By Liz Szabo
December 9, 2014

Full Article [Post-Newtown Momentum on Mental Health has Slowed] - USA Today


Two years after the shootings in Newtown, Conn., prompted calls to rebuild the country's frayed mental health system, the drive for change has slowed at the state level and ground almost to a halt in Washington.

"We're seeing less attention to mental health, and that's concerning to us, because we're still seeing so many tragedies every day," says Mary Giliberti, executive director of the National Alliance on Mental Illness (NAMI), which released the report Tuesday.

Although individual tragedies may not make the news, "the suffering is tremendous when people don't get the services they need," Gilibert says. "People end up in emergency rooms. People end up in jails and prisons, which is absolutely the wrong place for someone with mental illness."

The increased attention to mental health after Newtown gave many mental health advocates hope for real change.

In December 2012, Adam Lanza shot 20 children and six staff members at Sandy Hook Elementary School in Newtown, along with his mother and himself. A report issued last month by Connecticut's Office of the Child Advocate noted that Lanza suffered for years from untreated mental illness, including anxiety, depression and obsessive-compulsive disorder.

After the shootings, the White House held a mental health summit and 36 states increased funding for mental health services – an important step toward restoring $4.6 billion in recession-related cuts from fiscal years 2009 to 2013, the NAMI report says.

Only 29 states increased funding this year, however. Seven states reduced mental health spending. In some states, mental health funding is still less than it was before the recession, the report says.

"When you've been through a couple decades of these kinds of cycles, it gets pretty discouraging," said Paul Appelbaum, a professor of psychiatry, medicine and law at the Columbia University Medical Center in New York, who wasn't involved in the new report. "As the memory of these tragedies fade, there is a reversion to a state of indifference."

State budget cuts have led to huge reductions in community services and the number of psychiatric hospital beds for people in crisis, says Robert Pierattini, chairman of psychiatry at the University of Vermont Medical Center. Without community help, people with serious mental illnesses often deteriorate to the point where they need to be hospitalized. Without hospital beds, they may languish for days or even weeks in emergency rooms.

According to the NAMI report, mental health funding took its greatest hit in Rhode Island, which cut its mental health budget nearly 20% this year, slashing $33.6 million in state funding, the report says.

North Carolina, which has cut mental health spending two years in a row, also restricted access to psychiatric medications in its Medicaid program. The change requires that patients get special authorization to before receiving drugs that aren't on a "preferred drug" list. Getting that kind of approval can be very difficult, Giliberti says. "When someone finds a drug that is working well for them, they should be able to stay on that drug, rather than switch to a drug that works less well or has more side effects," she says.

Dewey Cornell, director of the Virginia Youth Violence Project, says, "funding cuts like these cost us more in the long run," because people who deteriorate may end up involved in the court system or in homeless shelters.

Events in 2014 kept mental illness and the failures of the mental health system in the news, from the killing spree at the University of California-Santa Barbara to the suicide of actor Robin Williams. Neither of those events spurred major calls to action, however.

In states that acted to improve access to mental health care, changes were more akin to "tinkering around the edges" rather than the sort of sweeping reform that advocates called for after the Newtown shootings, the report says.

"When there are bad things that happen to a mentally ill person, there is usually some media attention for a few days, and some policymaker attention for a few days, but the attention doesn't really stay," says Pierattini, who was not involved in the NAMI report. "We can't underestimate the ability of people to deny problems.

... It's so convenient to say, 'Well, I know that's happening, but it's not happening to me.'"

In Congress, two bills designed to modernize the mental health system and improve access to care – one introduced by Republican Rep. Tim Murphy of Pennsylvania and one by Democatic Rep. Ron Barber of Arizona -- stalled without a vote.

Ron Honberg, national director of policy and legal affairs at NAMI, said he hopes the bills will be reintroduced next year.

There were some bright spots for mental health in 2014, the report says, particularly in Wisconsin and Virginia.

Virginia lawmakers created an online database to help hospitals quickly locate psychiatric beds for people in crisis. Lawmakers were responding in part to a tragedy affecting one of their own. Last year, state Sen. Creigh Deeds' son, who had a history of mental illness, stabbed his father before committing suicide -- just a few hours after he was released from a hospital because the staff could not locate a bed for him.

Virginia also allocated nearly $55 million to improve mental health services in hospitals and outpatient clinics, the report says.

Wisconsin provided grants to develop mobile crisis response teams, whose staff can go directly to people or families experiencing a mental health crisis. Wisconsin also funded grants to encourage up to 12 psychiatrists to practice in rural areas where there is a shortage of mental health workers, and passed a law to allow children to receive mental health treatment in their homes.

 

Wisconsin also created respite centers run by people who have suffered from mental illness themselves, where people can go for short periods, such as a few days, when they are overwhelmed. Wisconsin also funded programs to help people with mental illness find stable jobs.