Dear NAMI Montana Members and Friends,
I know that a lot of you have read the articles about cuts to mental health services and you're worried. Those fears are justified. The State of Montana's budget is in tough shape and the weak economy has led to a sky rocketing demand for state-funded mental illness treatment. The reality is that it will be harder to access that care.
What We're Facing
Here is a breakdown of the cuts and service reductions as I see them based upon conversations with state personnel and an analysis of the available articles on the subject. (These articles are available at the News section of our website).
The most glaring reductions of services stem from the high demand on the Mental Health Service Plan (MHSP). The State is sharply reducing services, such as case management, and eliminating others, such as day treatment, to prevent MHSP from running out of money. On a personal level, these service reductions will really hurt many Montana families. On the state level, these service reductions risk funneling sick people from cost-effective outpatient care to more expensive placement at the Montana State Hospital or Department of Corrections.
The Governor canceled a $4.5 million renovation of the receiving hospital at the Montana State Hospital at Warm Springs. On top of that $4.5 million, it looks like the Department of Public Health and Human Services is facing a 5% reduction in its budget. It would be a good bet to expect later cuts beyond that 5%.
NAMI Montana has asked the Governor's office to please consider all of the reductions in the mental illness treatment system, including the cancelled renovation at the State Hospital, to ensure that Montanans with serious mental illnesses and their families don't bear more than our share of the burden of the budget cuts.
How You Can Get Involved
The most effective method of getting your voice heard on this issue is to contact Governor Schwietzer's office directly. His phone number is (406) 444-3111. You can write to him through the Governor's website, http://governor.mt.gov/contact/commentsform.asp. You can also send him a letter at this address:
Governor Brian D. Schweitzer
Office of the Governor
Montana State Capitol Bldg.
P.O. Box 200801
Helena MT 59620-0801
It's your state and your mental illness treatment system. Don't be afraid to express your views on how that system should be affected by the upcoming budget cuts.
Sincerely,
Matt Kuntz
NAMI Montana
Wednesday, January 13, 2010
Monday, January 11, 2010
No Good Deed Goes Unpunished
The National Alliance on Mental Illness for Montana (NAMI Montana) works with and against politicians all of the time. We don’t care whether someone is a Democrat or a Republican. The real issue for our organization is whether the politician is trying to help the one-in-five Montana families affected by serious mental illnesses. In many instances, we’ll support a politician on one issue and then fight them on another. With Montana’s suicide rate repeatedly among the highest in the country, we can’t afford to be ideologues. There’s just too much at stake.
In August of 2008, I met with Senator Baucus’s staff to provide input to their efforts to improve the healthcare system. NAMI’s position is simple. We’d like to get as many people access to medical care as possible. We also think that insurers should not be able to provide less coverage for biological brain disorders than they do for illnesses in other parts of the body. While many of our members may have different opinions about what the overall medical care treatment system should look like, those are our general goals.
Senator Baucus’s staff said that the Senator also supported those objectives and they felt we would be happy with their legislation. Then we discussed some of the challenges that they expected the legislation to face. The Senator’s staff was very clear that it was going to be hard to get a healthcare bill through the Senate. Anything too liberal or too conservative would fail. A bill with too high of a budget would also fail. They had to put aside utopian visions in favor brass tacks ways to improve the current system.
In the year and a half since that meeting, the healthcare reform debate stewed and then exploded. The men and women fighting for and against the legislation have been repeatedly tarred and feathered. For the most part, NAMI Montana stayed out of it. NAMI National has a federal advocacy staff that read every bill and fought for each point. But as far as we were concerned, Senator Baucus knew what Montana families affected by serious mental illness wanted and we trusted him to deliver it.
It’s too early to know what the final legislation is going to look like, but I asked NAMI’s Federal Advocacy Director to examine the Senate Bill to determine whether Senator Baucus kept his promise to our families. According to his analysis, the expansion of Medicaid eligibility alone will extend “health coverage and security to literally millions of Americans living with serious mental illness, including childless adults not able to qualify for Medicaid in their state.” The Senate bill also specifically requires that all of the health plans offered through new health insurance exchanges comply with the federal parity law that requires insurance companies to provide coverage for mental illnesses to the same degree they cover other illnesses. With those provisions, the Senate Bill honors Senator Baucus’s commitments to Montana families affected by serious mental illnesses.
The Senate Bill goes far beyond those provisions to protect the public from some of the more insidious practices in the insurance industry such as prohibiting the use of pre-existing health condition exclusions and caps on insurance payouts. The Senate Bill also provides for guaranteed issue and guaranteed renewal of coverage in the individual and small group markets. These consumer protection provisions will make a big difference in the lives of Montana families who are unfortunate enough to have a family member become seriously ill.
Senator Baucus, thank you for sticking your neck out to improve America’s healthcare system. When the dust settles, your efforts are going to improve the lives of a lot of Montana families. We really appreciate it.
Sincerely,
Matt
Matt Kuntz is the Executive Director of the National Alliance on Mental Illness for Montana (NAMI Montana).
