Source: The Times-News, Twin Falls, IdahoDec.迷你倉 18--TWIN FALLS, Idaho -- Despite Twin Falls' high suicide rate and urgent need, the city won't get a state mental health crisis center.But the Magic Valley is the next highest priority after three other crisis centers are established, providing they get state funding, say officials with the behavioral health division of the Department of Health and Welfare.Such a center is designed to treat at-risk patients before they reach a crisis. It also would cut psychiatric hospitalization and incarceration.Treatment of the mentally ill remains in the national spotlight in the wake of mass shootings such as those in Newtown, Conn., and Aurora, Colo., and since mental-health funding has been slashed by Idaho and other states since the recession."Unfortunately, the public often focuses on mental illness only when high-visibility tragedies of the magnitude of Tucson or Virginia Tech occur," wrote the Nation Alliance on Mental Illness (NAMI) in its 2011 report, State Mental Health Cuts, A National Crisis. "However, less visible tragedies take place every day in our communities -- suicides, homelessness, arrests, incarceration, school dropouts and more."Indeed, in Twin Falls, dozens of people have killed themselves over the years by leaping off the Perrine Bridge -- the most visible manifestation of the Magic Valley's struggles with mental illness.Idaho officials are pushing the crisis centers as one of several initiatives to patch a system in "tremendous need of transformation," said Ross Edmunds, behavioral health administrator.In fiscal year 2013, the behavioral health division served 13,389 people, up from 12,626 in 2009, the state reported. Yet while the patient count was rising, state mental health budgets were slashed from $69.5 million in 2009 to $58.6 million in 2013, and 35 state mental health workers were laid off in 2009 and 2010."As a large state with about a third of its population living in rural or frontier areas, Idaho desperately needs effective, accessible mental health services and transportation to such services," NAMI wrote in a 2009 report that gave the state a "D" for its mental health services.That's on top of recent news that Idaho won't expand its Medicaid eligibility under the Affordable Care Act. If Medicaid were expanded up to a maximum of 138 percent of the federal poverty level, Idaho would get $3.2 billion more from 2013 to 2022 and save $97 million in uncompensated care costs, NAMI reported.Medicaid funding is critical to mental health services. About half of all state-controlled funds for those services came from the program in 2008, NAMI reported. About 70 percent of Idaho's mental health services are Medicaid funded, and that share has grown from $112.1 million in 2009 to $137 million in 2013.If Medicaid were expanded, Edmunds said, that would cover 93 percent of Idahoans now being treated for mental illness by the state.Bill Aldrich said he wishes the state would expand Medicaid. Aldrich owns the Community Support Center, which relies on Medicaid to serve the severely mentally ill in Twin Falls, Burley and elsewhere.People will lose their lives because the state wants to save money, he said. The long-term damage, he said, will cost the system more than expanding Medicaid would.That's because officials "are on the outside looking in, trying to fix something they don't have a clue about," Aldrich said. "Then they fail to ask the people that really know and when we do tell them ... they blow us off."Safety netThe state hopes to build the centers in Coeur d'Alene, Boise and Idaho Falls to cover a broad geographic area and to coordinate with "organized stakeholder committees" in those areas, Edmunds said.The sites were chosen because they have "an existing pocket of people that has been pushing this hard," he said.Fewer than half of Americans who live with mental illness get treatment, and more than 1-in-5 people in jail and prison live with mental illness, NAMI reports. Around Idaho, when police contact the mentally ill, their options are limited to jailing them or taking them to an emergency room -- neither of which has staff dedicated to dealing with mental patients.More than 4,500 mental commitment cases -- in which a patient is held out of concern for his or others' well-being -- were filed in Idaho cour文件倉s last year, the Idaho Supreme Court reports. That's an 82 percent increase since 2007.That year, 7.6 million emergency room visits nationwide were for mental illness, NAMI reported.Aldrich said the crisis center is a great idea, but he wishes officials would have listened to mental health professionals years ago to prevent what's happening now."This is something we told them a long time ago: If you cut back the money, you are going to have more people commit suicide, the hospitals filling up and the jails filling up," he said.The crisis center would be a voluntary third option -- a safe environment where the person and a counselor can talk and draft a recovery plan, letting police return to the streets, Edmunds said. The walk-in centers would be open 24 hours a day, but the care must end within 24 hours. Otherwise, a costly, advanced inpatient license is required."It isn't really a treatment modality that these centers are about. It is more of a risk-reduction model," Edmunds said.The center then can send them out the door or refer them to inpatient psychiatric care, he said. Likewise, an inpatient center, which costs thousands of dollars a day, could refer walk-ins to the crisis center when appropriate, Edmunds said.So the crisis centers would be a safety net for the 22,806 childless Idaho adults with mental illness who are ineligible for Medicaid -- about 21 percent of the state's uninsured, NAMI reports.Edmunds is asking Gov. C.L. "Butch" Otter to add crisis center operation funding to his budget indefinitely, estimated at $1.2 million to $1.5 million per center per year. Edmunds, however, wouldn't divulge how much he requested for the centers' construction. Those costs would vary between communities, he said. Grants and other local money could alleviate state funding pressure."There has to be a community flavor to these things, and there has to be community buy-in," he said. "We want to make sure that communities are in the driver's seat."Doing moreTo increase community participation, Edmunds is proposing legislative action this session to merge two regional boards and give them more power.Each of the state's seven regions now has a regional advisory committee, which addresses substance abuse, and a regional mental health board. The boards make recommendations but "have no ability to be a doing group," Edmunds said.For years, those groups have been asking for a stronger role. Reviews of Idaho's behavioral health system have indicated more community-level control would be a good idea, he said. Best practices reason that mental illness and addiction don't exist in isolation from each other, he added.If the Legislature approves, the boards will merge into regional behavioral health boards -- a semi-governmental agency that will be able to handle money, apply for grants, have more authority and forward meaningful recommendations to the state."After years of what I might describe as frustrations of wanting to do more and wanting to have more of a system impact and not feeling like they have a chance to do so, I'm not sure there is a formal process in every region in which they do a good job of communicating up," Edmunds said.He said his department has the annual $50,000 each of the seven boards would need to hire a director and set up an office, and he doesn't expect that funding to go away.Despite years of budget cuts, Edmunds said, funding has been "pretty consistent over the last few years."Edmunds also wants the boards to fund and lead recovery support services -- things that help addicts stay clean and the mentally ill remain stable, such as finding housing and transportation."You can have an appointment with the best psychiatrist in the state, but if you live 10 miles out of town under a bridge without any transportation, I'm not sure it is going to help you a whole lot," he said.The quicker the mentally ill can get access to what they need to be stable, the quicker they can get off public assistance, Edmunds said."If I could pay $500 for a month's rent to help somebody get back on their feet, boy, isn't that better than paying for $2,000 a day for seven days of inpatient psychiatric hospitalization?"Copyright: ___ (c)2013 The Times-News (Twin Falls, Idaho) Visit The Times-News (Twin Falls, Idaho) at magicvalley.com Distributed by MCT Information Services存倉
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