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NAMI releases report on states' mental health cuts and their impact

NAMI, the National Alliance on Mental Illness, has released State Mental Health Cuts: A National Crisis, a report documenting deep cuts to state spending on services for children and adults living with serious mental illness.



These cuts, which occurred between 2009 and 2011, led to significant reductions in both hospital and community services for vulnerable individuals with serious mental illness.

Today, with demand for public mental health services extremely high, especially at a time of severe economic distress, the crisis in mental health care continues. The impacts are felt throughout society as people go without the treatment they need.

Increasingly, emergency rooms, homeless shelters and jails are struggling with the effects of people falling through the cracks due to lack of needed mental health services and supports.  You can download the entire report or individual state data at the NAMI website.

Some states, such as California, Illinois, Nevada and South Carolina, which made devastating cuts to mental health services previously, have made further cuts for fiscal year (FY) 2012, putting tens of thousands of citizens at great risk.

States have cut more than $1.6 billion in general funds from their state mental health agency budgets for mental health services since FY2009, a period during which demand for such services increased significantly. These cuts translate into loss of vital services such as housing, Assertive Community Treatment, access to psychiatric medications and crisis services.

Modest increases in state general fund mental health spending fail to compensate for the loss in federal Medicaid revenues that hit states due to reductions in federal Medicaid rates implemented at the end of June 2011. Moreover, to make up for these lost federal Medicaid revenues, states such as Arizona and Ohio have shifted state general fund mental health dollars to Medicaid recipients, leaving many non-Medicaid recipients with serious mental illness without services.

The data in this report is limited to general fund appropriations for state mental health agencies (SMHAs). It does not include mental health funds that are under the control of other state agencies such as state Medicaid agencies, housing authorities, or child and family authorities.

Further, state hospital or ward closures and personnel cuts may be in other departmental or agency budgets. Were all cuts affecting mental health services factored in, the sum of the total cuts would be significantly higher.

Aleisa McKinlay appointed director of Florida's VR Program

Aleisa McKinlay, a well-known advocate for people with mental illnesses, has been named as the new Director of the Division of Vocational Rehabilitation in the Department of Education.  Her appointment was effective November 1. She succeeded Bill Palmer, who retired.

McKinlay has served VR for nearly three years as chief of the Bureau of Partnerships and Communication, where she has overseen the Ombudsman Program, Centers for Independent Living, Division communication and legislative affairs duties and many other responsibilities.

Prior to joining VR in February 2009, McKinlay was adult community mental health chief and chief of operations for the mental health and substance abuse programs at the Florida Department of Children & Families.  Earlier in her career, she had also held mental health management positions at the regional level. 

She was also was a program director at the Advocacy Center for Persons with Disabilities. McKinlay became a member of the NAMI-Florida Board of Directors in 2009 and currently serves as second vice-president.

"Aleisa has significant experience in the mental health field and will be a tremendous advocate for the needs of our VR customers," Robinson said in a statement.

McKinlay has a master's degree in psychology from the University of Nebraska and a law degree from the University of Nebraska College of Law, where she held a National Institute for Mental Health Fellowship.

Several Floridians recognized at NAMI's 2011 National Convention

NAMI's 2011 National Conventiondrew more than 2,000 people to Chicago in July to participate in workshops and celebrate NAMI's 30th Anniversary, as well as to pay recognition to those who have made major contributions to the organization.  Several Floridians were among those recognized.

NAMI Florida’s President, Jim Sleeper of Miami, who attended the conference, later said that it had so energized him that he returned to Florida with "fire in his belly."

This year, NAMI Florida Executive Director Judi Evans and Program Director Carol Weber attended the conference, along with NAMI Pinellas Executive Director Gay Hawk.

Others from Florida included:  Karen Levy, Lake Sumter County;  Donna Helsel and husband, Nelson Kull and Joe Mendoza, Orange County;  Dorothy Kellerher, Christina Andreoli, and Curtis Russ, Palm Beach County; David Sarchet and Marsha Litsinger , Collier County; and Paula Leonard, Pasco County.

Carol Weber, Florida's Program Director, received the NAMI National Connection Leadership award for her exceptional efforts in furthering the growth of the NAMI Connection Recovery Support Group Program. 

