Arizona’s Mental Health Budget Crunch

January 13th, 2011 at 11:32 pm David Frum | 13 Comments |

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National Review has a fine editorial on the Tucson massacre and mental health:

The tragic irony is that Arizona boasts some of the strongest [involuntary commitment] laws in America. Had Jared Lee Loughner been referred to mental-health professionals, there is a chance that his bloody rampage could have been prevented. Think of all the people and institutions — his parents, his neighbors, his fellow Pima Community College (PCC) students, PCC administrators, the campus police, the Pima County Sheriff’s Office — who witnessed signs of his psychosis but apparently failed to notify the relevant officials. A simple court petition could have saved six lives.

On the other hand, as TAC founder Dr. Fuller Torrey has noted, Arizona’s public mental-health services are actually quite poor. The system is woefully — indeed, frighteningly — ill-equipped to manage the state’s psychiatric population. So even if Loughner had been referred to the proper channels, he might not have received treatment in time to stop his deadly outburst.

But question: why are Arizona’s mental health services so poor? The short answer: money.

To fill a $1 billion hole in its 2011 budget, Arizona slashed this year’s budget for mental health services by $36 million — a 37 percent cut. As a result, advocates say 3,800 people who do not qualify for Medicaid are at risk of losing services such as counseling and employment preparation. In addition, more than 12,000 adults and 2,000 children will no longer receive the name-brand medications they take to keep their illnesses in check. Other services such as supportive housing and transportation to doctor’s appointments also will be eliminated.

Arizona has been hit especially hard by the state fiscal meltdown of 2008-2010. But even if recovery accelerates, the problem will remain: how to pay for the government even conservatives want? Yes, much of the money can be found by reducing the government conservatives do not want. But I doubt all of it. The challenge to raise additional revenues in ways that do not burden work, saving and investment will beckon as one of the great challenges of the next decade for Republicans as well as Democrats.

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13 Comments so far ↓

  • rbottoms

    We don’t need no damn socialist health care taking crazies off the street.

    Put ‘em in the NRA where they’ll have company.

  • nwahs

    If Medicare wrote smaller checks to drug companies, do you really think they would flee America is search of larger profits? Where would they go?

  • jg bennet

    The health care law that Republicans are targeting for repeal provides significant assistance and options for people with mental illness, an issue that has received increased attention as details emerge about the alleged shooter in Arizona on Saturday.

    ALEXANDRIA, Va. (September 22, 2010)-Mental Health America today marked tomorrow’s six month anniversary of the Affordable Care Act, which will greatly expand access to mental health care and addiction treatment.

    “The Affordable Care Act marks a tremendous step forward in our efforts to improve access to care for individuals with mental health or substance use conditions and in our advocacy for prevention of these conditions,” said David Shern, Ph.D., president and CEO of Mental Health America.

    “Treatment for these conditions is recognized as critical to overall health by being included on the list of essential benefits that must be covered in new plans offered to the uninsured beginning in 2014.”

    Dr. Shern said several key provisions that take affect on September 23 will improve the lives of millions of Americans with mental health and substance use conditions.

    The groundbreaking enactment of the “Mental Health Parity and Addiction Treatment Act” (MHPAEA) firmly established that discriminatory limits on mental health and substance use conditions will no longer be permitted. The Affordable Care Act carries this principle forward and extends the MHPAEA requirements beyond current law to health insurance plans offered to small businesses and individuals. These principles are also reflected in the expansion of Medicaid which would require those newly eligible to receive mental health and substance use services at parity with other benefits.

    Among the many other important new programs and reforms are initiatives to support education and training of additional mental health and addiction treatment providers and to improve coordination of care through a new state option for medical/health homes in Medicaid that includes individuals with serious mental health conditions among the priority populations.

  • rbottoms

    The health care law that Republicans are targeting for repeal provides significant assistance and options for people with mental illness, an issue that has received increased attention as details emerge about the alleged shooter in Arizona on Saturday.

    Screw that noise.

    Are we going to let that Kenyan HilterStalinMao Cylon destroy our country?

