The mass killings at Columbine High School, a theater in Aurora, Sandy Hook Elementary School, and many others dramatize the need for legislation to address our mental health issues. Solutions to these massacres go beyond gun control. Certainly not everyone who suffers from behavioral and mental health issues will participate in such catastrophic events however, some of these events might have been prevented with the right attention and treatment. Mental health issues often suffer from a negative stigma to the point where those whom contract them are ostracized and alienated. People do not treat someone who is suffering from schizophrenia the same way they treat someone who is walking out of chemotherapy. Both are diseases and both call for solutions.
Governor Rick Snyder and Budget Officer John Roberts recently proposed a budget for the 2017 and 2018 fiscal years. Under this proposed budget, 45% of spending is designated to health and human services. One of Snyder’s main points in his presentation was putting the people first. This budget decision clearly reflects that priority. Although behavioral and mental health falls under the largest portion of the overall budget, only 12% of the given health and human services budget is set aside for mental health. The budget does set aside 3.25 billion dollars gross for programs such as the Mental Health and Wellness Commission, Medicaid and Mental Health Services, and substance abuse treatment. All of these programs are very important as a lot of them offer services to low-income individuals who feel as if they are already lacking means of support. Others are focused on making mental health as much as a priority as physical health. The most salient of these programs are those focusing on substance abuse. Michigan has seen a recent rise in opiate abuse. These programs are helping to combat that abuse by constructing proper treatment programs and rehabilitation centers.
The budget also showed a gain for mental services with an increase in 26.6 million in autism spending. This spending will go to help adaptive programs in schools and workplace which focus on integrating persons with autism in the workplace. Placing a high priority on autism, which effects one in every 68 people in the state of Michigan, is a big gain for mental health policy. The governor has also proposed to extend the applied coverage of behavioral analysis to individuals up to the age of 21. This helps keep a focus on mental health stability during stressful situations such as transitioning to college or moving out of family home.
The last mental health item mentioned in the budget was for the integration of mental health systems and physical health programs. The governor recommends that the state begin the process to better integrate mental and behavioral health services with a patient’s physical health treatments. “The governor expects to see improved coordination of care and a stronger focus on the needs of an individual patient by initiating a process by which all patient services are closely integrated. This budget recommendation asks the legislature and the health provider community to engage in an important conversation about integrating physical and behavioral health services into the larger consideration of patient need”(FY17 Budget). This may be one of the most important aspects of the budget as it is calling for legislative attention to better integrate mental health as priority. As previously mentioned mental and behavioral issues are diseases just as cancer and cystic fibrosis. The blame for a mental health disorder is often placed on the individual and not on the disorder itself. One would never tell a person who discovers they have leukemia that it is their fault rather than the disease they are facing.
One primary concern with this integration of mental and physical health programs is that the budget would be shifting the current public mental health to private funding. The plan is to turn over state funding to Medicaid HMO’s. This change is something the Michigan Association of Health Plans has been lobbying in favor of for awhile. The Michigan Association of Community Mental Health Boards stands in opposition as they see a larger need for the focus to be placed on patient care. They believe privatizing mental health care will not aid this cause considering the overheads of private plans is double the public ones. Even with opposition, this trend has been occurring in many other states such as Florida, California, New Mexico, South Carolina, Washington, Wisconsin, and Texas. These plans have been known to cut state costs by almost 200 million a year. Willie Brooks, the CEO of Oakland County Community Mental Health Authority thinks that the state needs to worry less about saving money and more about the 300,000 residents served by the public mental health system. Many legislators have raised question as to whether the quality of service will be affected by this switch to privatization. This issue will certainly find itself up for debate in the House and Senate in the following months.
In the United States, we spend approximately 113 billion dollars on mental health, which is less than most developed nations. Furthermore, most mental health spending is on developing new prescription drugs to combat disorders rather than on the patient. Michigan is trying to combat this by placing more importance on the individual and the issues they are coping with by promoting counseling. Two other salient issues concerning mental health care are access and cost. The Michigan budget addresses these issues in part by calling for increasing the coverage of behavioral analysis to the of age 21. Overall, states cut 1.8 billion from mental health spending during the recession. As the economy has improved, we can expect mental health spending to rise as well. Perhaps the largest issue that people face when seeking treatment is the social stigma associated with mental health. Michigan addressed this issue in the spring of 2014 with legislation designed to stop the use of the “R” word. However, more needs to be done to end this stigma.
Recently a man took the lives of six randomly targeted individuals in Kalamazoo. Whether this man was suffering from mental health issues or not, his behavior was certainly unbalanced. Not all disasters can be prevented but with a greater focus on mental health, progress can be made on these issues. Recent tragedies have drawn more attention to mental health issues. Hopefully something positive can come out of this and progress can be made to prevent such massacres in the future. More legislation is need to help individuals struggling with mental and behavioral health issues to become the best possible versions of themselves and positively contribute to our society and state.
Greene, J. (2016, February 11). Michigan would privatize mental health funding, services under Snyder's proposed budget. Retrieved March 10, 2016, from http://www.crainsdetroit.com/article/20160211/NEWS/160219967/michigan-gov-rick-snyders-proposed-budget-would-privatize-mental
Kliff, S. (2015, January 1). Seven facts about America’s mental health-care system. Retrieved February 28, 2016, from https://www.washingtonpost.com/news/wonk/wp/2012/12/17/seven-facts-about-americas-mental-health-care-system/
State of Michigan Fiscal Budget FY17
State of Michigan Mental Health and Wellness Commission 2014 Annual Report