In August of 2008, I met with Senator Baucus’s staff to provide input to their efforts to improve the healthcare system. NAMI’s position is simple. We’d like to get as many people access to medical care as possible. We also think that insurers should not be able to provide less coverage for biological brain disorders than they do for illnesses in other parts of the body. While many of our members may have different opinions about what the overall medical care treatment system should look like, those are our general goals.
Senator Baucus’s staff said that the Senator also supported those objectives and they felt we would be happy with their legislation. Then we discussed some of the challenges that they expected the legislation to face. The Senator’s staff was very clear that it was going to be hard to get a healthcare bill through the Senate. Anything too liberal or too conservative would fail. A bill with too high of a budget would also fail. They had to put aside utopian visions in favor brass tacks ways to improve the current system.
In the year and a half since that meeting, the healthcare reform debate stewed and then exploded. The men and women fighting for and against the legislation have been repeatedly tarred and feathered. For the most part, NAMI Montana stayed out of it. NAMI National has a federal advocacy staff that read every bill and fought for each point. But as far as we were concerned, Senator Baucus knew what Montana families affected by serious mental illness wanted and we trusted him to deliver it.
It’s too early to know what the final legislation is going to look like, but I asked NAMI’s Federal Advocacy Director to examine the Senate Bill to determine whether Senator Baucus kept his promise to our families. According to his analysis, the expansion of Medicaid eligibility alone will extend “health coverage and security to literally millions of Americans living with serious mental illness, including childless adults not able to qualify for Medicaid in their state.” The Senate bill also specifically requires that all of the health plans offered through new health insurance exchanges comply with the federal parity law that requires insurance companies to provide coverage for mental illnesses to the same degree they cover other illnesses. With those provisions, the Senate Bill honors Senator Baucus’s commitments to Montana families affected by serious mental illnesses.
The Senate Bill goes far beyond those provisions to protect the public from some of the more insidious practices in the insurance industry such as prohibiting the use of pre-existing health condition exclusions and caps on insurance payouts. The Senate Bill also provides for guaranteed issue and guaranteed renewal of coverage in the individual and small group markets. These consumer protection provisions will make a big difference in the lives of Montana families who are unfortunate enough to have a family member become seriously ill.
Senator Baucus, thank you for sticking your neck out to improve America’s healthcare system. When the dust settles, your efforts are going to improve the lives of a lot of Montana families. We really appreciate it.
Sincerely,
Matt
Matt Kuntz is the Executive Director of the National Alliance on Mental Illness for Montana (NAMI Montana).
Monday, December 21, 2009
Montana Legislature
Earlier this weekend I sent many of you the NAMI E-Advocate Newsletter. The emphasis of NAMI National this year is to maintain funding for state mental illness treatment budgets. Massive cuts to mental illness treatment budgets are occurring nationwide and we may be just beginning to feel the effects here in Montana. Interim Legislative Committees are sounding like there will be limited funding during the 2010 Legislative Session. Last week is was rumored there is currently a $250 million budget shortfall. And to rub salt in the wounds, last Monday the Health Care & Benefits Division of the Department of Administration sent out a letter informing state employees that the State of Montana has elected to exempt the Employee Group Benefit Plan from the following requirement; Parity in the application of certain benefits to mental health.
Individuals suffering from severe mental illness continue to be throw-away citizens. Even though 1 in 17, or 6%, of our population suffer from severe mental illness and the expected life span of those who suffer from severe mental illness is 25 years less than the average citizen, our society continues to greatly discriminate against this population. Until the 20% of the Montana families who have a family member who suffers from severe mental illness can convince the other 80% of families who don't have a family member who suffers from severe mental illness, our family members will continue to suffer.
Even if there is a budget shortfall we must continue to advocate to maintain these necessary services. The recent suicide at the Montana State Prison demonstrates what happens when an individual is unable to access needed mental illness treatment services. We must find ways to make improvements in the system even if there is not new funding. And, it can be done.
Dr. Gary Mihelish
Individuals suffering from severe mental illness continue to be throw-away citizens. Even though 1 in 17, or 6%, of our population suffer from severe mental illness and the expected life span of those who suffer from severe mental illness is 25 years less than the average citizen, our society continues to greatly discriminate against this population. Until the 20% of the Montana families who have a family member who suffers from severe mental illness can convince the other 80% of families who don't have a family member who suffers from severe mental illness, our family members will continue to suffer.
Even if there is a budget shortfall we must continue to advocate to maintain these necessary services. The recent suicide at the Montana State Prison demonstrates what happens when an individual is unable to access needed mental illness treatment services. We must find ways to make improvements in the system even if there is not new funding. And, it can be done.
Dr. Gary Mihelish
Thursday, December 17, 2009
Prison Suicide
Tuesday I read articles in both the Helena Independent Record and the Great Falls Tribune about the tragic suicide of the 28 year old inmate who suffered from schizophrenia who hanged himself on Monday. Please forgive me if I offend anybody, but please allow me to vent.
