Cuts to eliminate mental health programs, services

Cuts to eliminate mental health programs, services

(February 2009 Issue)

By Phyllis Hanlon

Citing a "legal obligation to balance the state budget" and a "moral obligation to ensure that our state government continues to provide, to the extent possible, the essential services we depend on as a community," Massachusetts Governor Deval Patrick has proposed significant spending cuts that will affect mental health programs and services.

While Gov. Patrick indicates that he has "preserved most funding for veterans, elders and disability services," Elena Eisman, Ed.D., executive director of the Massachusetts Psychological Association (MPA) cites the Department of Mental Health (DMH) reductions as "disproportionate to other cuts."

Several advocacy groups, including MPA, NAMI-Massachusetts, Massachusetts Clubhouse Coalition and the Massachusetts Association for Mental Health, assembled at the State House in Boston on December 2 to protest the cuts. Eisman notes that a large coalition of groups has also sent letters to the Executive Office of Health and Human Services (EOHHS), to the governor and to the commissioner to address the cuts to behavioral health services. "Our real concerns are the number of people left without intermediate services, for example, psychological day treatment and clubhouses," she says. "We continue to address the issue at every juncture. We are currently preparing another letter for the governor."

Reva Stein, MSW, executive director of the Massachusetts Clubhouse Coalition, who helped organize the December protest, says that some funding for day treatment and partial hospital programs has been restored. However, the state faces two critical times. "We have to get through January to June and then the next fiscal year poses a threat to the community mental health system," she says.

In spite of the letter-writing campaign and the December 2 protest, Eisman says that the "governor is sticking to his guns about the changes." She adds, "This round the cuts will stand as presented. If there are any changes, they will only be minor. We are more concerned about the 2010 budget. We are trying to make sure the future of behavioral health will be preserved as much as possible."

Toby Fisher, MBA, MSW, executive director of the National Alliance for the Mentally Ill of Massachusetts (NAMI) also expresses hope that some of the funding will be restored, although he is realistic in his expectations. "We don't yet know what the 2010 budget will be," he says. "We hope and expect the governor will spare us in the next round."

Eisman met with the commissioner of mental health to discuss unforeseen fallout from the cuts. "We talked about issues that impact psychologists beyond those working in mental health areas," she says. "There are a lot of students training at facilities who may lose psychologists [who oversee them]." To ensure continuity in the training process, she asked the commissioner to consider expanding internships and scholarships.

While psychologists will feel the effects of the 9C cuts, other professions associated to behavioral health will be impacted as well, according to Eisman. "The entire landscape of the behavioral health community is involved," she says. Chapter 29, Section 9C of Massachusetts General Laws states that if projected revenue is less than projected spending, the governor must cut the budget or introduce proposals to make up the deficit.

Kristina Barry of the EOHHS explains that initially, the total amount of 9C budget cuts for the Department of Mental Health (DMH) was $33.5 million. "However, DMH was allowed one-time access to $24.2 million in funds from trust accounts to mitigate the impact of the reductions. The reductions will occur in the area of administrative savings: $3.5 million; adult community services: $3.7 million; various child/adolescent community services: $1.2 million; inpatient pharmacy savings: $300,000, and elimination of earmarks: $650,000."

Barry continues, "These are very challenging times for DMH and the many agencies of our state government. The services eliminated in the 9C cuts were valuable services and no agency wants to be in a position to make these types of cuts, but the fiscal realities required that services be cut. At DMH, we remain aligned with our vision and principles of a strong consumer and family voice, to supporting housing for consumers and to the health and wellness of the individuals we serve. Our highest priority is continuing to deliver essential residential and rehabilitative services during these difficult times. We have and will continue to strive to balance our fiscal realities with the very real human impact behind each decision. These circumstances created opportunities for us to transform our system and we are moving ahead with reprocuring our adult community system. This transformation acknowledges our current budget realities and gives us the opportunity to do things differently."

Admittedly, mitigating factors will impact fiscal decisions, according to Stein, but she expresses cautious optimism. "We do think we have a governor and president who share a lot of our values. The economic mess we are confronting is so sad," she says. "But it's in everybody's interest to support the mentally ill. It works to our advantage to fund mental health services. It makes for a better society."