November 23, 2024
Editorial

CUTTING THE MENTALLY ILL

The Legislature’s Appropriations Committee is expected to encounter the toughest cuts of the governor’s partial attempt at closing the budget gap today, when it considers his plan to reduce funding by as much as $9 million to providers of direct care to the mentally ill. Those providers say this will mean that up to 4,000 fewer people will receive services, meaning that more will end up in local homeless shelters, more in jail and a few, perhaps, at the morgue. Documenting the savings in the governor’s plan today should prove interesting.

The state’s promise for the last 25 years in mental health has been that through proper treatment and attention, mentally ill people no longer needed to live in large institutions but could be better cared for in small community settings, thereby becoming more productive members of society and saving the state money. Maine’s Department of Behavioral and Developmental Services (BDS) has significantly expanded its regional offices in recent years even as it has reduced its institutional staffs. But it is the local nonprofit service providers that do most of the direct care and that are facing the governor’s cut.

Legislators no longer have time for a thorough review of the state’s mental health system before deciding whether to support this reduction, but they can ask this: Can the department cut administration and non direct-care workers before it passes the cuts on to the agencies and people who are providing treatment? After all, no administrative jobs are being cut under the King plan even as the department would have fewer clients to oversee; Commissioner Lynn Duby says turnover is high and predictable enough to create sufficient administrative vacancies, a fair point, but lawmakers must ask about actual cuts in precisely this area because the current proposal is so severe.

This is an important question for humanitarian reasons. Can anyone imagine treating the physically ill like this – saying sorry about the heart attack but we have a budget shortage so stay home and hope it goes away? It is also important because the $9 million is not actually being saved, part of it is simply shifted to the local level, on to property taxes that go toward homeless shelters, police departments and jails. When treatment is abandoned, this is the next step for many, though not all, mentally ill.

The job for lawmakers grows more difficult as they contemplate not just this ever-growing deficit but also the shortfall in the next budget cycle. The nonprofit providers know what is coming – more cuts, more layoffs, more mentally ill turned away from service. They want to know what the state’s plan is for serving this population, whether the state regional offices will grow and the nonprofit services will be pushed out or if they remain integral to the state’s plan. If it is the latter, why are they being handed some of the most severe cuts in the budget package?

Political candidates have just spent the last several months assuring Maine that its taxes would be cut and its budget put in order. Those are easy ideas in the abstract. But the service providers for the mentally ill don’t live in the abstract, they live with real people and real families in desperate need of help and they live with turning these people away because there is no state money to support them. With luck today, the members of the Appropriations Committee will see these very real problems too and take yet another look at the cuts in the department.


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