Op-Ed from Durham Herald-Sun: "Our Strained Safety Net"

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Ellen S. Holliman: Our strained safety net for mental health needs


By Ellen S. Holliman : Guest columnist

The Herald-Sun
May 15, 2009


It seems that almost everyone these days in Durham County is feeling stressed out, anxious and just plain worried.

So why, at a time when addressing people's mental health needs is increasingly critical, are an overwhelming majority of primary care doctors having difficulty finding mental health services for their patients?

Mirroring a national trend, demand for mental health services is increasing in Durham County. At the same time demand is increasing, at least 32 states are known to be enacting mental health funding cuts -- reducing services, closing programs, imposing hiring freezes and cutting or freezing reimbursement rates for providers.

Access to mental health treatment for people without insurance in many parts of Durham County is limited. Waiting lists are growing as funding decreases.
The number of clinical screenings provided by Durham Center Access is up significantly in 2009, and demand is strong at our 24/7 crisis facility.

Mental health advocates in many states are actively protesting against the budget cuts. Here in North Carolina, concerned citizens from across the state will gather in Raleigh on Wednesday for The Coalition Advocacy Day and Rally, an opportunity to advocate to legislators for better funding for mental health, developmental disabilities, and addictive disease services and supports.

The current state of community mental health -- the front line mental health safety net -- is, well, depressed. Further limiting access or reducing funding to mental health services will only exacerbate a festering problem.

"Every day we see more people showing up at our doors with mental health and substance abuse issues, so it seems clear that the safety net provided by our community's publicly funded services is beginning to strain," said Patrice Nelson, executive director of Urban Ministries of Durham, a local homeless shelter.

Abandoning people with unmet mental health needs puts additional strain on our local economies and North Carolina's welfare systems. Cutting services results in patients getting placed in costly state mental hospitals and nursing homes. Without treatment, others will end up on the street or in jail.

Before legislators vote to take away money for services for the mentally ill, they should listen to people like "Michael." Diagnosed with bipolar disorder, his heavy use of drugs and alcohol often led to his mental health breakdowns, resulting in a 26-page criminal record and Medicaid and Medicare payments of tens of thousands of dollars annually in ER visits and hospitalizations.

Then he became part of Durham's Integrated Dual-Disorder Treatment program, an evidence-based practice combining substance abuse and mental health treatment.Team members are trained in both treatment approaches, use a non-confrontational approach, provide support and actively look for ways to motivate the consumer to change.

Today, Michael is clean and sober, taking his medication regularly, living in his own apartment, holding down a good job and finishing his high school education. He plans to continue his education and is optimistic about his future. He has his life back in his own hands.

As we continue to bail out some of the richest and most powerful corporations, banks and investment brokers, let us not abandon our most vulnerable citizens.


Ellen S. Holliman is area director of The Durham Center. To learn more about The Coalition Advocacy Day and Rally, visit mha-nc.org.

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