Several other Floridians were recognized for their contributions. They included:

Anne McWilliams  of NAMI Collier, who was inducted into the Family to Family Hall of Fame for having taught over twenty Family to Family courses in Pennsylvania and Florida

Donna Helsel of Greater Orlando, inducted into the Family-to-Family Hall of Fame for teaching ten Family to Family Courses

Christina Andreoli, of NAMI Palm Beach, inducted into the Connection Hall of Fame for five years of facilitating a NAMI Connection Recovery Support group

Sandi Sumner, Greater Orlando, and Eileen Trainor, Palm Beach, who were inducted into the Family-to-Family Hall of Fame for teaching ten Family to Family Courses 

(McWilliams, Sumner and Trainor were unable to attend the convention but received their awards back home.)

Evans had the honor of presenting Joyce Burland, PhD, with the NAMI Distinguished Service Award.  Burland recently retired as director of the NAMI National Education, Training, and Peer Support Center.

The award is NAMI’s highest honor, given in recognition of exceptional efforts to further NAMI’s goal of improving the lives of people who live with mental illness.

A clinical psychologist, Burland is the author of the NAMI Family- to- Family Education Program, and the NAMI Provider Education Program.  Burland's work has not only transformed individual lives, but also has helped to transform the mental health care system.

“The army of NAMI members that Joyce Burland armed with knowledge and passion is changing the way persons living with mental illness are treated," said the NAMI Board of Directors.  "The army is on the move because of Dr. Burland and the programs she created and nourished.”

Burland was also presented with a special Florida Tribute Scrapbook, a compilation of messages and pictures from Florida members, creatively arranged into album pages by Gloria Strother of NAMI Pasco.

Two Florida crisis centers get federal grants

The Crisis Center of Tampa Bay, Inc. and Switchboard of Miami, Inc. each have been awarded $60,000 grants from the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop follow-up services for those at high risk of dying by suicide.

The two Florida centers were among six centers affiliated with the Nation’s Suicide Prevention Lifeline that received the awards. 

The Lifeline works with a nationwide network of more than 150 crisis centers to provide round-the-clock phone counseling, emergency intervention when necessary and referral services to callers contemplating suicide or concerned about a friend or loved one who may be in crisis.

Often people at risk of suicide who have contacted the Lifeline do not receive the follow-up care recommended, according to SAMHSA. The centers selected for these grants will develop systems to reach out and help ensure that critical follow-up care is provided for people in need.

“ Sixty percent of people who received follow-up help from the Lifeline said that these services made a lot of difference in making them feel safer,” said SAMHSA Administrator Pamela S. Hyde, J.D.

Hospitalization survey finds psychiatric impairments are more acute in youth

Short-term inpatient psychiatric stays increased for youth but declined for older adults between 1996 and 2007, according to an analysis published in the Archives of General Psychiatry.

Admission information and diagnostic trends over the same time period also indicate that impairments and problems of hospitalized patients appear to have grown more acute. The study also notes that the trend corresponds with an increase in bipolar diagnosis, especially among youth.

Joseph C. Blader Ph.D., of Stony Brook University, evaluated data from 1996-2007 from the National Hospital Discharge Survey, an annual survey conducted by the National Center for Health Statistics.

His data showed that hospitalization rates increased the most for children ages 5-12, going from 155 per 100,000 children in 1996 to 283 per 100,000 children in 2007. Among teens, the rate increased from 683 to 969 per 100,000.

Among adults, the rate increased from 921 to 995 per 100,000. By contrast, the rate declined among the elderly, going from 977 to 807 per 100,000.

Hospital stays were consistently shorter among children and teens, especially those with private insurance. The proportion of inpatient days paid by private insurers declined among children (going from 36 percent to 21 percent), adolescents (going from 52 percent to 22 percent) and adults (going from 35 percent to 23 percent.)

The trends likely reflect an increase in clinical need rather than an overuse of hospital resources, especially when taking into account the decline in number of psychiatric beds available, according to Blader. Surveys among state mental health officials during the same time period indicate they were worried about a shortage of beds for acute care as well.