The Washington County Mental Health & Addiction Recovery (MHAR) Board is seeking from voters approval of a one-mil, five-year levy for mental health and addiction treatment services for county residents who are not covered by insurance or Medicaid. This will enable the MHAR Board to restore basic services lost over the past five years because of devastating funding cuts.
More than two million Ohioans have a mental illness, yet less than one-third of adults and one-half of children receive treatment. Mental illnesses are biologically based brain disorders that disrupt a person's thinking, feeling, mood, daily functioning and ability to relate to others. Mental illnesses cannot be overcome through willpower and are not related to a person's character. In a study conducted by the World Health Organization, mental illness is second only to cardiovascular disease in regard to burden (i.e., years of life lost to premature death or disability).
An effective mental health and addiction treatment system includes a spectrum of services, from state hospitals for the most severely mentally ill and detoxification services for treating addiction to services provided in the community on an out-patient basis, like counseling, case management, and housing and job placement services. The key is a balance between making sure beds are available at the state hospital for those who truly need such intensive treatment and having enough community services in place to keep people out of those beds.
For years the state provided local alcohol, drug addiction and mental health boards an allocation from which to pay for the following: purchasing bed days in state psychiatric hospitals, paying the state's share of Medicaid match and funding community services and supports. Over time, the Medicaid match obligation and the cost of state hospital bed days continued to rise, while the total amount of state funding declined. As a result, 75 percent of the funding the MHAR Board had left to purchase critical and cost-effective community services has been cut. That has created the hole we are trying to fill.
The consequences are being felt across Ohio. According to the Ohio Suicide Prevention Foundation, an average of three Ohioans die each day by suicide, which is a 10-year high. Most suicides, 43 percent, occur in men between the ages of 36 and 65. According to the Ohio Hospital Association, four Ohioans die each day because of drug-related overdoses. The Ohio Department of Public Safety reports that since 2007 there have been more deaths from drug overdose than from motor vehicle crashes. We can't help but feel we could have saved some of these lives if the individual could have accessed life-saving treatment.
When mental health services are inaccessible, the impact is felt in all areas of our economy and society. Untreated mental illness results in missed educational opportunities for children, lost productivity and unemployment, inappropriate use of hospital emergency departments and increased crime and incarceration. Based on numbers provided by several State Departments, for the cost of one prison bed at $25,000 annually, three individuals with mental illness (the average annual cost of community mental health treatment, including two anti-psychotic medications, is $7,400) or 15 individuals in need of addiction treatment (average $1,600 annually) could be served in the community. For the cost of one bed in the Department of Youth Services, at an annual cost of $85,000, 11 individuals with mental illness or 53 individuals in need of addiction treatment could be served in the community. For the cost of one state psychiatric bed, 26 individuals with mental illness could be served in the community. We are all paying the cost of untreated mental illness, just not directly. But it would be less expensive overall, and keep people in the community, if we could treat mental illness and addiction before they become emergencies, or possibly lead to incarceration.
Currently in Washington County we are just trying to keep people maintained and out of the state hospital system. We are unable to pay for the full array of services necessary to teach people the skills need to overcome their addiction and/or mental health problems. Due to lack of funding, even the most severely mentally ill people are not receiving the support services necessary to facilitate recovery.
Recovery refers to the process in which people are able to live, work, learn and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life; for others, recovery implies the reduction or complete remission of symptoms. Recovery support services contribute to an improved quality of life for an individual by facilitating social connections, community supports, education and empowerment. These supports allow a person to better understand their illness and focus on their recovery. Every individual is different, so a different mix of these services is applicable to each person's circumstance.
Currently, L & P Services, located on Colegate Drive in Marietta, is the only provider under contract with the MHAR Board to provide services to those people without Medicaid coverage. There seems to be a misconception that the MHAR Board gives L & P Services money and they are then responsible to provide services to everyone. That is untrue. L & P Services is reimbursed on a fee-for-service basis. Fee-for-service is the predominant method of payment for health care in which a payor pays a provider for treatment provided upon submission of a valid claim. L & P Services does not receive funding from us unless they have provided specific services to individuals. A service provider must earn the money before the MHAR board will pay the claim. The rates for reimbursement are set by Medicaid and have not increased in over ten years.
Another misunderstanding is that services are not available locally. L & P Services offers the same services to those without insurance or Medicaid as to those with insurance or Medicaid. But they cannot provide the services for free. Until we have a way to pay for it, those individuals cannot access these services.
A "yes" vote for the levy will allow us to re-establish a sliding fee scale so that individuals who do not have insurance or Medicaid, but do have a certain level of income, will pay for services based on household income and the number of people in the household dependent on that income.
We are not asking for money from the taxpayers so we can go out and try new things and new programs; we are asking for funds to get us back to the same basic level of service provision as we had five years ago. Those funds will be invested into proven and cost-effective methods for treating mental illness and facilitating recovery. It will enable access to services for those who need and want it.
Treatment works. People recover. Recovering people work. Working people pay taxes. Please invest in Washington County's future by voting "yes" for the levy.
David Browne is executive director of the Washington County Mental Health & Addiction Recovery Board, 344 Muskingum Drive, Marietta.