Short-Sighted Budget Cuts Hurt Us All

Ohio once was a state that provided good mental health services. It was a leader in evidence-based, community recovery programs. It was a model when it came to implementing Crisis Intervention Teams, Mental Health Courts, and jail diversion programs. 

Tragically, short-sighted budget cuts and poor leadership has caused Ohio to slip from being a leader to becoming a failure.

In a recent front page story headlined: “Illusion of Treatment,” Columbus Dispatch reporters Alan Johnson and Catherine Candisky warned that Ohio’s system is “on the verge of collapse.”

Thousands have been slashed from the mental-health-care rolls. Others might have to wait months to see a psychiatrist. State funding for mental-health services has been decimated…hundreds of small group homes for the mentally ill have closed.

Prisons, nursing facilities and homeless shelters are the new homes for thousands of mentally ill Ohioans…“Our state leaders have washed their hands of Ohioans who are suffering from mental illness,” said Terry Russell, a veteran of 37 years at the local and state level in Ohio’s mental-health system. “If we are to be judged by how we treat the sickest in our society, we should all be ashamed.”

Like other states, Ohio faces huge deficients — an $8 billion budget shortfall. The governor and legislature have reacted by slashing some $100 million in the past three years from community mental health care services.

Ohio is not alone in making drastic cuts in mental health care budgets. I returned last week from Texas which is poised to cut services. Virginia may soon close two much-needed hospitals. Pick a state and you will hear the same lament. Cuts must be made and mental health services are an easy target.

While I understand the need for belt-tightening, cuts to mental health services actually cost a state money rather than saving it funds.

How is that possible?

Because serious mental disorders don’t disappear just because you stop paying to treat them. Like stepping on a balloon, the costs associated with mental illnesses simply shift over and increase costs in areas, such as jails and prisons.

The Perryman Group, a Texas-based economic research and analysis company, was asked in 2009 to study the Texas mental health service. What it found should be required reading by every governor and state legislator in our nation.

The group looked at the cost to Texas for medication, hospitalizations, clinic visits and emergency rooms visits by persons with mental disorders. Economists also factored in what they called “spill over” costs, such as lost earning potential, lost tax revenues, the costs of jails and prisons, the impact of alcohol and drug abuse in a community, and costs due to homelessness.

What it concluded was that “savings generally exceed the cost of providing mental health and substance abuse treatment in a state.”

The authors found that providing treatment for alcohol and substance abuse would give the state a return on investment of $2.26 for every $1 that was spent. Jail diversion, which enables persons with mental disorders to get treatment rather than being locked-up, averaged a return to the state of $2.70 per every $1 that it spent.

The most interesting statistic was a projection about cuts that Texas has made during the last decade. If the state had stuck with the budget that it had in 2000 for mental health and substance abuse services, rather than butchering those funds — Texas would be earning a  170% return on its money or netting $32.76 today for every dollar that it spent.

Instead, reducing services resulted in Texas losing productivity, losing jobs, and losing tax revenues. At the same time, Texas has seen an increase in state costs for jails, an increase in suicides, increases in drug and alcohol addiction, and an increase in homelessness.

After crunching the numbers, the Perryman group concluded that cutting the mental health services in Texas actually had contributed to the budget deficit that the state now faces, rather than helping reduce it!

None of this surprises me because I have witnessed it on a personal level. When my son, Mike, was psychotic, he was arrested. He ended-up in costly emergency rooms. He was hospitalized.

Thankfully, a case manager in a jail diversion program took charge of his case. She got him into an apartment, into treatment, and eventually got him a job. Today, he is paying taxes and is in recovery.

Not everyone is as fortunate as my son, but I have seen people recover who once would have been considered “unrestorable” and locked in back hospital wards.

We must stop paying more and more each year for bigger jails, more prisons, endless hospital emergency visits and overnight stays in traditional homeless shelters. We need to use our sparse tax dollars to pay for evidence based programs that actually help people recover.

Please tell your state politicians about the Perryman report. Please tell them that recovery is possible. It is not only the moral thing to do, but now we know it is the financially smart thing to do.



About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.