States in Crisis:
Crisis, Solution, and Crisis
|For more information, see the Report of the Governor's Blue Ribbon Commssion on Mental Health|
Connecticut, the richest state in the Union, completed the closure of two of its three large state hospitals in 1995. For the next five years, Connecticut's adult community mental health budget was essentially flat, adjusted for inflation, while its client population of people with serious mental illnesses increased by 20%. At the same time, Connecticut experienced huge budget surpluses, which it refused to use as a downpayment in restoring its public mental health system, until last year.
Since the fall of 1999, NAMI-CT has co-led a coalition of family, consumer, advocacy, church, and legal groups, called the "Keep the Promise" coalition. The coalition has grown in size and influence over the last two years, spurring the Governor to appoint a Blue Ribbon Commission on Mental Health at the beginning of 2000. This Commission produced an outstanding (and astounding) report that documented the neglect of services and treatment for children and adults with mental illnesses, the gridlock in hospitals and emergency rooms, the raging homelessness, and the criminalization of both juveniles and adults with mental illnesses. The major state newspaper, the Hartford Courant, has made rebuilding the mental health system a central cause, and other newspapers in the state have diligently covered the issues.
As a consequence, last year, the Connecticut General Assembly and the Governor agreed to increases in the operating budgets for both the children's and adult mental health agencies, and also passed landmark legislation that used surplus funds to provide front funding for the most critically needed services. Even more importantly, the legislation, called the Community Mental Health Strategic Investment Fund, provided for the reinvestment of new federal Medicaid funds, under the Rehabilitation Option, which has never been implemented in Connecticut.
Then in the summer, and after September 11, Connecticut began to experience a deficit for the first time in almost 10 years. The first programs the Governor cut were the operating budget for the adult mental health services, and recommended severe cuts to the new Strategic Investment Fund. The General Assembly, our legislative body, refused in a special session to make significant cuts in the new Fund. Our advocacy paid off. Now comes the major test. The state in FY 03 faces a deficit of about 2% of the budget. The Governor has presented a budget that again takes significant cuts from the adult system, and recommends cutting the new Investment Fund in half. Fortunately, he has not cut the development of a children's community system of care.
Our coalition has documented and continues to document the costs of not providing care and treatment to people with mental illnesses: $660/day for the state hospital bed, $207/day for nursing homes, $70/day for prisons compared to $36/day for supported housing. We continue to fight for the reinvestment of new future Medicaid funds, which the state can leverage with existing expenditures. It is bad fiscal policy and bad public health policy not to continue to invest in strong community mental health services. It makes no sense, and this is the message we must keep in the public's mind.