Catholic Relief Services - Hunger Facts: Children Around the World
FACTS REGARDING THE MENTAL HEALTH CRISIS IN ILLINOIS
May 5, 2009
Community Mental Health Services in Illinois are Dramatically Underfunded
Problems include:
- Illinois ranks no better than 35th in per capita spending on community mental health services.
- Many important services, including Assertive Community Treatment (ACT), are not available to all who need them. This problem has been greatly exacerbated by the manner in which the state has converted to a Fee for Service (FFS) funding system. The proposed FY2010 budget will eliminate services to thousands of persons in Illinois with serious mental illnesses.
- Persons are regularly turned away or discharged from public and private hospitals without a community treatment plan which is reasonably calculated to insure that the person can succeed in the community.
- Reimbursement rates for mental health services, including psychiatric services, ACT and rehabilitation services, do not cover costs. The State has conducted independent rate studies which have demonstrated the inadequacy of rates, yet nothing has been done to correct this.
- Illinois has brought in new Federal Medicaid dollars through the FFS conversion. However, much of this funding has been diverted to other needs and not spent to fix the large service gaps.
Children and Adolescents with Mental Illnesses are Being Denied Adequate Care
- Some years ago, Illinois created a landmark Children’s Mental Health Partnership. The Partnership created to detailed plan to fix our broken system for caring for children and adolescents. The proposed FY2010 budget will cut Partnership funding by 10%
- Recently the Department of Human Services has created new procedures which have been used to terminate Individual Care Grants (ICG) for some of the most seriously ill children in the state. These changes were implemented without consulting anyone and families whose children are being denied care have not been given help in transitioning these children to other services.
- Diagnosable mental illness in children and adolescents affects over 20 percent of the population, yet only one in five of these receive any kind of treatment. In Illinois, mental health programs and services for children are highly fragmented, under resourced and limited in scope despite the fact that research clearly demonstrates that children’s healthy social and emotional development is an essential underpinning to school readiness, academic success, general health and overall well-being.
- Problems include: a lack of early intervention services; a lack of trauma care and aftercare within the juvenile justice system; a deficiency in a qualified and trained workforce with sufficient numbers of professionals to serve all of Illinois’ children and their families needing them.
Housing for Persons with Mental Illnesses is Desperately Needed
Illinois consistently receives “failure” grades in terms of providing supported and assisted housing for persons with mental illnesses living situations.
Problems include:
- At least one quarter of homeless persons have a mental illness.
- Without appropriate housing, persons with mental illness substantially are at risk for relapse and the necessity for treatment in settings which are much more expensive, including hospitalization, nursing homes and even prisons and jails.
- Supportive housing costs the public an average of $27 per day. This contrasts with: state prisons, costing $52 per day; Dixon Correctional Center (for mentally ill prisoners), costing $55 per day; a shelter bed, costing $59 per day; Cook County Jail, costing $70 per day; an IMD (nursing home for persons with mental illnesses), costing $104 per day and a State psychiatric hospital, costing $209 per day.
- A shortage of approximately 40,000 units of affordable housing for this population throughout the State.
- The failure to provide housing creates other problems including the fact that individuals living in nursing homes and/or who are homeless have more difficulty obtaining employment due to their living situations.
The Criminal Justice System is Overburdened with Persons with Mental Illnesses.
- Because Illinois’ mental health system has been underfunded for so long, large numbers of persons with mental illnesses end up in prisons and jails.
- There are more persons with mental illnesses in our state prisons than in all of the State’s public and private psychiatric hospitals and more in Cook County Jail than any single psychiatric hospital in the State.
- Treating the mentally ill in prisons and jails is expensive and difficult and places unfair financial burdens on county jails across the state.
- Many prisoners with mental illnesses are subjected to deliberate sensory deprivation in Illinois’ ‘supermax prison, Tamms Correctional Center, despite evidence that this worsens their mental illnesses.
- With little assistance from the state, a number of counties have created mental health courts in order to connect persons with mental illnesses with treatment. Despite their recent creation, these courts have already demonstrated remarkable reductions in recidivism. Unfortunately, mental health courts are threatened by the absence of community mental health services and the likelihood that existing services will be cut.
