Mental health ideas laid out

A state commission’s report calls for an ambitious five-year blueprint to reform Georgia’s troubled mental health system, but contains no financial plan on how to fund the improvements.

Gov. Sonny Perdue’s mental health commission, in recommending expanded mental health services, cites the current “economic realities” the state faces. The panel, though, questions recent spending cuts for mental health that state officials have pursued in the face of Georgia’s budget shortfall of $1.6 billion to $1.8 billion.

“It’s a good report, but there’s no money or funding behind it,” commission member Julie Spores said Friday. “It’s only as good as the funding behind it.”

The panel, as expected, does not endorse the state’s recent push to turn over Georgia’s mental hospitals to private firms. Instead, the report includes a list of 21 “critical questions” about privatization for the state to answer prior to awarding a contract, including how the state will measure the performance of company-run hospitals.

The Atlanta Journal-Constitution reported last month that Georgia is seeking the privatization of state psychiatric hospitals. Officials want to hire for-profit companies to build and operate three new psychiatric facilities to replace all seven existing state hospitals, according to documents obtained by the AJC.

No other state has privatized its entire network of psychiatric hospitals.

Georgia’s mental hospitals have been the target of an ongoing U.S. Department of Justice investigation. The AJC’s reporting found at least 136 suspicious deaths of hospital patients and almost 200 confirmed cases of patient abuse from 2002 through late 2007.

The Perdue commission, created in the wake of the newspaper articles, included legislators, consumer advocates, law enforcement and judicial system representatives, and state agency officials.

Its report acknowledges that “historically, Georgians with mental illness and addictive diseases have been a hidden population whose needs have largely gone unmet.”

The Department of Human Resources, which runs the public mental health system, did not respond to a reporter’s request for comment on the report, which was dated last week but was not widely released.

State Rep. Judy Manning (R-Marietta), a commission member, said Friday that she believes the panel made good recommendations. “The only thing that is lacking is the money,” she said. “The mental health system, we all agree, is definitely broken. The services we want in the community take money.”

The commission, which met monthly for more than a year, says Georgia recently has made progress in a few areas, including establishing programs for children with mental illness.

Still, to address glaring needs, the commission recommends increasing:

> Mobile teams of professionals and short-term crisis units to help prevent hospitalizations.

> Housing assistance for adults with mental illness.

> Case managers to address the needs of patients.

> Help in obtaining employment for individuals.

> Wider access to psychotropic medications.

It endorses Perdue’s plan to move mental health services out of Human Resources and into a separate department. The panel also recommends a standing committee of representatives from state agencies involved in mental health care, along with consumers, law enforcement representatives and others, to tackle widespread problems in the system. This ”collaborative,” the report says, can help end ”a fragmented set of services that do not meet the needs of most Georgians.”

And the commission calls for the funding of a mental health ombudsman, an office created this year by the Legislature but never funded.

“The commission’s greatest concern is that the development of a mental health system … will be hindered by the state’s current economic challenges or the lack of public and political will to implement these recommendations,” the report said.

The final report is more detailed than an interim document, issued in June, that provoked outrage after revelations that large sections of it had been plagiarized from other sources, including a Michigan study published in 2004. That report credited none of the cloned material.

The final version also does not contain the name of commission member Charles Nemeroff, an Emory psychiatry professor who has been a subject of a U.S. Senate Finance Committee investigation into whether drug company money paid to doctors and academics compromises medical research and scholarship.

Nemeroff, an internationally known expert on depression, did not attend recent commission meetings.