Adequate and available mental health care was the focus of the Institute for Public Policy and Social Research’s first fall Public Policy Forum. A call for collaborative solutions and integration between public services rang through the the forum as panelists outlined mental health services for those in the criminal justice system, for military veterans and their families transitioning to civilian life, and for patients struggling with addictions yet unaware of the resources available to them.
All called for efforts to end stigmas associated with behavioral health problems and to break down the ‘silos’ that stand in the way of a community of caring that addresses issues and works to produce solutions in a holistic way.
Sheryl Kubiak, professor of social work at Michigan State University, spoke on the burden placed on local law enforcement officers who are often the first responders in cases of behavioral health problems. Kubiak described the purpose of 24-hour crisis centers and how their low numbers force law enforcement officers to take patients straight to emergency rooms where psychiatric beds are often in low supply too. Multiple members of the forum panel related hospital emergency rooms to ‘ground zero’ where mental health patients can receive immediate treatment but due to ER resources and capabilities, long-term patient care varies.
Because long-term behavioral health problems aren’t consistently addressed law enforcement funding is often on patient issues which could be prevented with suitable long-term care options.
Similarly, within county jails, the question of where funding comes from and who is responsible for patient care is a common theme in mental health debate, panelists said. Kubiak repeatedly pointed out that jail staff isn’t necessarily trained to detect symptoms related to behavioral health problems, and that the tools to intercept those exhibiting behavioral health issues are often ‘risk’ driven rather than valid mental health screening tools. In many cases, inmates also receive different medications during treatment than they were prescribed while living outside jail or prison. That can be caused by lack of funding and a disconnect between community services and the criminal justice system.
Tom Watkins, president and chief executive officer at Detroit Wayne Mental Health Authority, called for those involved with behavioral health care to start speaking about and understanding the integration of care at a provider level, rather than at a funding level. Watkins reminded the audience that no one in a community is unaffected when health care problems are addressed from the wrong angle and patients fail to receive the care they need.
Adrian Blow, MSU associate professor of human development and family studies, presented alarming statistics about the mental health of veterans and their spouses during a veteran’s transition to civilian life. Veteran suicide rates are up 35 percent since 2001 and suicide risks are at a peak during the first 12 months after a soldier returns home from combat. Both veterans and their spouses encounter barriers that stand in the way of the mental health services they need, he said. Most obstacles are related to the stigma of seeking help and the often complex logistics of knowing where to look for treatment and what resources are available. A recent poll included in the MSU’s State of the State Survey indicated that Michigan citizens were willing to pay additional taxes to help veterans transition to civilian life and obtain the mental health services needed to do so.
As the forum continued into a discussion period, Tom Watkins explained why it is essential for the integration of behavioral health care to shift to a local and service delivery level. Forum panelists agreed that communities need to address and end stigmas associated with mental health problems. Watkins called for audience members to watch and share the video, Opening Minds, Ending Stigmas. Members of the audience also agreed with the panelists’ call to begin training to address behavioral health problems early, whether at the academy level for law enforcement officers or in degree programs for educational administrators and teachers. Early intervention on all fronts is critical and services must remain consistently available to all mental health patients, especially when they are actively seeking and ready for help. The ‘silos’ separating different services and activities related to mental health care will only be broken down if systems involved actively work together and public policy becomes driven by a common understanding that the primary mission of mental health care is to help some of the most vulnerable citizens in our society.