............ Many mentally ill persons in Illinois do not have access to appropriate medications
Most serious mental illnesses can be successfully treated with psychotropic medications, often used in conjunction with other therapies. While these medications are often costly, they are far less expensive than the costs that are created when access to medications is restricted or denied. Additionally, medications which fall within the same class often work quite differently for different individuals. Psychiatrists frequently have to try several medications until they find the right solution of a particular patient. Hence it is essential that persons with serious mental illnesses have access to a full range of medication possibilities. Those who do not obtain appropriate medications often wind up losing their jobs, friends, family and ability to function in the community. Some become homeless or institutionalized. Some even end up in the criminal justice system.
Problems include:
- Little coordination among the State and county agencies treating persons with mental illnesses to ensure that persons moving from one system to another to continue receiving the same medicate. Often, these entities each have different “approved” lists of medications which they provide. These government entities include: Illinois Departments of Healthcare and Family Services, Human Services and Corrections, county jails and county hospital
- Newer medications are often more effective and have fewer and less severe side effects than older, cheaper ones. Persons with mental illnesses are more apt to comply with medication regimes that include these newer medications. Nevertheless, many government agencies restrict access to them in the mistaken view that this policy is more cost-effective. However, since such restrictions lead to less use of the needed medications, they end up costing the public sector more and impose otherwise-preventable suffering on patients.
- One mechanism sometimes used in an effort to cut costs is to require “prior authorization” before prescribing psychotropic medications. This policy particularly hurts indigent patients because physicians treating them rarely have the time or means to obtain such authorizations.
- The Department of Healthcare and Family Services has a policy of delaying approval of all new medications. This policy is not based upon concerns regarding safety or efficacy of the medications, but rather upon cost concerns.
Inpatient Care in Illinois is Unavailable and Substandard
- The number of State-operated beds has declined over the past decades from 55,000 to 1,400. Largely due to inadequate reimbursement rates, the number of Illinois private psychiatric beds has declined from 5,000 to 3,500 over the past 15 years. A recent study by the Treatment Advocacy Center indicated there is a need for 50 beds/100,000 population; however, Illinois has only 11 beds/100,000.
- Staffing in State hospitals has continually declined since 2001. There is a well-documented shortage of psychiatrists and other trained mental health care staff. This fact means that patient and staff safety are jeopardized and the likelihood of adequate treatment is reduced.
- Persons with serious mental illnesses who need inpatient care often wait for hours in emergency departments or even strapped down in ambulances outside of state hospitals waiting to be admitted.
- The closure of Tinley Park Mental Health Center will further exacerbate these already documented problems. Although the state has suggested that Tinley Park will be replaced with a privately-run, publicly funded hospital, it has failed to provide any details about how such a facility would work or how it would guarantee adequate care in such a facility.
WE NEED YOUR HELP
- Support Governor Quinn’s proposed income tax increase. Without more revenue, the already underfunded mental health system will be devastated.
- Support Senate Joint Resolution 31, calling for use of funds that have been appropriated for community mental health. These funds are available due to increased Federal Medical Assistance Percentage (FMAP) funds along with funds in the HHS Medicaid Trust Fund and the Community Mental Health Medicaid Trust Fund.
- Support other tax increases needed to fund mental health and substance abuse services. Increases of 1 to 2 cents per drink in the State alcohol tax would yield $93.6 million which we propose be used as follows:
- $30 Million for veterans’ assistance, healthcare and supportive services;
- $20 Million for the DHS-Department of Mental Health;
- $20 Million for the DHS- Department of Alcohol and Substance Abuse
- $20 Million in improved payments to community providers of mental health.
We also ask you to support the following bills:
SB 231 Permitting inmates to have Medicaid reinstated promptly upon discharge
HB 2400 Strengthening the prompt payment act
HB 751 Requiring that proceeds from the sale of state-operated facilities be placed in the Medicaid Trust fund for use in the mental health system
HB 758 Amending the allocation formula in the Community Mental Health Medicaid Trust Fund to preserve those funds for community mental health services and preventing sweeps of these funds
HB 4429 Appropriating a total of $3.0 Million from the Health and Human Services Medicaid Trust Fund and GRF to the DHS for supportive housing services
SB 2093 Amending the Mental Health and Developmental Disabilities Administrative Act and the State Finance Act and providing that 100% of the Community Mental Health Medicaid Trust Fund be used for the purchase of community mental health services |
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