By Muntaha Saad, WHF Policy Intern
Take a look at the above map of Washington State. All but three urban counties face shortages in mental health care.
The map also shows that the majority of shortages within counties are geographic, meaning that everyone in the region has difficulty getting access to mental health services. Our state’s estimated under-served population of 25.1 percent is greater than the national average of 18.7 percent, and the shortage areas for mental health far exceed the shortage areas for primary care and dental health. Not only is access to medical and behavioral health care providers limited, but rural areas also face higher levels of poverty and chronic disease, lack of health insurance, and more natural barriers such as longer travel distance to healthcare facilities.
As a result of a $5.1 billion shortfall in the state budget, deep cuts in Olympia to the proposed 2011-2013 budget have slashed state spending across all areas, with already struggling mental health services losing millions of dollars in state funding. Mental health spending in Washington State is expected to fall by $42 million over the next two years.
These massive cuts to mental health services affect community and hospital based psychiatric care, housing, and access to medications. As money is stripped from outpatient services and as psychiatric facilities remain filled to capacity, emergency rooms have become overcrowded with mentally ill patients who often must wait long hours before receiving care – even though the ER “[is] the wrong place for someone in the midst of a psychiatric crisis.”
In a recent e-mail Robert Campbell, CEO & President at Providence Mount Carmel Hospital in Colville, WA, agreed:
“The mental health system has first deinstitutionalized the system and put many mentally unstable patients out on the street relying on outpatient facilities. Many of those individuals are managed with state and federal funds and those funds seem to have systematically been reduced over the year. The implication is a slow rise in mental health issues being seen in the emergency department or in the primary care office.”
Of the expected $42 million in cuts to Washington State mental health services, $17.4 million will come out of community-based mental-health programs. This reduction in funding will cut services to 26,000 people, a drastic decrease from the 144,000 clients served last year through the Washington community mental-health system. These cuts further strain community clinics across the state and disintegrate “the safety net’s safety net” for uninsured and under-served populations who depend on essential grants for medical and dental care.
Mental health advocates suggest these cuts do not save money in the long term. Social Work professor Christopher Larrison insists that when outpatient services in rural areas are cut, they often don't return when state finances improve. Mental health cuts end up costing communities more than they save, hurting individuals, families, and the people, facilities, and agencies that serve and protect them.
While dollars may be stripped from our state budget, our powers to advocate for the mentally ill and under-served members of our communities are not! What we can do in these difficult economic times is to continue to look out for our neighbors and families by writing to legislators and state officials and voting in elections to help preserve beneficial programs. In all of our advocacy and awareness efforts, we should also fight stigma by representing mental illness accurately and ethically and treating people with mental illness with respect, dignity, and compassion.