Cuts to mental health budgets affect New England

Massachusetts is worst hit

Of the changes to healthcare budgets across the country since 2009, New England is among the regions most in flux, according to a report issued by the National Alliance for Mental Illness. And though some New England states have actually seen an increase in their mental health budgets, Massachusetts has cut care by $55 million, more than any state in the region.

In NAMI’s report “State Mental Health Cuts: The Continuing Crisis,” Mass. is listed as losing 8.1 percent of its operating costs, which has resulted in cutting or shuttering programs offered by the Department of Mental Health. Three specific day services no longer supported by the state include Support, Education and Employment program; Day Treatment Programs and Social Clubs; and two PACT teams (Program for Assertive Community Treatment). Further, more than 150 hospital beds were lost when Westborough State Hospital closed in 2009, as well as a handful at Quincy Mental Health Center.

But while Mass. has suffered, some New England states have seen modest increases: Maine’s budget rose by 15.4 percent and R.I.’s by 10.6 percent. Vt. and N.H. weren’t as lucky, with increases of only 1 and 1.3 percents, respectively. According to Laurie Martinelli, executive director of NAMI Massachusetts, it’s hard to know exactly why some states see bumps while others endure losses.

“We’re like the poor stepchild,” says Martinelli, who has held her office since 2007. “Massachusetts touts itself as a leader of health reform, yet we give crumbs to mental health.”

Mass. isn’t the only state to suffer significantly. NAMI National’s report says that 28 states and D.C. have cut approximately $1.7 billion from their budgets, and among the nation’s 22 remaining states, mental health budgets increased about $487 million. The discrepancy in cutting versus increasing, says NAMI, was due to states cutting Medicaid, the country’s largest public payer of mental health care.

States with the largest funding cuts were Ill. (31.7 percent), Nev. (28.1 percent) and Calif. (21.2 percent).

Martinelli only surmised that when a state governor has no money, the first place to look is big-ticket items. In Mass., when the FY 2012 budget was released last year in mid-January, several DMH programs were on the chopping block. Between January and May, Martinelli says that an outcry from people who rely on the services helped put back at least $1 million.

“I feel optimistic about NAMI rallying the troops,” she says; but with the report by NAMI National saying that Mass. already has seen a $500 million decline in MassHealth, “I wish I could say I’m optimistic going forward.”

Martinelli does believe that active involvement by practitioners who treat patients suffering most from the cuts is a strong part of the solution. The relapse of clients recovering from mental illness – clients who have had their regular programs cut – appears to be the largest result from the Bay State’s budget woes.

“I think the first step is psychologists getting involved,” says Martinelli. Questioning how many practitioners actually know who their representatives are, she says there is power in psychologists, families and even clients themselves sharing in their own words about their experiences with cut programs or lacking services.

“People really underestimate the power of the personal story and what these cuts mean to practitioners.”