Psychiatr News July 7, 2006
Volume 41, Number 13, page 7
© 2006 American Psychiatric Association
Creative Thinking Needed To Stretch Limited Budgets
Rich Daly
Advocates are urged to work toward shifting juvenile-justice funding to
mental illness prevention and treatment programs.
Reflecting an increasingly austere federal and state budget environment, a
number of leaders at the 2006 annual meeting of the National Mental Health
Association (NMHA) urged colleagues to find more cost-effective ways to spend
the large sums already devoted to the various areas of mental health care.
Taking the stage at the mid-June event in Washington, D.C.—one of his
first public appearances since returning from a substance abuse rehabilitation
program—Rep. Patrick kennedy (D-R.I.) urged attendees to push their
elected officials for more funding to prevent mental illness, including
substance abuse.
"That's where we get the biggest bang for our buck," kennedy
said.
David Shern, Ph.D., president and CEO of NMHA, said no level of treatment
ever eliminated a disorder. He urged the increased use of "preventive
strategies" as the only way to eliminate mental illnesses.
Another way to make better use of existing funds is through increased
accountability from existing programs. kennedy called for more research on and
accountability from special-education programs, which have received steadily
larger amounts of funding in recent decades without showing commensurate gains
for the children in those programs.
One way to obtain more benefits from existing mental health programs is to
mandate the use of evidence-based practices and increased research into the
uses of cognitive-behavioral therapies that appear to be the most efficacious,
he suggested.
`Smarter' Spending Urged
"How can we spend smarter?" asked Jane knitzer, Ed.D., director
of the National Center for Children in Poverty, who noted that about $4
billion is spent annually nationwide on children's mental health, excluding
juvenile-justice programs.
| |
Jane Knitzer, Ed.D., tells attendees to push for a family-based mental
health treatment system.
David Hathcox
|
|
She urged the replacement of the mental health systems for both children
and adults with a family treatment system to treat all of the people affected
when mental illness arises.
She criticized the fact that many mental health programs "only
grudgingly" focus on the emerging research on various aspects of
children's mental health systems.
Another money-saving approach that kennedy urged mental health advocates to
take when approaching legislators is to highlight the low cost of the
long-sought goal of mental health parity coverage in insurance. He cited the
federal Office of Personnel Management's 2001 report, which found that adding
the benefit of mental health parity for federal employees increased costs by
just 1.3 percent, while other research has found parity's benefits exceed its
costs.
Change Traditional Treatment Paradigm
Expanding mental health care beyond the traditional single-patient-focused
approach was a common theme among the meeting's speakers. knitzer said new
data have identified the benefits of treating young mothers for depression as
an early intervention for their children. Research also has identified
benefits from cognitive-behavioral therapy for new mothers and their
children.
The benefits of familial approaches to therapy often extend beyond mental
health to other areas.
For example, depressed parents are less likely to buckle up their children
and provide adequate care for their asthmatic children, knitzer noted.
Comprehensive approaches can address increased use of the juvenile-justice
system as a place to confine children with mental illness, Shern said.
Comprehensive approaches also will benefit from increased use of
community-based care, which research has shown can facilitate recovery from
even the most severe mental illnesses.
A person not often cited by mental health advocates, former Speaker of the
House of Representatives Newt Gingrich, urged advocates during his keynote
address to push legislators to reorganize health care in ways that provide
mental health care as part of a person's comprehensive care.
Comprehensive approaches should include efforts to bring entire families
into planning the mental health treatment of individuals.
"More than enough" health care funding is now provided by
federal and state governments, he suggested, but antiquated allocation methods
squander much of the money on bureaucracy and allow fraud on a massive
scale.
"When you believe that money is being wasted, it is much more
difficult to get people to agree to give you new funding," Gingrich
said, noting that studies have found that about 10 percent of some Medicaid
programs' funding is lost to
graft.
| |
Rep. Patrick Kennedy (D-R.I.) advises attendees at the National Mental
Health Association's annual meeting to seek more government funding for mental
illness prevention efforts.
David Hathcox
|
|
Massive savings and better care are possible only when the current budget
system of program "silos" is scrapped in favor of an approach that
funds health care of the long-term, overall needs of each individual, said
Gingrich, founder of the Center for Health Transformation.
The major changes and reductions in Medicaid and Medicare programs in
recent years will likely accelerate over the next five years. The recent
controversial changes to those programs only make them more expensive and less
beneficial because the changes "are all chewing around the edges of the
programs." Only fundamental change will provide more care with fewer
dollars, he said.
Knitzer pointed out that mental health advocates spend considerable time
and money "end running the system" to get care for those in need
and that both could be better spent through a system that provided mental
health care regardless of the specific circumstances of those who need it.
Among the "key fiscal challenges" for mental health advocates,
knitzer said, is the ability to create new partnerships with emerging family
groups that push for improved mental health care for families and children.
Get information about faster international access.
Privacy Policy
Copyright © 2006
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
| 
