Community mental health system in crisis

Daniel McCarthy and Christian Stephens
Posted 1/29/15

Recently, arguments have surfaced in favor of our state’s mental health system returning to a “medical model” of community mental health care. In short, this means publicly insured Rhode …

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Community mental health system in crisis

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Recently, arguments have surfaced in favor of our state’s mental health system returning to a “medical model” of community mental health care. In short, this means publicly insured Rhode Islanders, from Cranston to Newport, would have their treatment managed and directed by large hospital-based health care networks.

Unfortunately, this model of care devastatingly lacks key mental health supports that local residents with serious mental illness rely on. Hospitals and medication are of limited value without connection to adequate housing, job training, employment, peer support and community-based services – key factors that directly contribute to quality of life. We’ve heard this from clients in recovery, family members, care providers and supporters – treatment for those coping with severe mental illness takes wrap-around community-based support.

Professional medical models emerged out of a belief that most patients don’t know what’s best for them, and, particularly if they suffer from mental illness, others should decide for them. This antiquated approach to care is discriminatory and limiting. Today, we must focus on keeping our community and its members safe by engaging those who suffer with mental illness – in their homes and in their communities – empowering them to believe in themselves and others, then follow through on key steps that promote their recovery.

In a community-based mental health setting, trusted peer advocates, case workers and multi-disciplinary teams that include psychiatrists, nurses and counselors help inspire the recovery that comes with home and community-based services.

Rhode Island’s community mental health organizations serve our uninsured and underinsured. They serve our veterans, our homeless and our ex-offenders. They serve our schools, our non-profits and our local businesses. They collaborate on programs funded by practically every state agency, including Corrections, Children and Families, Health, Education, and Behavioral Health and Development Disabilities. They are routinely called by emergency rooms, housing authorities, police departments and probation and parole. Unlike larger hospital-based organizations, these community-based organizations are truly run by and serve our unique communities.

We need these accountable community-based mental health organizations to continue to provide the many health and human services that reduce the use of emergency rooms and hospitals. These organizations prevent our state from spending much more down the line on avoidable hospital and emergency visits, incarcerations for crimes often linked to untreated mental illness, and more.

Our state needs several regional, non-profit, safety net community mental health organizations that are designed to serve our unique communities. Despite the elimination of funding for these organizations in 2014, we cannot walk away from the decades of success that came when our public sector and the community mental health organizations worked together to discover best practices and significant cost savings.

As we move further into 2015 under new state leadership, we must commit to addressing our community mental health system in crisis. Our state cannot afford to wait, and neither can the many at-risk Rhode Islanders struggling with serious mental illness.

Daniel McCarthy served for many years as the Director of Community Services for the Rhode Island Department of Mental Health. Christian Stephens served for many years as the CEO of the Community Mental Health Center for Northern R.I., and currently serves as the CEO of Horizon Healthcare Partners, a network of regional community mental health organizations.

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