State Officials and Advocates: Mental Health System Improving, Still Needs Work

In response to recent mass shootings like the one in Newtown Connecticut, federal and state governments are examining mental health system improvements.

Before Newtown, Georgia started overhauling its system after the Atlanta Journal-Constitution reported suspicious deaths in state hospitals and after two settlements with U.S. Justice Department. Under the most recent settlement, at least 9,000 developmentally disabled and mentally ill Georgians are supposed to receive services in a community setting rather than at state hospitals.  WABE’s  Michelle Wirth spoke with state officials and mental health advocates about Georgia’s progress.

Frank Berry has been commissioner of the Georgia’s Department of Behavioral Health and Developmental Disabilities since last August. He’s the second commissioner to hold the position since the department’s creation in 2009. Since then and following the 2010 settlement, Berry says the state has made a large amount of progress.

“It took a lawsuit for that to ultimately happen, but if you look across the country mental health programs have been significantly cut for the last many years and Georgia’s system has had increases.”

Enlarge image

Credit Georgia Department of Behavioral Health and Developmental Disabilities

Georgia Department of Behavioral Health and Developmental Disabilities Commissioner Frank Berry

Berry has also witnessed changes in the lives of many mentally ill and developmentally disabled Georgians.

“People living in their own homes after living in either a state hospital or a group home, and now living on their own, with possibly a roommate or living on their own.”

But there are also challenges.

“We’ve got to get the conversation going nationally, so that more federal dollars can be allocated to the states.”

Especially when nearly all state departments face a 3 percent budget cut.

“We’re working very closely with the governor’s office on looking at ways to not have that cut impact providers. I would much rather look at administrative costs and reducing those costs.”

But Berry says settlement dollars won’t be affected by the potential cut.  A recent report on the 2010 settlement by an independent reviewer cited significant progress. But it also highlighted areas of improvement:

The reviewer expressed concerns about the state providing adequate day programming... monitoring health care and obtaining informed consent for some medications.

Berry says the department is doing its best to respond.

“We will be doing a much more thorough job of doing unannounced visits. We have begun to talk to the provider network as a whole of the absolute number one priority being high quality care. I think the department can do a better job of providing technical assistance of what that looks like and we’ll be setting up guidelines of how we’re going to be doing that.”

In general, Berry says the department’s goal is collaborate with providers and mental health advocates like the Carter Center.

During the past several years, the Center and the Department have co-hosted town hall meetings throughout the state.

Their goal? to bring the Carter Center’s research on mental health services to local communities and to get feedback about what kind of support systems communities need most. 

Dr. Thom Bornemann is the mental health director for the Carter Center.

Enlarge image

Credit The Carter Center

Carter Center Mental Health Director, Thom Bornemann

“We learned a lot that organizations are tending to collaborate better than they used to. There was always a lot of competition particularly among advocacy groups. I think there’s less of that now, so that’s good.”

Bornemann says the state’s mental health system has improved significantly since the 2010 federal settlement, but he says more work is needed.

“There’s a growing body of evidence through the Institute of Medicine that has been looking at promising prevention practices. That’s where we’re really going to get the yield if we’re ever going bend the cost curve…if we can begin to identify those who are at risk for a condition and mitigate that risk, and maybe even prevent the onset of a full-blown condition, everybody wins.”

Bornemann says Georgia needs to take a hard look at children and adolescent needs in the state, because the 2010 settlement agreement only covers the adult system.