Increased Funding Benefits the Vulnerable
When Susan came to our clinic, she had attempted suicide-the culmination of a lifetime filled with pleas for help and acts of desperation. She had finally come to us at Galaxy Counseling Center for help because she did want to leave her daughter with such a legacy.
“I was so lost. My soul was shattered, my heart broken and my spirit shredded. “
There are countless other lost souls in Texas, but they often struggle to get access to help. Mental health funding levels are at a historical low, with Texas as the 49th state in funding allocated per person. This has led to people seeking care in emergency rooms, homeless shelters, foster care, or the prison system as a de facto provider of last resort.
The 83rd Texas Legislature has finally recognized that increased funding is urgently needed for prevention and better access to services, and has appropriated $332 million for mental health and substance abuse disorders. While this reflects an almost 70 percent increase; it still represents just 5 percent of the funding of local mental health authorities’ budgets.
The recognition that all Texans benefit from a stronger mental health system with increased funding is a step in the right direction. In a letter that Susan wrote to the agency, she expressed her gratitude for “a safe place where I was finally able to share my story, learn to accept what happened to me and become a person I like.”
Susan’s story is a familiar one that we encounter daily. The sexual abuse started when she was 5. First, a neighbor, then a friend, a step-brother, her father. Before her conscience memories of the abuse, she was diagnosed with depression, anxiety, anorexia, bipolar, borderline personality, and physical ailments she could never explain. She was in a psychiatric ward multiple times, given shock treatments and medicated. When the memories came back, she” felt powerless, terrified, guilty, dirty”. She thought it was her fault and she wondered what she had done to make these people want to hurt her. Susan tried to cope in unhealthy ways like alcohol and drugs, an eating disorder and cutting.
Although the economic impact to our state and local governments in lost productivity due to mental illness is $1.5 billion per year, the personal toll like that of Susan, is priceless. More than 4.3 million Texans suffer from mental disorders, many resulting from trauma like Susan’s; with 1.5 million unable to function at work, school or the community due to their mental illness. 1.2 million children suffer from emotional and behavioral problems severe enough to impair normal functioning, while less than half receive treatment.
Our legislators must awaken to the lesson of “pay me now or pay me later”; and in most cases, prevention is the least cost solution. It costs the state an estimated $55,000 per year if a person is repeatedly jailed, hospitalized or admitted to detoxification center. An equal effort must be placed on funding early intervention and prevention. Without the requisite care and efforts for prevention, costs will continue to grow.
While the additional funding has the potential to begin closing the gap created, there are still obstacles that need to be overcome. As the legislature acknowledges the need for increased funding, the Sunset Advisory Commission has recommended eliminating NorthSTAR, which is a pilot program created 15 years ago to deliver mental health and substance abuse treatment to Medicaid and other indigent patients throughout seven North Texas counties. NorthSTAR serves nearly 74,000 clients annually, which represents almost 1/3 of the patients seen in Texas. As with any systemic changes, in addition to positive changes such as improved coordination of behavioral and primary care for patients; there is the potential for patients who are currently receiving services to get overlooked in the transition/if the program is eliminated.
For Susan, “Therapy helped me to remove the shame and guilt. I am happier, and have a greater sense of inner peace. I no longer crave chaos as a distraction. The biggest lesson learned is that it was never my fault and I am not alone in my struggle. The best part is getting to know myself; that I really like me. I’m funny, witty, intelligent and caring. I have a strength that comes from deep inside and I CAN deal with life.”
Like Susan, a promising step has been taken by the Texas Legislature; however, we must be vigilant to ensure that the necessary programs and funding are allocated appropriately so that patients do not fall between the cracks, and the resources are available to provide access to mental health services to all. We must ensure that our legislators do not give with one hand and take with the other.
Lynette Payne is the Executive Director of Galaxy Counseling Center, and a member of The OpEd Project’s Dallas Public Voices Greenhouse.