Do the Math – Not the Myths of Psychological Healthcare

by Dan Cobbs, MPA, FACHE, Chief Executive Officer

The first question you need to ask yourself, has the problem of access for anyone to receive substance abuse and mental health treatment been solved?  The answer is an obvious “NO”, and the “NO” has been reinforced in Florida for over 20 consecutive years.  This has been devastating for the uninsured and persons with disabilities. 

1. Myth:  Bridgeway Center, Inc. (BCI) is closing the doors for all services in Okaloosa County.

Truth:  Bridgeway Center, Inc. is open for business and will continue mental health and substance abuse outpatient services.  Last year BCI provided in excess of 200,000 client services to the community.  The only areas that are affected by the closing on May 3, 2013 at midnight are the Inpatient Services Programs which consist of the Crisis Stabilization Unit, the Detoxification Unit, Emergency Services, and Food Services.

2. Myth: The cost for a person who is psychologically ill and incarcerated is the cheapest cost for taxpayers.

Truth: The cost to provide outpatient psychological treatment is four (4) times less than the cost of incarceration. Legislative freezes on reimbursement rates to providers without an inflation factor, multiplied for over 20 years, have been devastating. It is no longer an option to do nothing for access to public safety nets for mental illnesses and substance abuse addiction diseases.

3. Myth: There are a small percentage of people with severe mental illness in jails and prisons.

Truth: The Bureau of Justice statistics found that over half of all jail and prison inmates have mental health illnesses. Over 56% of these mentally ill inmates never received treatment prior to incarceration.

4. Myth: Bridgeway Center, Inc. is fully subsidized as a public safety net to take care of the uninsured for access to treatment for mental illnesses and substance abuse addiction illnesses.

Truth: Reimbursement rates for BCI and other non-profits like BCI across the State of Florida have not increased for over 20 years and the population needing services continues to grow. Rates for all providers in Florida need to be competitive e.g., the entry level salary for a Master Degree provider is $25,000. The entry level salary for a licensed provider is $29,000.

5. Myth: The number of people suffering from mental illness has gradually decreased since 1998.

Truth: The number of people suffering from mental illness has increased over four (4) times since 1998.

6. Myth: BCI’s treatment services are for social, light duty, counseling.

Truth: BCI treats individuals who have severe and persistent mental illnesses (SPMI) and substance abuse illnesses. BCI services are a public safety net.

7. Myth: Violence “cannot” be predicted.

Truth: A history of violence to property, animals, and individuals is one of the best indicators of future violence. Substance abuse is often a co-existing factor with violence.

8. Myth: Treatment does not work for mental illness.

Truth: Treatment for anxiety, depression, schizophrenia, rage, and other types of mental illness are very effective.

9. Myth: Mental illness treatment expenses cost more than physical medical illness treatment.

Truth: Mental health expenses cost less than 10% of physical health care expenditures nation-wide.

10. Myth: We need to put the brakes on an “out of control” healthcare system.

Truth: The growth rate of national health expenditures compiled by the Centers for Medicare and Medicaid Services has decreased from 9.3% in 2002 to 3.9% in 2010. The reasons are a combination of factors. New medications that are now in generic form, consumer choice for types of insurance with co-pays, deductibles, tiered medication plans, urgent care, costs of an ARNP instead of ER Physicians, and the emerging science of disease management and prevention.

The “meat axe” approach to cutting substance abuse and mental health funding for direct care services for the needy must be halted immediately! This has been on-going for over two decades.

The bottom line: we need to broaden critical access for psychological healthcare treatment.

The 2013 Legislative sessions need to restore the mental health and substance abuse cuts of $24 million taken by the 2012 Legislature and further invest $75 million for additional services for people with serious mental illnesses. The investment would improve Florida’s ranking among the states in per capita mental health spending from 49th to 47th. Annual per capita spending for state-funded services would increase from $39.55 to $44.55 or 12.6%. The national average per capita for mental health spending is $120.

Substance abuse prevention and mental health treatment saves taxpayers dollars and saves lives.