The wisdom in Rhode Island’s May is Mental Health Month’s rallying cry: “Mental Health for Everyone: Invest in Us” is far-reaching this year.
With one in four families having at least one family member with a serious mental health disorder, (World Health Organization), we often look to the individuals with mental illness as warranting attention and we should, but what about family caregivers and parents who day after day shoulder the financial, emotional and physical tolls of helping someone who is seriously ill?
With the surging demand for mental health services and the shortages of psychiatrists, therapists, and beds in psychiatric facilities, the bulk of people who need care are now receiving more of their support at home. This situation aligns perfectly with the latest research that shows that people with mental illness who receive support from family and friends together with a mental health provider, fare better and are more apt to show progress than people who receive support solely from their mental health providers or worse yet, do not receive any professional help.
However, the 8.2 million caregivers (and that number continues to grow daily) who average 32 hours per week of unpaid support are left empty-handed, their nerves frayed, and livelihoods often threatened. According to the National Library of Medicine 2020 study conducted by Dr. Omyna Ehbrahim, caregivers feel their role is “marginalized, undervalued, and invisible to medical services,” and as a result caregivers themselves suffer emotionally with about half at risk for anxiety and depression themselves.
Moreover, this downward spiraling of caregivers feeds into an unhealthy cycle of stress and ability to care for their mentally ill loved ones. One essential question remains: How do caregivers preserve their sense of compassion when they put their own lives and self-care on hold? Caregivers are often the first to witness the frustrations of their loved ones trying their best to recover. They understand the painfully slow and uncertain process of recovery. They appreciate the single good day despite the string of bad ones. Many times, however, caregivers are left alone to wonder what they are doing wrong.
Isn’t it time for our state to INVEST in the mentally ill, their caregivers, case managers, and community mental health staff that support them? Factor the preceding potential caregivers’ cost to Rhode Island taxpayers if caregivers could no longer provide support to their loved ones. Then consider the cost of individual care for the person with severe mental illness who has no caregiver to support them. By funneling the national American Rescue Plan Act (ARPA) dollars into community mental health centers to expand behavioral health facilities, staffing, and programming, everyone wins. By their nature, community mental health centers (RI has nine) must provide services to everyone regardless of their ability to pay or their insurance level.
Congress is poised to pass the Mental Health Excellence Act which will expand the Certified Behavioral Health Clinic (CCBHC) program to all 50 states including Rhode Island. The primary way to help all Rhode Islanders is to urge your state representatives and senators to hold true to the Certified Community Behavioral Health Clinic (CCBHC) model and to bring RI to the forefront of mental health and substance use recovery by becoming a designated CCBHC state . A CCBHC state establishes seamless, comprehensive, and high-quality behavioral health services available as soon as someone starts to need help. In turn, participating CCBHC centers receive an enhanced Medicaid reimbursement rate, which will bring over $30 million in new federal dollars for community-based behavioral health services. Rhode Island is notorious among neighboring states for its low Medicaid reimbursement rate, which has not changed in over a decade despite record high levels of behavioral health needs in the aftermath of the COVID pandemic.
Strict adherence to the federal CCBHC requirements is needed to receive this increased federal funding. The 10 states that have already adopted the federal CCBHC model have achieved transformational results including dramatic improvements in the number of people accessing care, reduction in the pain and suffering of the individuals with behavioral health disorders and their families, and net savings to the state in reducing costly emergency department and hospital admissions.
While Rhode Island has proposed its own watered-down CCBHC program requirements, national experts have already predicted the RI plan will not achieve the results seen in the 10 other pilot states. Therefore, the RI plan will not be eligible for the new federal funding.
Rhode Island currently spends more per person on behavioral health than surrounding states and the primary reason for this expense is because the state has not invested funds in programs before people become seriously mentally ill. As a result, people’s conditions often become so serious that they end up in hospitals.
With the burgeoning numbers of people in this state with complex substance use and mental health needs and caregivers who support them, mental health services must be at the top of everyone’s priority list. Rhode Island residents must be able to access help before they reach a crisis and before they need to be admitted to a hospital. Isn’t it time to INVEST in us and adopt the new federal CCBHC program?
Jamie Lehane is president and CEO of Newport Mental Health in Middletown. Peace of Mind, which is co-written with Sandra Oxx, runs in The Daily News and online at newportri.com.