Trump’s Budget Cuts Funding for Mental Health and Substance Abuse Programs

Much attention has been paid to the effect of Trump’s proposed cuts to Medicaid.  Numerous editorials, articles, advocacy statements, and personal testimony have described the damage they would cause to mental health and substance abuse services.

Now, Trump has added new targets to his hit list.  Here is the list of cuts in his federal budget proposal.

Substance Abuse and Mental Health Services Administration  (Decrease of $400 million)
Mental Health Block Grant (Decrease of $116 million or approximately 20%)
Substance Abuse Prevention and Treatment Block Grant  (Level funding)
Primary and Behavioral Health Care Integration and Technical Assistance and Training Center (Program eliminated)
Mental Health First Aid (Program eliminated)
National Institutes of Health (Decrease of $5,673 million or approximately 25%)
White House Office of National Drug Control Policy (Decrease of $2 million)
Click here to read the full story from the National Council on Behavioral Health.

New Efforts to Promote Jail Diversion Programs

We are pleased that Paul Rusk, chair of the Public Protection and Judiciary Committee (PP&J), has organized a joint committee meeting with the Health and Human Needs Committee (H&HN) to discuss the availability of mental health and substance abuse services, as they relate to plans for the Dane County jail.

The meeting is at the request of the League of Women Voters of Dane County and other advocates.  The H&HN Committee passed a unanimous resolution, asking for the meeting.  It will take place on June 6 at 5:30 in the City/County Building in room 354.

Chairperson Rusk has asked the county’s Director of Human Services Lynn Green to describe mental health and substance abuse programs offered by the county, with an emphasis on  jail diversion efforts.  Sheriff David Mahoney will talk about difficulties posed by the lack of “special needs” beds and the resulting inappropriate use of solitary confinement.  The county’s corporation counsel will be available to discuss legal issues.

Time will be available for public comment and discussion between the committees.   The LWVDC will testify, as will NAMI-Dane, Journey, and MOSES.  Attendees can register in support of jail diversion programs for people with mental illness.

UPDATE:  Click here for a story from Cap Times about the meeting.  Check back for testimony.

UPDATE:  Click here for a story from the Wisconsin State Journal about the most recent plan to renovate the jail.  It includes comments from mental health advocates at the meeting.

UPDATE: Click here for an article from Cap Times with a comprehensive description of the new plan.

UPDATE: Click here for an article from Isthmus (6/22) entitled “Parisi Still Not Ready to Endorse Jail Proposal. “

Two Steps forward in Efforts to Decriminalize Mental Illness: New York City and Arkansas Set Up Crisis Stabilization Centers

New York City has awarded contracts totaling $90 million to two nonprofit agencies to establish diversion centers providing short-term stays for people with mental illness or substance abuse issues who might otherwise be arrested.   An estimated 2,400 people will be served annually.  (Wall Street Journal: May 11)

The centers will offer counseling, behavioral-health assessments and help with substance abuse.  They will not be available for violent or high-level drug offenders.  As described by a city official in the article, “This is someone who may be exhibiting problems, they may need to talk to somebody, they may be having a particularly bad day.”

Although a welcome effort to help people with mental illness avoid a jail cell and criminal sentence, advocates have identified shortcomings with the approach.  Police officers will be making the decision about eligibility for the centers.  The crisis centers will become a revolving door unless there are long-term supports, said the director of behavioral health at the Council of State Governments Justice Center.

Arkansas’s investment in crisis stabilization centers is much smaller ($5 million), but the centers are part of a major reform effort in the state.  Legislators and officials worked with the Council of State Governments (CSG) staff to address the financial and social problems of a rapidly increasing prison population.  Click here to read the report on Arkansas’s justice reinvestment approach.

Act 423, passed by the state legislature in March 2017 and signed by the governor, limits the period of incarceration for people sanctioned for low-level violations of their parole; requires training for law enforcement officers in how to respond to people with a mental health crisis, and creates local crisis stabilization centers that enable law enforcement officers to divert people with low-level offenses away from county jails to receive mental health treatment in the community.