I do not pretend to know any of the circumstances related to this young man's incarceration related to the fact he was convicted of killing his mother in 2006. I have heard his mother also suffered from schizophrenia, but I do not know that for sure. This story is all too familiar to NAMI families. As I said, I do not know the actual circumstances of this tragedy, but let me guess how these events has transpired over the years.
Brandon John Orr probably developed schizophrenia in either his late teens or early twenties. From the story it would appear that he did not receive adequate treatment or did not receive any treatment at all. I do not know if his mother tried to access treatment for him, but in most cases she would have tried. Then one night while she was sleeping his command hallucinations instructed him to kill his mother. He may have done this because he hated her or wanted to save her from a worse fate. He then hit her in the head with a hammer while she was sleeping and then slit her throat.
He pleaded guilty to the crime and was hospitalized in the Montana State Hospital. There was probably no chance he would ever be released back into public life. He was receiving treatment at the Montana State Hospital until July when he was transferred to the Montana State Prison. He probably received better treatment at the hospital, but since he would probably never be released and the hospital is overcrowded, he was transferred to the prison. He probably received some treatment at the prison, but it was not as effective as the state hospital. The prison's responsibility is to incarcerate dangerous felons and protect the public and they are effective in doing that. He was very cordial when the staff brought him his food. :"He was kind and the staff did not see any problems." Then he hanged himself in a one person cell on Monday.
Who is to blame and who will take the responsibility? We can say "the system" failed and everybody is off the hook. We know that mental illness cannot be prevented, but disability can be prevented. Early intervention and appropriate treatment can prevent disability. We now know that early treatment to avoid psychosis, mania and depression can prevent damage to the brain and reduce cognitive deficits and an individual can lead a rewarding life and recover. But the law implies that a criteria of "imminent danger" is required to mandate treatment. By the time Brandon Orr was an "imminent danger" his mother was dead.
Now Brandon Orr is dead and two lives have been tragically lost to mental illness. If the pattern continues another Montanan will lose their life to mental illness in the near future or maybe even take the life of another individual. But, we do not have to accept the blame or responsibility. We can continue to blame "the system" and that relieves our guilt. There is an old saying, "The more things change, the more they stay the same." There have been significant changes in the mental illness treatment system in Montana, but people still die because they cannot access early intervention and appropriate treatment.
Every person suffering from a severe mental illness has, or had a mother and a father. They may have had a brother and a sister. The may have even had children. In most cases they had, or have someone who cares!
Dr. Gary Mihelish
I do not pretend to know any of the circumstances related to this young man's incarceration related to the fact he was convicted of killing his mother in 2006. I have heard his mother also suffered from schizophrenia, but I do not know that for sure. This story is all too familiar to NAMI families. As I said, I do not know the actual circumstances of this tragedy, but let me guess how these events has transpired over the years.
Brandon John Orr probably developed schizophrenia in either his late teens or early twenties. From the story it would appear that he did not receive adequate treatment or did not receive any treatment at all. I do not know if his mother tried to access treatment for him, but in most cases she would have tried. Then one night while she was sleeping his command hallucinations instructed him to kill his mother. He may have done this because he hated her or wanted to save her from a worse fate. He then hit her in the head with a hammer while she was sleeping and then slit her throat.
He pleaded guilty to the crime and was hospitalized in the Montana State Hospital. There was probably no chance he would ever be released back into public life. He was receiving treatment at the Montana State Hospital until July when he was transferred to the Montana State Prison. He probably received better treatment at the hospital, but since he would probably never be released and the hospital is overcrowded, he was transferred to the prison. He probably received some treatment at the prison, but it was not as effective as the state hospital. The prison's responsibility is to incarcerate dangerous felons and protect the public and they are effective in doing that. He was very cordial when the staff brought him his food. :"He was kind and the staff did not see any problems." Then he hanged himself in a one person cell on Monday.
Who is to blame and who will take the responsibility? We can say "the system" failed and everybody is off the hook. We know that mental illness cannot be prevented, but disability can be prevented. Early intervention and appropriate treatment can prevent disability. We now know that early treatment to avoid psychosis, mania and depression can prevent damage to the brain and reduce cognitive deficits and an individual can lead a rewarding life and recover. But the law implies that a criteria of "imminent danger" is required to mandate treatment. By the time Brandon Orr was an "imminent danger" his mother was dead.
Now Brandon Orr is dead and two lives have been tragically lost to mental illness. If the pattern continues another Montanan will lose their life to mental illness in the near future or maybe even take the life of another individual. But, we do not have to accept the blame or responsibility. We can continue to blame "the system" and that relieves our guilt. There is an old saying, "The more things change, the more they stay the same." There have been significant changes in the mental illness treatment system in Montana, but people still die because they cannot access early intervention and appropriate treatment.
Every person suffering from a severe mental illness has, or had a mother and a father. They may have had a brother and a sister. The may have even had children. In most cases they had, or have someone who cares!
Dr. Gary Mihelish
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