The News Courier in Athens, Alabama

July 28, 2013

Suffering in the Shadows: Funding an issue in helping affected

By Jean Cole

Editor’s note: This is the third and final part of a series examining mental health services at the local and state levels. A public forum on mental health issues will be held at 6 p.m. Tuesday in the ballroom of the Sandridge Student Center on the campus of Athens State University.

An Illinois trucker named Anton Barvinok led dozens of law enforcement officers on a three-county chase along Interstate 65 before wrecking his tractor-trailer at the Alabama-Tennessee state line in 2011. Barvinok, who was found to be mentally ill, believed he was battling the forces of evil.

While no one was injured, the delusional trucker did have weapons in his vehicle. He has never been well enough to face his 10 charges.

Although these kinds of cases draw widespread attention, most people with mental illnesses never make the headlines. That is due, in part, to the efforts of mental health professionals treating the mentally ill in Limestone County and throughout the state. However, drastic federal and state budget cuts over the past few years are straining resources.

Meanwhile, the National Alliance for the Mentally Ill, or NAMI, says a loss of federal Medicaid funding for those with serious mental illnesses is creating a nationwide crisis.

(For example, the decision by Alabama to turn down more than $14 million in federal Medicaid dollars would have allowed 78,691 uninsured adults to obtain treatment for any kind of mental illness, according to NAMI.)

The Alabama Department of Mental Health Division of Mental Illness Services serves more than 100,000 residents — about 5 percent in state-operated facilities and 95 percent by certified community providers. To reduce costs, the state closed two hospitals in South Alabama — Searcy and Greil, though Bryce Hospital in Tuscaloosa and North Alabama Regional Hospital in Decatur remain open.

State lawmakers believe they are doing all they can with the revenue they have to fund mental health services. One lawmaker, Rep. Mac McCutcheon, R-Capshaw, who represents residents in Limestone County, doubts the state will return money for mental health services.

“I don’t know if it is realistic to say we could put more money back into mental health due to the fact that there is no extra money out there,” he said.

Through efforts by Gov. Robert Bentley and the Legislature, McCutcheon said the state is saving about $1 billion a year through cost cuts and reorganizing agencies to make them more efficient.

“That is good management on the state’s part, and we continue to look for ways to save,” he said, noting the savings is merely used to cover rising costs.

“We could always try to take the easy road and raise taxes, but is that the best way?” McCutcheon asked. “When we had the economic downturn, it helped us go back and take a serious look at what we spend in government and how efficient we are in what we spend.”

Funding for corrections and Medicaid make up the largest portion of the state’s general fund budget, putting the pinch on funding for other needs, such as mental health care.

McCutcheon said the state’s mental health agencies are doing a wonderful job with the dollars they receive and in the ways they are giving service to those in need.

“Do they have all the money they need?” he asked. “No. Demand is greater than their resources. But, they have become very lean and they are watching their budgets and being creative to deliver those. There are local groups and nonprofit that are coming to the table working with mental health agencies trying to create communities they can live in and have a lifestyle that is supported other than through taxpayer dollars.”

Once such program is available in Athens.

Habitat for Humanity of Athens and Limestone County has partnered with the Mental Health Center of North Central Alabama to build a triplex next to the MHC office on Elm Street. William Giguere, development officer for the Foundation for Mental Health, has already briefed both the Athens Planning Commission and the Athens City Council on the proposal.

The triplex would house nine patients who are capable of living on their own but who still need to be close to the facility. Eventually, there will be more such facilities, said Amanda Garlen with Habitat.

The creation of this housing is not a reaction to state budget cuts or crisis, she said.

“Housing for people with mental illnesses has been a priority for the Foundation and the Mental Health Center for decades,” she said. “Given the current economic situation, however, this project is even more valuable than before.”

The housing helps address a shortage of housing at in-house mental facilities.

The MHC in Limestone County provided treatment for more than 1,100 clients last year, not all needing residences.

“Currently, Limestone County only has access to 10 permanent beds and 10 transient beds for clients, which are being provided through a grant from the Department of Housing and Urban Development,” Garlen explained. “The triplex homes will increase the amount of permanent beds available to our community without the risk of loss of funding.”

What if the housing were not there?

“With such a severe lack of options for those in need of immediate housing while receiving counseling or treatment, or both, these clients may be forced to end up on the streets or be unable to get the services they need,” she said.

Another program Limestone and others counties could implement is already available in Madison County and the city of Huntsville.

Madison County Circuit Judge Ruth Ann Hall and Huntsville Municipal Court Judge Sybil Cleveland worked together to create mental health courts designed to help those arrested, but suffering from a mental illness, to obtain and maintain treatment and reroute their lives.

“It is basically a treatment court where we concentrate more on the person’s issues,” Cleveland said, crediting Hall with the initial idea. “When someone has a serious mental illness — schizophrenia, bipolar disorder, post traumatic stress disorder and illnesses like that — if they are already diagnosed and have committed a crime, we will review them for the possibility of committal into our program.”

If accepted as clients, the district attorney’s office diverts the person from prosecution on the crime with the stipulation that they adhere to treatment, which could include medication, therapy and cessation of drugs or other substances.

Clients are seen in court every other Friday, not only so the court can hear whether they are adhering to treatment but so their family members can report how they are doing at home.

“It helps the courts because otherwise they end up re-offending,” Cleveland said. “It also helps the clients. We have helped hundreds over the years. We get letters and cards from people whose lives have been saved, so it is a win-win.”