesses. This expansion will save lives. According a Harvard study published in the American Journal of Public Health, 375 New Mexicans die each year because they are uninsured.
Data released this month from “The Serious Mental Illness Innovations Project” demonstrated the huge benefits of integrated care for Medicaid beneficiaries with mental illness. This study showed savings, which came through reduced emergency room visits, mental health-related hospitalizations and hospital readmissions.
The study did not look at the burden untreated mental illness has on law enforcement. But according to a national law enforcement survey, over 80 percent of officers surveyed indicated there has been an increase in the time spent with people with mental illnesses.
Bernalillo County reflects these national trends. A testament to this fact is that the metropolitan detention center is currently the largest psychiatric provider in the state. An expansion of Medicaid will shift some of the burden of mental illness from law enforcement and criminal justice back to health care providers.
This way police can be public safety officers instead of social workers, jails will not be hospitals, and proper uses of services will save money.
Homelessness remains a persistent and expensive public and mental health concern. Between one-fourth and one-third of homeless people have a serious mental illness.
A study published in 2005, in the “Journal of American Psychiatry,” showed that 15 percent of patients treated for serious mental illness in a large public mental health system had been homeless within the last year. One of the risk factors the study found for homelessness was a lack of Medicaid. The expansion will reduce the burden and cost of homelessness.
Lack of health care coverage causes people to delay treatment. People avoid routine health care until their medical problems become critical and expensive. Emergency last minute care is the most expensive and least effective. We have all heard stories of people who have lost their homes and livelihood to medical treatments they couldn’t afford.
Saving money is important and always a good selling point. But we are also a society of high moral and social consciousness. The Medicaid expansion is good policy, financially sound and the benefit it can bring to thousands of New Mexican’s is morally admirable, compassionate and kind.
Barri Roberts and Dr. Nils Rosenbaum represent the Bernalillo County Forensic Intervention Consortium, a mental health advocacy group that includes people in law enforcement, corrections, housing specialists, advocates to end homelessness, people from the legal and court systems, local behavioral health collaborative NAMI, families and consumers.