No one disputes the danger of texting while driving. In a very short time, we have grasped the undeniable truth of this claim.
Here is another claim, equally true and equally undeniable: quality behavioral health care (mental health and substance abuse services), especially for low-income individuals and families, is in a state of crisis so dire that we may be on the brink of catastrophe. Without a State budget to fund community mental health grants, with managed care plans that restrict sessions of care for those with severe mental illness (many of whom depend upon their long-established relationships with providers), and with the dramatically decreased access to care created by losses of funding, the health and stability of our community is in jeopardy. Several days ago, Lutheran Social Services announced a decision to lay off 750 staff, directly because of the lack of State funding, seriously weakening one of the very strong members of our provider community.
For example, our agency’s award-winning psychiatric respite program, The Living Room, has lost 100% of its State funding. Since its inception in 2011, The Living Room has saved the State of Illinois more than $2 million by deflecting persons who would otherwise go to emergency departments to our most cost effective and hospitable alternative. Our success rate is 98%. Not funding The Living Room and other programs like it results in higher costs. It’s as simple as that. We know the inestimable value of the program, so we are scrambling to save it. This is an exceptionally difficult burden for an organization already stretching to follow its mission to serve our low-income clients.
What will it take to convince the legislators and other decision-makers that this is a true and dangerous reality and that this is intolerable?
Community mental health rests on the capacity of all citizens to access and utilize treatment that allows them to live full and productive lives. When this happens, adults are able to work, to vote, to care for their families, send children to school, and participate in the civic lives of their communities. When access to care is limited, serious harm results that begins with the individual in need. If individual suffering isn’t enough (although we believe that it is), lawmakers should know and remember that untreated emotional distress and mental illness can quickly escalate to criminal acts and dangerous behaviors.
Without a State budget, behavioral health services can’t be provided and needs cannot be met. Providers and clients in community-based settings see this clearly. What will it take to convince members of our broader communities, including our governor and other lawmakers?
How do we articulate these concerns so that funding can be restored? It is a sad yet indisputable fact that individuals who benefit from State-funded behavioral health care have very little influence when most budget conversations take place. Their lack of socioeconomic power, coupled with the stigma of mental illness, creates a deafening and dreadful silence.
Community mental health is in serious trouble. Many state agencies have closed because they cannot afford to continue to operate without State funding for programs that serve low-income clients. Other agencies are restricting services, not taking new clients, laying off staff, shuttering satellite locations, as our colleagues at Lutheran Social Services have been forced to do. Because there are fewer and fewer agencies and services, those that remain are inundated with requests for care that often come from people at high risk for suicide, homicide, and homelessness who deserve immediate, life-saving care.
The lack of basic funding for essential services has created a catastrophe for the citizens of Illinois. It is not just those of us who have lost services who are suffering; it is also the families, the employers, the schools and churches and wider communities. The fabric of our community is being torn apart because we are not supporting those with the fewest resources and, often, greatest need.
Texting while driving may result in death. We understand this, and most of us grasp it well enough to curtail our own behavior. Lack of funding for behavioral health is equally perilous.
We must see these realities clearly. There is still time to restore at least a measure of life-saving services that will allow all of our citizens to access expert care that can result in lives of recovery, enriching the health of all of our communities.
It’s not too late. But we don’t have time to waste.
Ann Fisher Raney, AM, LCSW, is chief executive officer at Turning Point, Skokie
Mona Shattell, PhD, RN, FAAN, is a professor and chairperson of the department of community, systems, and mental health nursing at Rush University, Chicago; member of the Board of Directors at Turning Point, and former Public Voices Fellow with the OpEd Project.