Carolyn Petrak is the executive director of the Ability Network of Delaware and a voting member of the Behavioral Health Consortium. Rep. Kamela Smith, D-Bear, serves on the House of Representatives’ Health & Human Development Committee.
You may see them at intersections asking for help or in downtown Wilmington, talking to themselves. Maybe you see them when you’re driving along Dupont Highway in Dover. You might even cross to the other side of the street out of instinct or look away if they approach you. Maybe you don’t see them at all. They are fellow Delawareans with severe and persistent mental illnesses. SPMIs include conditions such as schizophrenia, bipolar disorders or severe depression and anxiety. And, for as many of them as you may notice, there are so many more you don’t because they’re engaged in comprehensive, community-based mental health services.
Highly specialized, community mental health programs provide a multidisciplinary approach to patient care for people with these illnesses. The mental health professionals that work in this field provide 24/7 wraparound case management, including psych rehabilitation, housing and homelessness assistance, medication management, education support and vocational rehabilitation, just to name a few. The stability these services provide keeps individuals with SPMI safe, healthy and active.
In Delaware, only a handful of nonprofits care for over 2,000 residents with such conditions. Four of the largest that serve most of our friends and neighbors with mental illness are members of the Ability Network of Delaware, the statewide community disability service provider association. These four members — Horizon House, Resources for Human Development, Conexio Care and Elwyn — are in severe financial crisis. The service system is now at a tipping point, and if we don’t take action, a preventable tragedy will unfold.
These nonprofits are contracted partners with the state of Delaware. The members of AND that serve your family and friends with SPMI are not paid the actual cost of providing services. In fact, some programs are paid as little as 60% of the actual cost. These nonprofits operate multiple specialized initiatives that are all taking large financial losses every month.
Why are these services so far behind? The state has not increased reimbursement rates for community mental health care in 13 years. While Delaware’s increasing minimum wage reflects important economic progress, it also highlights the growing gap between what it costs to provide care and what providers are reimbursed. As a result, these four providers are losing bachelor’s degree-level staff to less stressful jobs in food service or retail because providers can’t compete. Their ability to increase pay is directly linked to how much the state pays them to operate these programs.
CMH services are a cost savings to Delaware. Providers keep Delawareans with severe and persistent mental illnesses out of more costly hospital and institutional settings, which saves the state money. More importantly, it’s a better standard of care. When CMH providers cannot accept new clients, it creates a bottleneck in hospitals. And, when people with SPMI cannot access these programs, they are more likely at risk for homelessness, incarceration and substance abuse. All of which cost the individuals and the state greatly.
The Ability Network and our providers were happy to see Gov. Matt Meyer propose an additional $2.9 million in state funding for community mental health services. It’s the first increase in any governor’s recommended budget since 2012. But it’s a Band-Aid on a bullet hole. These four organizations have seen, on average, $1 million in losses annually.
Delaware has been a national leader in advancing mental health services and reducing stigma. In the last five years, the state wisely added $80 million in state funding for school-based mental health services. But what about adults with SPMI?
The state must act immediately to stabilize services before tragedy unfolds, and we lose this critical health care. Whether or not you know or care for someone with mental illness, it is in the best interest of us all to care for them. What does it say about our humanity if we keep looking the other way?
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
