Atlanta Forward / Another View Community options critical to providing care

By Ellyn Jeager

It’s been four months since the new state Department of Behavioral Health and Developmental Disabilities (DBHDD) was created.

Although the department is new, the problems with Georgia’s behavioral health system are long-standing and the lack of community services remains a top priority for consumers of mental health and addictive disease services, their families, and advocates.

So where are we?

There is new leadership in DBHDD that is reaching out to consumers, families, advocates, providers and professionals. This clearly is a new and positive development, and is, in fact, the first action needed to ensure trust and accountability. We urge the state to take the next step to clearly define its vision and commitment to a system of community-based care that is grounded in peoples’ actual needs (such as mental health services, housing, employment) and divest itself from outmoded and harmful models of institutional services.

The question then is: How can people with mental illnesses and addictive diseases be appropriately discharged from state hospitals when community services are unavailable? In a recent court filing, the state wrote that “there is nothing wrong with readmissions.” We profoundly disagree. Georgia’s hospital readmission rate is one of the highest nationally and is a direct result of the lack of community services. This situation is not only reprehensible – who wants to constantly have to wait to be so sick they need repeated hospitalizations to get better – but also extremely costly. Hospitals are vastly more expensive, and less effective, than community services; they are an antiquated model that cannot be the central focus of our mental health system.

Georgia still unnecessarily confines more people in state hospitals than almost any other state, and spends less on community services. We rank 46th in the nation on per capita spending on community mental health services. We are fully aware of the state’s fiscal crisis, which is why we are advocating for more community services. People can be better served, at decreased costs, in the community.

We are watching new initiatives by DBHDD, including its recent partnership with the Medical College of Georgia. There also is evidence that
DBHDD is starting to establish priorities focusing on community services.

While we hope these initiatives bring positive changes, it is unclear that the new department has the capacity to oversee them or the community providers available to implement them. We have yet to see a serious commitment from the state to reduce its over-reliance on hospitals and develop sorely needed community services. The state needs to invest in the changes necessary to make the new Department of Behavioral Health and Developmental Disabilities successful and improve the lives of Georgians living with mental illnesses and addictive diseases.

Ellyn Jeager is chair of the Behavioral Health Services Coalition.