American Forum Op-Ed

GEORGIA FORUM

By Paul Bolster

Congratulations to Georgia for recently settling the challenge to its mental health system that has hung over the state for years.

The settlement of U.S. v Georgia will shift treatment from a reliance on hospitalization and incarceration to a reliance on community-based treatment. The new plan, which won support from all parties to the federal lawsuit, came from the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD).

Yes, the DBHDD budget will be bigger, but the cost and local burden will be less than what we now spend on jails, prisons and hospital rooms for the same individuals. With the legislature’s support, the DBHDD budget must increase by $90 million state dollars over this and the next budget year. These dollars will draw down more federal dollars to support the change.

More importantly, the plan will offer health and housing rather than incarceration and neglect.

One in every four Georgians lives every day with mental illness. Many of these persons live isolated from our community life, much like the “caves” in Biblical times. Our modern caves are local jails, state prisons, mental health hospitals, nursing homes, and homeless encampments. Some 20 percent of new state prisoners are being treated for mental illness at the time of their incarceration. Our local jails have become treatment centers for mental illness and addiction. The cost of mental health treatment shows up in the sheriff’s jail budget, at the hospital emergency room and on a homeowner’s property tax bill.

Supported housing is a critical component of the settlement. We know it works. If support services are creatively connected to affordable housing, persons with mental illness, who are now caught in the justice system, can live stable lives in our communities. When you close the door to the hospital, you must open a door to a home in the community. The settlement will expand treatment capacity for persons with serious mental illness, but it also calls for the state to have “capacity to provide supported housing to any of the 9,000 people in the target population who need such support.”

In a broad outline, the settlement expands: 1. Primary mental health treatment; 2. Crisis services; 3. Intensive case management; and 4. Supported employment. But the glue that holds the plan together is supported housing. Housing is the key to health.

By shifting mental health resources away from institutions, Georgia will put into practice the many lessons we have learned about mental illness over recent decades. Modern medications can help persons we used to “shut away.” It’s time to let people with a disability live in housing just like the rest of us. If we do this right, we will become a model for other states.

It bears repeating -- this new approach will cost taxpayers less in the long run. State data projects that we could lower institutional spending by $13,000 for every person with mental illness that we succeed in helping to attain housing.

However, the work is not over just because a federal judge has given his blessing to the plan. We have had “shelved” plans before. Our local representatives will need to support the settlement as well. Local officials will need to get behind plans that create supported housing in their communities. Churches, service providers and nonprofit organizations will have opportunities to help bring about the change. Under the settlement there is a real opportunity for citizens to make a significant difference in the lives of our neighbors and friends. We all need to roll up our sleeves and get to work.
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Bolster is the Executive Director of the Georgia Supportive Housing Association.
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Copyright (C) 2010 by Georgia Forum. 11/10