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Improving mental health services can’t wait

Our capacity to treat mental illness in Bernalillo County is in disarray and this is an important issue that demands priority attention. That’s why I support Bernalillo County Commissioners Maggie Hart Stebbins, Debbie O’Malley and Art De La Cruz in their move to raise gross receipts taxes and finally address this crisis that is weighing down every aspect of our society.

It reflects a statewide problem. New Mexico ranks at the bottom in terms of investment in mental health infrastructure.

What capacity we’ve had in the past has dramatically regressed in recent years: a sharp decline in numbers of hospital beds, clinics that serve persons with mental illness, service providers and a lack of aftercare and rehabilitation services.

The services we do have are utterly fragmented.

Mental illnesses are chronic diseases that can be treated. This is true also for addiction and many other behavioral health problems. Successful management requires a connected system of services and continuity of care.

This is a challenge given current limitations on financing. Insurance coverage including Medicaid focuses on episodes of care and imposes time limits, requirements and restrictions even on outpatient services. Medicaid stopped coverage for caseworkers and offers limited coverage for residential treatment, and nothing for step-down care and rehabilitation.

Recent efforts to create connections between services such as behavioral health and primary care have been insufficient to produce results.

Scrimping on coverage is penny-wise and pound-foolish. The impact is evident in the costly demand for emergency room services and publicly funded social services.

Untreated mental illness and alcohol and drug addiction are major contributors to homelessness. They drive the rates of property crime, domestic violence and other criminal activity that stretch the capacity of law enforcement, clog our courts and fill our jail to overflowing – all at a huge cost to the public.

They increase the demand for general medical care and undermine its effectiveness and increase costs. They impede performance of our schools, workforce development, productivity and capacity for economic growth.

The status quo is unacceptable. The human toll is huge. Real action is needed – and wanted.

More than 69 percent of Bernalillo County voters responded “yes” when asked whether gross receipts taxes should be increased by one-eighth of a percent to improve mental health services. This reflects broad public awareness and support.

This funding would immediately address some important gaps, for example by creating a crisis assessment and triage center and building connections to treatment and essential support services that are simply not otherwise available.

That alone won’t be near enough. We can’t afford to approach this in a piecemeal way. We need a Marshall Plan with strategic planning to knit together a comprehensive approach, anticipating a 10-year effort or longer to seriously rebuild infrastructure.

The major stakeholders must be assembled right now as a team to develop solutions – not as guardians of parochial interests that ultimately keep us divided and perpetuate fragmentation. It requires commitment to assemble the components for a comprehensive system of effective clinical care and capture the resources to sustain it.

This requires leadership and the best minds from all parts of clinical services delivery, health care financing, Medicaid, business, law enforcement, criminal justice, education and economic development.

The voices and participation of people suffering from mental illness and coping with addiction are integral and essential to the process.

We can no longer use the excuse that we are a poor state and that there is no funding. The costs of leaving these issues unattended underlie the reasons that “there is no funding.” We cannot afford to ignore this. Reinvestment and rebuilding are urgent and necessary. Leaders please step up and lead!

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