    Heck no.

  • jorae

    Most of us know cuts in mental health care started with Reagan in California. He closed the facilities in the state of California for involuntary confinements, and as President, closed the Federal Mental Care programs.

    The costs were determined to be a burden on the tax payer…..When he became president, he closed the Federal Mental Care programs.

    Republicans and the tax dollar is a continuous game….It never mattered in Reaganocomics who suffered with this cut. So in typical Republican style, the tax dollar came first.

  • TerryF98

    And the GOP wishes to repeal a health care bill that would add funding for mental illness.

  • armstp

    The state of Arizona’s budget has be completely butchered to pay for continued tax cuts. They could care less about any government services in that state. AZ is the test case to see how the new GOP/Tea Party will rule. So far it ain’t pretty.

    I would directly you to this very good article on AZ. Here is an exerpt:

    “The general unsightliness of the capitol makes it a fitting home for today’s Arizona legislature, which is composed almost entirely of dimwits, racists, and cranks. Collectively they have bankrupted the state through a combination of ideological fanaticism on the Republican right and acquiescence and timidity on the part of G.O.P. moderates and Democrats. Although dozens of states are facing budget crises, the situation in Arizona is arguably the nation’s worst, graver even than in California. A horrific budget deficit has been papered over with massive borrowing and accounting gimmickry, and the state may yet have to issue IOUs to employees and vendors. All-day kindergarten has been eliminated statewide, and some districts have adopted a four-day school week. Arizona’s state parks, despite bringing in 2 million visitors and $266 million annually, have lost 80 percent of their budget, with up to two thirds of the parks now in danger of closure. The legislature slashed the budget for the Department of Revenue, which required the agency to fire hundreds of state auditors and tax collectors; lawmakers boasted that these measures saved $25 million, but a top official in the department estimated that the state would miss out on $174 million in tax collections as a result.”

    http://harpers.org/archive/2010/07/0083023

  • aed

    rbottoms, could you post something worth reading instead of this ugly discharge?

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  • Arms Merchant

    Good article from NR on the issue. And yes, these conservatives are advocating for more funding.

    “Clearing out state mental hospitals was sold as a compassionate policy during the 1960s and 1970s. Yet the “reforms” of that era left behind a grisly trail of human wreckage.”

    “At a time when state budgets are under enormous strain from burgeoning Medicaid rolls, steep levels of education spending, and bloated public-sector pensions, directing more money toward psychiatric care may seem a low priority. But the consequences of neglecting mental health are all around us: on our street corners, in our hospitals, and throughout our jails. Moreover, the price of AOT and similar policies must be weighed against the price of inaction.”

    “While this is primarily a state issue, Washington can help — by getting out of the way… Despite its worthy aims, [federal program] PAIMI has long functioned as a de facto arm of the ACLU, bitterly resisting compulsory treatment for the mentally ill… In the aftermath of Tucson, such obstructionism is no longer tolerable. ”

    http://www.nationalreview.com/articles/257058/lesson-loughner-editors

  • Joe In NH

    Pay now or Pay later. Don’t provide good outpatient services and you can provide later in-patient care….opps… I mean prison. Prisons are our new insane asylums. Anyone know what is the largest asylum in the US? The answer is the LA County Jail which has a whole building for over 1000 prisoners with serious mental problems.

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  • Catherine

    Why are we assuming that he needed a state funded, or, medicaid outpatient treatment center? He could just as well as been covered by private health insurance. Here in AZ, a few corporations, called Regional Behavioral Health Authorities, have mental health treatment locked into their own centers, by the state dept of Health and they get excellent reimbursements for lousy services provided by low level therapists. They have revolving doors for therapists who don’t stay because they are poorly trained and do not receive proper clinical supervision and have terrible working conditions. So if you happen to be poor, or have difficult circumstances where you are medicaid eligible, you do not have a choice in a private mental health provider. There is no such entity as “Community Mental Health Centers” in AZ. People complain constantly about not getting the services they need and thus, don’t get better.