Decline in state’s mental health programs unconscionable

The Capital Times

As the father of a son with serious mental illness, I was saddened to see how my state’s mental health program scored in a recent national study. It received a fair-to-poor grade, a score of C.

In 2006 our state had received a B and since no state had earned an A, this performance went largely unnoticed, in part because Wisconsin is the birthplace of a pre-eminent national mental health advocacy organization ---the National Alliance on Mental Illness. NAMI has led the nation both in mental health advocacy and in the creation of the most innovative and effective community-based service program model in the nation.

In 2006 NAMI National conducted and published its first Grading the States Report: “Grading the States 2006: A Report on America’s Health Care System for Serious Mental Illness. Recently NAMI released its Grade the States 2009 report. In it they used the 2006 findings for baseline comparisons. This report measures each state’s progress ---or lack of progress in many cases ---in providing evidence-based, cost-effective recovery- oriented services for children and adults living with serious mental illness.

In NAMI’s 2006 progress report the nation’s grade was D and Wisconsin scored a B. In this more recently released report the nation again scored a D while Wisconsin’s grade slipped downward from a B to C. Wisconsin was one of twelve states who fell back while 23 states stayed the same. Wisconsin has over 188,000 residents with serious mental illness.

Measures evaluated by NAMI had to do with the extent that the state mental health program had a workforce development plan, state mental health insurance parity laws and mental health coverage in programs for the uninsured. Other significant measures included the state’s ability to provide accurate data on a variety of services, including evidenced-based practices, service outcomes, and demographic data. Such measures undergird NAMI’s fundamental assertion that public funding for mental health treatment services must be tied to outcome performance measures.

Financing and core service measures also included Wisconsin’s 79 Community Support Programs (CSPs). These programs were found to fall far short of national fidelity standards. Funded in part by state Medicaid funds but heavily dependent on local county tax dollars, CBS produces a wide range of service quality and performance outcomes throughout the state.

The Division of Mental Health and Substance Abuse Services (DMHSAS) is the state mental health agency that works directly with county mental health agencies. While DMHSAS 2008 -09 program plans were found to be well intended, they failed to address these critical deficiencies.

Ironically, this conclusion was also supported in an August 2007 Wisconsin Council on Mental Health letter. Members of the council expressed concern “about the bluntness and ineffectiveness of the DMHSAS State Plan indicators as measures of state progress toward meeting important mental health goals and objectives.”

This state planning and review public watchdog agency also expressed its “concern about the quality and sources of data collected.” Its concern was particularly acute with respect to reports of services by counties who were delegated much of the responsibility for the plan’s implementation.

Let me quote the council: “Both the DMHSAS indicators and Department of Human and Family Services data are critical for the State and council to identify and support appropriate funding recommendations and decisions. Our recommendations are unfortunately undercut by inadequacies in both.“

So what has caused Wisconsin’s once innovative and dynamic mental health program to sink into mediocrity? This report suggests limited access and availability of services; insufficient funding; inequities of the state’s decentralized funding system and a still- broken information system that cripples the state’s ability to effectively plan, evaluate and account for its spending and service-delivery decisions.

If this isn’t a call to action what is? Won’t you join with NAMI and with our mentally ill sister and brothers and their families and as concerned taxpayers simply say, “We are not going to take this anymore!”