Needs higher, funds lower for mental health
Utah, like other states across the nation, is struggling with its budget to make ends meet. And, as in other states, funding for mental health and substance abuse programs may have to take another hit.
While Arizona's cuts in mental health services have gotten attention lately in the wake of the tragic shooting spree in Phoenix, Utah has also balanced its budget in part with reductions. "Since 2009, Utah has cut $5.3 million (21 percent) in mental health services like counseling, case management, hospitalizations and medication coverage," stated Jan Bodily, executive director of Four Corners Behavioral Health.
She went on to explain that those reductions have a greater impact than that. It takes 30 cents in state and county contributions to get a dollar in matching federal Medicaid funds. When state funding decreases, the federal funds go down by a multiple.
What this has meant for Carbon, Emery and Grand counties is a reduction of services. "With mental health services, we've had to space out services, or have more counseling in groups instead of in individual counseling," Bodily said. Substance abuse issues, while in a different category of care, are in basically the same boat.
The numbers tell the story. In 2009, Four Corners served 975 clients in mental health. Last year the agency was able to handle only 887. Substance abuse case load increased slightly, from 434 in 2009 to 449 in 2010.
The need in the community has not gone away with the past and proposed cuts. Carbon County has a high proportion of Medicaid-eligible people, and a bigger proportion than elsewhere of eligible people seeking services. "The needs have increased and we struggle to meet those needs," she said. With the prospect of further funding cuts looming, Bodily said she and fellow mental health care professionals are worried about the quality and quantity of services that will be available..
"Our first concern is for the individuals who could be affected," she continued, "But what will happen to the community? There will be a social cost."
To explain what's meant by social cost, she cited a comment from John Rouse, a psychiatrist at San Francisco General Hospital, who told the San Francisco Examiner that "it means more people in jail, it means more people pushing shopping carts down Market Street, it means more wasted resources because it makes it hard to intervene early and cheaply."
The state's drug court system, which Bodily called "precarious," is a case in point for cost effectiveness. In this system, people accused of substance abuse can plead "guilty in abeyance" and avoid spending time behind bars. They must complete a counseling program and stay clean for a set period. If they succeed, they go free. If they fail, they go to jail.
Jail and prison time isn't cheap. A check of the dollar cost of imprisonment in the state's budget shows that for Fiscal Year 2011, the state appropriated more than $261 million for the Department of Corrections. With about 6,600 inmates statewide, that averages out to more than $39,000 for each prisoner.