On Vermont Public Radio’s “Vermont Edition” House Speaker Shap Smith shared how the tragic events in Newtown touched him at a deeply personal level, and stated “this is a mental health issue and an issue about guns.”
In the wake of the Newtown tragedy, President Obama has pledged to make “access to mental health care as easy as access to a gun.” His proposal details the need “to increase access to mental services” and to “ensure quality coverage of mental health treatment.” Indeed, research shows that as access to mental health care goes down, violence and homicides go up.
Sadly, in Vermont, access to mental health care is in crisis and it continues to get worse.
On Jan. 1, the Department of Vermont Health Access, which manages the state Medicaid budget, slashed outpatient mental health care reimbursement rates by nearly 10.5 percent. Most other provider groups received a boost in reimbursement rates. Now, the state’s most vulnerable citizens — those with chronic physical and mental health issues — are even more vulnerable because access to outpatient mental health services is in jeopardy.
Vermont’s struggling mental health system was dealt a serious blow by Tropical Storm Irene, when 54 inpatient beds were closed in Waterbury. Many hospitals, small residential programs, and emergency departments have done an outstanding job of trying to stabilize patients in acute psychological distress. The inpatient crisis is ongoing despite progress made in beginning construction on a new state facility.
However, outpatient mental health practitioners in public agencies and private practice are, and continue to be, the workforce that delivers most of the mental health services in Vermont. Outpatient providers work tirelessly to keep patients stabilized, prevent hospitalization, and treat those who suffer from depression, anxiety, addictive disorders and other often life-threatening conditions.
What is the state doing to support these front-line practitioners? The Department of Vermont Health Access has cut reimbursement rates for mental health care. This is reckless and short-sighted. It bends the health care cost curve in the wrong direction. Decreasing Medicaid pay rates to outpatient mental health providers jeopardizes the success of health care reform, interferes with recruitment and retention of quality mental health professionals, and forces current providers to reconsider accepting new patients.
This oversight needs urgent correction. When mental health issues are untreated, it doesn’t just increase the physical and mental suffering of individuals. It affects all of us, whether it’s a tragedy of the magnitude of Newtown or commonplace events such as domestic violence, suicide, divorce, grief, stress, sexual misconduct, etc. And, as such, untreated mental health conditions increase costs.
The facts speak for themselves. Every $1 spent on mental health and addiction treatment saves $7 to $10 in overall health costs. The World Health Organization suggests that mental disorders are the most costly conditions in the world because of the inseparable interconnection of the mind and the body, even going so far as to suggest that many chronic physical illnesses are secondary to a primary mental illness. Nearly eight out of 10 patients with depression will improve through treatment.
Cutting outpatient mental health services will cost the state more lives, not less, and cost the taxpayers more money, not less. The outpatient mental health system is vital to our state’s fiscal health, public health and public safety.
If we don’t restore and increase funding for outpatient mental health services, we put public health and safety at risk and the entire health care delivery system under enormous strain.
Dr. Rick Barnett is president of the Vermont Psychological Association.
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