State’s mental health system adjusts to tighter budgets
by Patrick McCreless
Sep 12, 2013 | 4985 views |  0 comments | 47 47 recommendations | email to a friend | print
Employees at the Calhoun-Cleburne Mental Health Center listen Thursday to a presentation from Debbie Bryant about mental health and dealing with issues. (Anniston Star photo by Bill Wilson)
Employees at the Calhoun-Cleburne Mental Health Center listen Thursday to a presentation from Debbie Bryant about mental health and dealing with issues. (Anniston Star photo by Bill Wilson)
Growing up in Anniston, Lacey Williams decided she wanted to always live close to her family and spend her life helping people. For the last six years she has done both as an outpatient therapist for the Calhoun-Cleburne Mental Health Board in Anniston.

"I love my job ... I enjoy helping people, especially during these hard times when they don't have anyone else," Williams said.

But Williams' job is not easy. Providing evaluations, individual therapy and medication monitoring, Williams' caseload averages between 150 and 200 patients a month. Many of her fellow staff members face similar high workloads.

"That's too high a caseload, but there is nothing else to do because of funding," said Mickey Turner, executive director of Calhoun-Cleburne Mental Health. "The average caseload was less than 100 about 20 years ago, but with today's money, there's no way to do that."

The Alabama Department of Mental Health is observing National Recovery Month through September, holding special events around the state to promote the societal benefits of prevention, treatment and recovery from mental illnesses and substance abuse. However, such services have suffered in recent years due to budget cuts, culminating in the closing of two state mental hospitals last year and requiring local community facilities to pick up the slack. The state's cuts are part of a national trend in mental health funding reduction, resulting in declining care, some mental health industry experts say.

Adjusting the system

As fallout from the recent hospital closures, Calhoun-Cleburne Mental Health will be one of five north Alabama care centers required to open a 24-hour-a-day, 16-bed facility, Turner said. The state closed Searcy Hospital in Mount Vernon and Greil Montgomery Psychiatric Hospital late last year due to budget deficits and now needs new facilities to house mentally ill patients. Also, services are being scaled back at Bryce Hospital in Tuscaloosa and North Alabama Regional Hospital in Decatur.

Called a designated mental health facility, the new care center in Calhoun County will treat only non-criminal patients petitioned for commitment and treatment by the court system. Such patients will include those exhibiting major depression, suicidal tendencies or erratic behavior.

"We're having to find places to commit these patients," Turner said. "But the positive is we'll be able to treat these patients locally and families will be able to visit and not have to travel."

Jim Reddoch, commissioner of the Alabama Department of Mental Health, said his department received an extra $13.5 million for the 2014 fiscal year from the state Legislature to pay for the new facilities in the northern part of the state.

"We intend to expand and enhance community care in the northern part of the state," Reddoch said.

Surviving budget cuts

Though Calhoun-Cleburne Mental Health provides various services, it is not a 24-hour-a-day facility. It provides services for mentally ill children and adults, the developmentally disabled and substance abusers. The center employs 210 people and last year treated more than 6,000 patients.

The center is operating on a $13 million budget and expects level funding next year, Turner said. He added that the center has not had to lay off any workers due to state budget cuts.

Other than some layoffs due to the state hospital closings, the budget cuts have had few other effects on mental health care in the state, Reddoch said.

"The repercussions have been minimal ... it's been an almost seamless transition for people that have been committed in state hospitals to community facilities," Reddoch said.

However, Debbie Platnick, senior director of state policy for Mental Health America, said Alabama's mental health funding cuts are similar to those being made by all the other states in the country.

"All of the states have cut funding, especially since 2008," Platnick said, referring to the start of the Great Recession. "We've seen the effect of it — fewer people getting treatment, longer wait times and people falling through the cracks."

Mental Health America is a national advocacy group that promotes quality mental health care for all Americans.

More centers, less cost

Platnick said that throughout the country, there is a movement to close large mental health facilities in favor of opening smaller, community-based ones.

"That's not a bad thing," Platnick said. "What people have found is the large hospitals are not sustainable and they segregate people ... people seem to respond better to treatment when they are in the community they're from."

Platnick said the smaller facilities also are more cost-effective.

"What happens is those areas without community-based services is those patients eventually show up in emergency rooms ... and that creates greater costs in the long run," she said.

However, she noted that not all community-based centers have been successful.

"Community-based services are all too often underfunded," Platnick said.

Budgetary changes and increased workloads do not concern Cynthia Thomas, however. Thomas has worked as a licensed counselor at Calhoun-Cleburne Mental Health for more than three years, mainly with children. Thomas said she has worked with children for nearly 40 years, first as a math and science teacher in Talladega, and will never give that up.

"I absolutely love my job," Thomas said.

Turner said all his staff are the same way, willing to do what it takes to provide care to those who need it in the community.

"They are committed and do work overtime and are very committed individuals," Turner said.

Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star.
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