OPINION: A mental health crisis in the speaker’s hometown

Foggy morning in Blue Ridge, Ga., Nov 1-4, 2007.

Credit: Karen Putney

Credit: Karen Putney

Foggy morning in Blue Ridge, Ga., Nov 1-4, 2007.

BLUE RIDGE — As one of the last stops on my Georgia Politics Roadtrip this summer, I headed north to Blue Ridge. Even as it deals with COVID-19, the little town in the North Georgia mountains is thriving by nearly every measure.

Mountain cabins are booked solid with tourists and trout seekers. Downtown buzzes with high-end restaurants and breweries. The artisan Pasta Market is so authentic and lovely, you could as easily be in Tuscany as on Mountain Street.

But like a lot of people and places, Blue Ridge’s physical beauty doesn’t tell the whole story, especially when it comes to some local residents’ very real struggles with mental health.

Law enforcement officials estimate 50% to 60% of the people in their courts and jails have some form of mental illness. Access to care in Fannin County, like the rest of Georgia, is expensive if it’s available at all.

“People think this is heaven up here,” said House Speaker David Ralston. “They want to come up to be around the beautiful mountains and the lake and the trout streams. But there are people here struggling with real problems.”

And of all the issues Ralston is focused on, the need to fund mental health access has jumped to the top of his priority list. And it’s been informed by the lives of the people here. Ralston’s own father struggled with dementia for the last eight years of his life.

“It is a cruel, cruel illness,” he said. “The stages all go in one direction and that’s down. I get what it does to a family. I saw what it did to my mother.”

Watching his family struggle to care for his father showed Ralston the strain mental and cognitive issues have on individuals. But the sheriff and the Superior Court judge in Blue Ridge have told him what mental illness is doing to his community.

They describe a system where the judges and jails are often the last resort for people and families in mental health crisis.

Sheriff Dane Kirby said his office repeatedly gets calls, often in the middle of the night, about people obviously struggling with mental health. One person was wandering next to the highway. Another was at home, threatening their family.

“People just don’t know anywhere else to go,” Kirby said. “When they’ve tried everything and nothing else works, they call the sheriff.”

In the absence of mental health professionals to call locally, or a mental crisis team to respond, those people often end up in jail after commiting crimes, when what they really need is mental health care. But help is hard to find.

“I’ve called before and been told there’s a six-month wait for a bed,” Kirby said.

Judge Brenda Weaver started a mental health court in her three-county district, including Fannin County, after years of seeing people arrested by the sheriff’s department, including juveniles, who were also dealing with mental health issues.

“It became very obvious that the same individuals were in and out of the system, all the time,” Weaver said.

Like other accountability courts, her mental health court works to keep offenders out of jail after they’ve committed a crime, instead of in jail.

Weaver oversees a team of lawyers, health care providers and caseworkers that manages everything from a person’s daily medications to employment to treatment and drug testing.

Weaver said mental health courts are working for many, but the courts alone are not enough.

She pointed to supported housing, where people can live semi-independently, along with crisis response teams, and options for in-patient treatment as the greatest needs in small communities.

“If we’re not taking care of them in supported housing, if they’re not taking their medication, then they are capable of committing more serious crimes,” she said. “They’re also in danger of getting hurt themselves "

Both the sheriff and the judge said more funding for mental health services could give people the help they need and, ideally, keep them out of the criminal justice system. They both talk to colleagues across the state managing the same set of crises.

“It just seems morally, ethically and legally wrong to house someone in a jail who is mentally ill,” Weaver said. “What if it was you? Or if it was me? What if it was my child? We don’t have any choices.”

It’s no surprise that a local issue would get a speaker’s attention. But the lack of access to mental health care in Blue Ridge is a part of a statewide crisis.

A 2020 report from Mental Health America ranked Georgia 51st in the nation for access to mental health care.

Another report, from a special committee of the state House on mental health, chaired by Rep. Kevin Tanner, found that all but nine counties in Georgia have shortages in mental health workers. Dozens of counties have no mental health professionals at all.

The progressive Center for Budget and Policy Priorities reported that expanding access to Medicaid would also expand coverage for mental health and substance abuse services. But state Republicans have ruled out expanding Medicaid under the Affordable Care Act.

In large part because of the conversations Ralston has had at home in Blue Ridge, he said his highest priority now, and likely for the rest of his speakership, will be expanding mental health services in Georgia.

He added $58 million to the state budget for mental health care last year, which he says is just a beginning. In 2022, he’ll push for at least $75 million more.

“I know now why mental health became a second-class citizen in the health care system,” he said. “It’s just hard and those of us in government just don’t like to deal with hard stuff. But we’re going to have to deal with this.”

This article is the seventh installment of the AJC’s Georgia Politics Road Trip series, reporting from the road on the politics throughout the state.