Behavioral Health Services in Chicago The Current Landscape for Mental Health and Substance Use. June 13, 2012

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1 + Behavioral Health Services in Chicago The Current Landscape for Mental Health and Substance Use June 13, 2012

2 + Eileen Durkin President & CEO Community Counseling Centers of Chicago (C4) C4 provides mental health services and substance use treatment to more than 10,000 adults and children at five sites.

3 + Investing in prevention, treatment, and recovery support services benefits everyone by reducing the social and economic burdens that substance use and mental disorders have on society. -SAMHSA 2012

4 + Overview Our current landscape is shifting. Mental illness and substance use have to be addressed as public health issues in order to deliver successful and cost-effective care. We need to collaborate and integrate a holistic approach that includes prevention strategies and community-based care.

5 + Our Current Landscape is Shifting Landmark consent decrees Colbert v. Quinn Williams v. Quinn Ligas v. Maram The Illinois Human Services Commission is making a plan to revamp human services. Budget cuts

6 + National Landscape Mental health issues cut across borders, race, gender, socioeconomic standing, and age. 1 in every 2 will experience a diagnosable mental illness over a lifetime (National Institute of Mental Health). In any given year, 57.7 million Americans 1 in 4 suffer from a mental illness (National Council for Community Behavioral Healthcare - NCCBH). Up to 2/3 homeless adults suffer from chronic alcoholism, drug addiction, mental illness, or a combination of all these three (NCCBH).

7 + Mental Illness in Illinois An estimated 20-30% are affected by mental illness in a given year million (National Institute of Mental Health - NIMH). 10% of our children (3.5 million) under 19 years of age have a serious emotional disturbance (NIMH). 11,000 people with mental illness in nursing homes, the largest number of any state (NAMI Report Card). Between 2009 and 2011, Illinois cut $113.7 for services for those living with mental illnesses (NAMI).

8 + Mental Health in Chicago Cook County Jail has been called the state s largest mental institution, with 1,200 cases at any one time. Mental disorders account for more than 13% of all hospitalizations citywide (Illinois Health Care Cost Containment Council). A CDC survey found that 40.4% of Chicagoans said that their mental health was not good at least once in the past 30 days. The same study found that 42.7% do not believe that people are caring and sympathetic towards the mentally ill (Behavioral Risk Factor Surveillance System Report). In the Uptown area, 1 in 4 hospitalizations are linked to mental disorders (Chicago Department of Public Health).

9 Illinois Mirrors National Trend National trend: States have cut $3.4 billion in mental health funding since 2009, while demand for community-based services increased by 56% (National Association of State Mental Health Program Directors). Illinois community mental health system is in shambles : NAMI s Grading the States gave Illinois a D in In 2011, Illinois was 1 st in mental health budget cuts with a reduction of more than 31% (NAMI). The budget cuts are creating a defunct mental health system. Dr. Joseph E. Troiani, Adler School of Professional Psychology

10 + Costs of the Cuts National Leads to increased and expensive use of emergency rooms, community hospitals, law enforcement agencies, correctional facilities, and homeless shelters (NAMI). Human suffering as a result: lost relationships, jobs, homes, shattered lives. Indirect economic costs are great: lost earnings, homelessness, incarceration, and increased healthcare costs. Mental illness drains our economy of more than $80 billion every year (National Council).

11 Costs of the Cuts Cutting Illinois mental health funding by $81 million now will ultimately cost Illinois taxpayers up to $403 million (Center for Tax and Budget Accountability). For every $1 spent on mental health, we save $5 (American Psychological Association). For every $1 invested in substance use disorder treatment, society saves $7.46 (Mental Health America). The budget reductions are cutting the safety net of last resort (NAMI).

12 Pitfalls and Uncertainty in the Current Landscape Slow reimbursements for fee-for-service is causing some providers to shut down due to lack of operating capital. Closing of city mental health clinics, while accompanied by extensive planning to transition services, causes significant anxiety for consumers and providers. Affordable Care Act will help, but its fate is still uncertain.

13 Mental Health is a Public Health Issue Treatment success rates for mental health disorders equal or exceed those for physical health. Success rates for treating asthma and diabetes is 70-80% and 60-70% for cardiovascular disease. Success rates for treating bipolar disorder is 80%; 70% for major depression, panic disorder, and OCD. Success rates for treating schizophrenia is 60%. (National Council for Community Behavioral Healthcare)

14 + Barriers to Treatment Despite successes, 2 in 3 people with mental health disorders go without treatment, due to lack of access to treatment and stigma (Mental Health, United States 2010, SAMHSA). 40% of people with Serious Mental Illness do not receive care (SAMHSA). Cuts to funding reduce access to mental health care.

15 Removing the Barriers to Treatment Three basic needs for recovery Food Employment Stable housing Major challenge in Williams decree Recognize that mental health is a public health issue.

16 Navigating the Current Landscape Work toward integrating primary and mental health care. We need new models. Current efforts share location, but not medical data. Example of integration: Health Homes Provide community-based care. Neighborhood Recovery Initiative in schools. Provide mental health counseling to at-risk youth and families. C4 partners with Evanston s Moran Center.

17 Encouraging prevention Implement cost-effective and efficient strategies for preventing and reducing the severity of substance use and mental disorders. Half of all diagnosable mental illness is present by age 14. Alcohol and drug use prevention programs. C4 s Life Skills Training in area middle schools teaches alcohol, drug, and gang violence prevention. Cost-benefit estimates indicate that school-based programs can save $18 for up to $1 spent (SAMHSA Toolkit).

18 Encouraging prevention Parenting education programs Reduce childhood abuse and exposure to household trauma, which puts children at greater risk for developing a range of physical and mental health problems and substance use. C4 s evidence-based Parenting Fundamentals (PF) Program has reached 4,000 low-income Chicago parents and 10,000 children since PF is used in Puerto Rico as part of a federal effort to prevent teen pregnancy.

19 Encouraging prevention Mental Health First Aid Innovative mental health literacy program that teaches non-mental health professionals how to recognize signs and symptoms of mental illness. Since 2008, MHFA at C4 trained more than 1,300 social service professionals, teachers, nurses, ministers, and members of the general public. Reduces stigma and promotes early intervention before more serious mental illness can develop.

20 Collaborate and Coordinate for Success We have to change the way we deliver mental health services. We must collaborate and coordinate our efforts in order to thrive in the shifting landscape.

21 Perhaps the most important part of a recovery-based system is hope. Fred Friedman, Next Steps

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