John A. Hornik: State funding choices undermine community mental health
AMHERST — Late last month the Massachusetts House passed a budget that added $10 million to support 45 psychiatric inpatient beds at Taunton State Hospital. The additional expenditure is a wasteful attempt to keep open a psychiatric facility that is in disrepair and no longer needed. The Massachusetts Department of Mental Health (DMH) already pays for more inpatient beds than it needs, and DMH did not ask for funding at Taunton.
Throughout the 20th century, new psychiatric hospitals were built around Massachusetts and the United States principally to create jobs. Now most of those facilities, including the Northampton State Hospital, have been closed or replaced. But Taunton lives on, driven by the same desire to fund employment for hospital administrators and staff.
Unfortunately, the mental health budget is a zero-sum game. The House budget includes an overall reduction in the state’s adult community mental health budget of about $8 million, as compared to the amount needed to maintain existing programs. Because of an anomaly in the way community programs are funded, western Massachusetts will bear a disproportionate share of these cuts.
Continuing to fund unneeded inpatient beds at the expense of effective community mental health programs flies in the face of good policy and common sense. Community programs in western Massachusetts provide innovative services that are largely successful in reducing the need for hospitalization for people with psychiatric disabilities. People are assisted in finding and maintaining a home of their own, building relationships with friends and family, participating in meaningful daily activities, including work, and generally becoming integrated into the community.
These programs are modestly funded at best, relying upon the commitment of direct care staff compensated at salary levels that put them barely above poverty.
The Western Massachusetts Area DMH citizen advisory board recently undertook a study of DMH-funded adult community mental health programs in this area, including day-long visits to each program. I personally visited four programs, meeting with program managers, direct care staff and recipients of services at each site. While there are certainly improvements to be made, my area board colleagues and I were all impressed with the dedication of staff and the level of innovation.
Any reduction in the community services budget will result in fewer people having access to community mental health programs and eliminate any hope of better compensation for their staff. The Legislature should be looking at how best to strengthen the effective efforts of these community programs, not undermine them.
John A. Hornik of Amherst is president of the Department of Mental Health Western Area Advisory Board. The opinions expressed are those of the author and do not necessarily reflect positions of the DMH.