Mental health: Cuts at what cost?

Article published Jan 28, 2010

Mental health: Cuts at what cost? By DANIEL BARLOW Vermont Press Bureau MONTPELIER – Tom Slayton worries about his brother if Gov. James Douglas' proposed budget cuts are approved. Slayton, the former editor of Vermont Life magazine, said his brother was diagnosed with schizophrenia at the age of 19. Now in his late 60s, Slayton's brother has been in and out of homes all his life, including two years when he was homeless and living behind a Montpelier church. He's in a safe home now, Slayton said, and receiving the services he needs. But that could all soon end if the state cuts funding for Vermont's community mental health system. "There are hundreds, perhaps thousands, like him across the state," Slayton said at a Wednesday morning Statehouse press conference where he was joined by a dozen mental health organizations and a room full of supporters. "If we lose funding, how many will die? How many will injure themselves? These are the questions that we need to ask ourselves." Ken Libertoff, the executive director of the Vermont Association for Mental Health, said his estimates are that the governor's proposed budget has about a 5 percent cut for mental health, substance abuse and disability services. That's on top of the 4 percent cut these services saw in the current budget. He said if the state proposed cutting services to treat cancer, lung disease or other physical health emergencies, there would be a vast outcry. But because many people still see mental health as separate from physical health, it is easier politically to target these programs. "There is significant outrage, concern and fear out there that we are at the tipping point in our mental health system," he said. But convincing lawmakers to keep mental health and disability services free from the growing budget problem may be a hard sell. Vermont faces a $150 million hole in next year's budget – and an even larger estimated hole in 2011 – and Democrats and Republicans say they are united in finding fiscal solutions that don't include new taxes. Several key Democratic lawmakers spoke at the press conference Wednesday, each with different takes on how to tackle the issue. Sen. Doug Racine, D-Chittenden, the chairman of the Senate Health and Welfare Committee and a gubernatorial candidate, suggested, for example, using some of the state's $60 million rainy day fund to close the budget gap. Sen. Susan Bartlett, D-Lamoille, the chair of the Senate Appropriations Committee and also a gubernatorial candidate, called on the mental health system to consolidate organizations and cut administrative costs by 8-10 percent to retain more services for their consumers. Senate President Pro Tem Peter Shumlin, D-Windham, also a gubernatorial candidate, offered less specifics, but said the state faces the danger of heading backwards toward its policy of institutionalizing the disabled as opposed to caring for them in community settings. House Speaker Shap Smith, D-Morristown, said lawmakers know there are "real consequences to the decisions we make here." He agreed with Libertoff that many still see mental and physical health as separate, adding that if funding for cancer treatment was cut there would be "blood in the streets." "We forget that," he said. "It's partly because of the language we use. But it is also partly because of societal prejudice." Libertoff said it is particularly frustrating for him to see the Vermont State Hospital in Waterbury, the state's former asylum, still open in the year 2010 with about 50 patients about two decades after state officials first began the process of shutting it down. Because of the poor conditions at that hospital, it has lost federal funding, costing the state about $40 million more over the last several years. Add into that total another $10 million in changes at the hospital and $2 million for replacement designs that seem to be stalled, and Libertoff said it is clear that the state is putting its resources in the wrong place. "We are spending money, but we are not spending it in the right place," he said. "There is a ticking clock. There is a finite number of dollars for mental health and right now it is going toward a program that is not moving forward." Connie Stabler, the board president of the Vermont chapter of the National Alliance on Mental Illness, said cutting these services does not make fiscal sense because it will simply push costs elsewhere, such as law enforcement and corrections. "Many people who are trying to get services today are being told there are no services," she said. "It's going to get worse. We are going to fill up our hospitals and our prisons." Daniel.Barlow@timesargus.com