Analysis: Report on mental health due

By KATHY A. GAMBRELL, UPI White House Reporter  |  July 16, 2003 at 2:43 PM
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WASHINGTON, July 16 (UPI) -- Mental health advocates are hoping a soon-to-be-released presidential commission report on the nation's beleaguered public mental health system will drastically change how adults and children receive treatment.

"The situation is really dreadful," said Michael Faenza, president of the National Mental Health Association.

President Bush established the New Freedom Commission on Mental Health last year, directing it to identify policies that could improve coordination of treatments and services and promote community integration for adults with a serious mental illness and children with a serious emotional disturbance. The panel addressed issues in the nation's $23 billion public mental health system that serves some 6.1 million people. Those issues included children and families, seniors, medication issues and suicide prevention.

"Millions of Americans -- millions -- are impaired at work, at school or at home by episodes of mental illness. Many are disabled by severe and persistent mental problems. These illnesses affect individuals, they affect their families and they affect our country," Bush said in April 2002 as he launched the commission.

More than 54 million Americans have a mental disorder in any given year but fewer than 8 million seek treatment, according to the NMHA. Depression and anxiety disorders are the most common mental illnesses, affecting some 19 million American adults each year. Some 20 percent of children have mental, emotional or behavioral disorders and up to 10 percent may suffer from a serious emotional disturbance. Seventy percent of affected children do not receive treatment, the group said.

The issue of mental health services has the same problem as many other items on the Bush domestic agenda: a lack of money. It is unclear whether the report will spur additional funding from the administration as it faces a more than $450 billion budget deficit and 6.4 percent unemployment rate.

The U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration has a proposed $3.4 billion budget in 2004, up $206 million over fiscal year 2003. The budget includes $834 million for mental health services, an increase of $12 million over 2003 funding levels.

The budget proposes $107 million for children's mental health services, a 10-percent increase over 2003, and $433 million for community mental health services block grant that would provide services for 222,500 adults with serious mental illnesses and children with serious emotional problems.

Faenza said the United States was losing ground on providing services for children with mental disorders and adults who are diagnosed as persistently mentally ill. The General Accounting Office reported that 12,700 children and teens were turned over to state welfare agencies when their parents could not afford treatment for them or Medicaid would not pay for services.

Sen. Susan M. Collins, R-Maine, chairwoman of the Senate Committee on Governmental Affairs, has taken up the cause, scrutinizing problems facing families caring for mentally ill children. Collins had requested the report earlier this year.

Collins pointed to the story of Theresa Brown, a single mother from Maine who had to refuse to take her teenage daughter home from the hospital in order to secure mental health services for her.

"My struggle to find appropriate and effective services were with suggestions that I had to take a parenting class on 'hard to manage children' and rely on school counselors. I now realize that it was not my child that was hard to manage, but a disorganized and undeveloped system that did not provide services that could not meet her needs," Brown said in testimony before the committee.

Robert Bernstein, executive director for the Bazelon Center for Mental Health Law in Washington, told United Press International that he expected a clear declaration from the commission that the nation's mental health system was in need of reform. The Bazelon Center for Mental Health Law is a national legal advocate for people with mental illnesses or mental retardation.

Bernstein also said he expected the commission to declare that recovery should be the goal, giving mental health patients the tools to be productive and a chance to participate in a meaningful life. He said he was not anticipating any surprises from the commission.

"Then the real work starts," Bernstein said, adding that once the report was released mental health advocates would pinpoint the areas for change that are most critical. He recognized the fact that the economy was not good and could pose problems with funding, but said it ultimately may not be a factor.

States have been struggling with massive budget shortfalls -- the worst since World War II, experts say -- requiring severe cutbacks on services.

Faenza said the report would be used as a platform for change in the system, which has been plagued with problems for decades. Many persistently mentally ill patients find themselves in and out of emergency rooms or jail and some die.

The report is expected to be released in a matter of weeks. The question advocates are pondering whether the commission's recommendations will be backed with leadership from federal officials and the White House.

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