As Republican Gov. Bruce Rauner does battle with the Democratic forces of Mike Madigan in Springfield and Illinois residents choose sides in the political feud, an organization that advocates for people suffering from mental illness in Illinois has issued a report.
You probably don’t care. Most such reports are boring, full of facts and technical jargon and usually about stuff that’s of little interest to anyone. I haven’t heard about anyone shooting up a shopping mall or movie theater recently, so mental health care is not high on anybody’s list of priorities.
But I think it’s interesting, especially in light of the debate over the state budget, taxes and the public outcry to cut the fat in state government. Because here’s what the report says happens when governors and state legislators take out their budget ax:
*Between 2009 and 2012, Illinois cut $113.7 million in funding from mental health services.
*Since 2009, the state has closed two inpatient facilities (including the Tinley Park Mental Health Center), six Chicago mental health clinics and several community mental health agencies throughout the state.
*Emergency room visits for people experiencing psychiatric crisis increased by 19 percent between 2009 and 2012.
*Cook County Jail has become the largest mental health provider in Illinois. Of approximately 76,400 people who were admitted to Cook County Jail in 2012, 45,840 were people with a mental illness.
*The total number of nights spent in a shelter statewide increased from 2 million in fiscal year 2011 to 3 million in fiscal 2013. The National Alliance to End Homelessness estimates that approximately 32 percent of the roughly 14,000 homeless people on any given night in Illinois have a serious mental illness.
All of this and much more is included in the white paper by the National Alliance on Mental Illness-Chicago. The report warns that “Governor Runner’s proposed Fiscal Year 2016 budget cuts will further strain our already fragile health system.”
That’s likely to make the people who voted for the governor unhappy because they figure it’s us (taxpayers) against them (free-spending Democrats and their freeloading buddies).
I’ve been trying to explain to people for months that nothing is that simple. I’ve written numerous columns about people in need (the developmentally disabled, the homebound in need of support services to stay out of nursing homes and the mentally ill, to name a few) who are going to bear the brunt of any budget cutting.
I’ve repeatedly asked readers if those are really the people they wanted to suffer when they voted against raising taxes and against the Democrats who have controlled Springfield. The silence has been deafening because people really don’t want to deal with the reality of this economic crisis facing our state.
And that reality includes mentally ill people not getting the help they need, while the state actually shells out more money to treat them in prisons, jails and hospital emergency rooms.
Providing adequate, community-based mental health care would be far cheaper, NAMI-Chicago maintains, as does Cook County Sheriff Tom Dart.
In a column last week, I described how the Orland Park Police Department created a team of officers trained to deal with those who are mentally ill after seeing a dramatic spike in cases involving them following the closing of the Tinley Park Mental Health Center.
According to the NAMI-Chicago report, 38.5 percent of adult in Illinois 18 and older reported poor mental health (feeling depressed and/or anxious and having to limit daily activities because of mental health problems). And it says that more than 16 percent of Illinois adults were living with a mental illness and 3.37 percent with a serious mental illness.
NAMI-Chicago estimates that translates to approximately 5 million Illinois adults with poor mental health, 2.1 million living with mental illness and 434,000 with a serious mental illness.
The report says agencies paid by the state to provide treatment for these people have declined as state funding has been cut. In addition, a lawsuit against the state forced Illinois to provide mental health care for anyone living in a nursing home who needed it, further overloading a system that wasn’t able to care for the existing mentally ill population due to state budget cuts.
Medicaid reimbursement rates have remained flat for years, meaning fewer psychologists and psychiatrists are willing to see mentally ill patients, and at the same time the number of medical practitioners in these areas have dramatically declined throughout the state.
For decades, private insurance companies failed to pay for mental health care. The Affordable Care Act (Obamacare) was supposed to address that issue by providing insurance for those who are mentally ill.
“After five years of dealing with funding cuts, eligibility restrictions and consent decrees, Illinois has a bare-bones publicly funded mental health system,” NAMI-Chicago’s report states. “It’s great that the ACA helps more people living with mental illness pay for services, but today’s providers just don’t have the infrastructure to serve them. They don’t have the staff, the funding and the less-intensive services that these newly eligible … people need. The promises of the ACA is not so promising without providers to deliver services.”
When the state began closing mental health institutions, it created a strategic plan to help those suffering from mental illness. NAMI-Chicago says the plan was great in concept but never received the funds needed for full implementation.
“Governor Runner’s proposed Fiscal Year 2016 budget cuts will further strain our already fragile mental health system,” the report contends. “The proposed $1.5 billion cut to Medicaid — the largest source of funding for mental health services in Illinois — will further decimate the system and be devastating to people living with mental illness, including the thousands who are newly eligible for Medicaid under the ACA. The governor’s proposed cuts include the $27 million cut to … eliminate (a grant program) that enables community mental health agencies to hire psychiatrists who can’t afford the low Medicaid reimbursement rates that haven’t been raised since 1996.”
Of course, Runner’s budget proposals have been dumped into the trash bin by Democratic legislators who are proposing a budget that is $3 billion to $4 billion short of the revenue needed to fund it.
But it should be remembered that it was under a Democratic governor and during the reign of Madigan that mental health care took a beating in Illinois. Even in the good old days before the financial crisis this state shafted the mentally ill.
The NAMI-Chicago white paper contains a lot more information than I could possibly include in a newspaper column. But it contends that most people who are mentally ill could live productive lives with treatment.
They could be contributing to the workforce and society instead of acting as a drain on resources. And NAMI-Chicago suggests several common-sense approaches to mental health care that could address some of its more serious concerns.
I doubt anyone will read the white paper. I don’t think politicians care much about the mentally ill. And that probably reflects the attitude of their constituents, the people who vote.
Yet most of us know someone who is mentally ill — a relative, neighbor or co-worker. The statistics make that clear. And all of us rise up in anger when someone who should have been treated goes off the deep end and starts shooting people who are merely going about the business of living.
“Why didn’t somebody do something?” we ask after such tragedies. Good question. But you’re the one who has the answer.