The legislation is expected to reduce the projected growth in the prison population by nearly 10 percent and avert hundreds of millions of dollars in prison construction and operating costs.

Governor Asa Hutchinson (R) said of Act 423.  “We have neglected the mental health challenges in our nation for too long.  Through the creation of these crisis stabilization units, this bill will provide much-needed assistance to those suffering from mental illnesses and also provide relief to our law enforcement officers who so often have to deal with incidents involving those who need help rather than detention.”

The League of Women Voters of Dane County is encouraging the county board of supervisors to consider crisis stabilization centers and other diversion methods as part of its review of the next version of the Mead & Hunt recommendations about the jail.

Unfortunately, these steps forward are occurring at the same time as a giant retreat in Washington, D.C.   Click here to read a story in the Washington Post (May 13) that describes Attorney General Jeff Sessions’ directive to federal prosecutors to “pursue the most severe penalties possible, including mandatory minimum sentences, in his first step toward a return to the war on drugs of the 1980s and 1990s that resulted in long sentences for many minority defendants and packed U.S. prisons.”



Join Efforts to Provide Treatment instead of Jail Time for People with Mental Illness

At least 40 percent of the inmates at the Dane County jail have a mental illness, according to Sheriff Dave Mahoney.   Several years ago, he described the abysmal conditions under which many of them were housed and pressed for action on a new jail that would include better options for those inmates.

The Dane County Board of Supervisors appointed three task groups to consider problems of racial equity and the prevalence of mental illness among inmates.  The Board issued a report including  30 recommendations in September 2015 and appointed a task group to develop additional recommendations to divert people with mental illness from jail.

Click here to read the initial report.  Click here to read the report of the Diversions Task Force.

Recommendations in both reports include the idea of a crisis restoration center to which people with mental illness could be taken for assessment, short-term treatment, and referral to other community-based treatment.  Crisis restoration centers have been successful in other communities and ultimately have saved taxpayers dollars.

Some recommendations in the reports have been implemented.  However, there has been no movement towards establishing the center.  In fact, the share of county funds directed to mental health services continues to decline in relation to population growth and the share allocated to the criminal justice budget.

The League of Women Voters of Dane County and NAMI-Dane County want further conversation about how effective diversion, mental health, and addiction programs can be supported and established.   An excellent op ed from NAMI-Dane County appears earlier in this blog.

As a good step towards this dialogue, the LWVDC is urging people to contact their county board supervisors to request a joint meeting between the Public Protection and Judiciary (PP&J) and Health and Human Needs (HH&N) Committees before June 15 to discuss formulating a plan that would increase opportunities for diversion.   On June 15, the full board is scheduled to receive the latest version of the Mead & Hunt recommendations concerning the jail.

Members of PP&J include Carousel Bayrd, Dorothy Krause, Maureen McCarville, Michael Willett, and Chair Paul Rusk.   Members of H&HN include Hayley Young, Heidi Wegleitner, Chair Jeremy Levin, Matt Veldran, Nick Zweifel, Richard Kilmer, and Ronn Ferrell.   Click here to access the website for the Dane County Board of Supervisors.

UPDATE:  Advocacy works!   The Health and Human Needs Committee unanimously passed a resolution asking for a joint meeting with the Public Protection and Judiciary Committee to discuss jail diversion programs.

David Wahlberg has an excellent article in the Wisconsin State Journal that finds evidence for the oft-repeated claim that money is being transferred from the Health and Human Services budget to the General Fund, where it plugs holes in the budgets of over-spending departments.  Since 2011, the HH&S department has given up $25 million.

Here is an excerpt from the article:  ” [CEO] Lampert said in an interview that Journey could use additional money to expand treatment sites, boost substance abuse programs, add services for the homeless, serve more teenagers and help keep people out of the jail and Mendota Mental Health Institute.”

Click here to read the article.