{"id":620894,"date":"2023-03-22T17:49:33","date_gmt":"2023-03-22T22:49:33","guid":{"rendered":"https:\/\/news.sellorbuyhomefast.com\/index.php\/2023\/03\/22\/a-lot-of-thought-little-action-proposals-about-mental-health-go-unheeded\/"},"modified":"2023-03-22T17:49:33","modified_gmt":"2023-03-22T22:49:33","slug":"a-lot-of-thought-little-action-proposals-about-mental-health-go-unheeded","status":"publish","type":"post","link":"https:\/\/newsycanuse.com\/index.php\/2023\/03\/22\/a-lot-of-thought-little-action-proposals-about-mental-health-go-unheeded\/","title":{"rendered":"A Lot of Thought, Little Action: Proposals About Mental Health Go Unheeded"},"content":{"rendered":"
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Thousands of people struggle to access mental health services in Florida. The treatment system is disjointed and complex. Some residents bounce between providers and are prescribed different medications with clinicians unaware of what happened. Jails and prisons have become de facto homes for many who need care.<\/p>\n

These problems and more were identified in a scathing report released earlier this year by the Commission on Mental Health and Substance Abuse, a 19-person panel<\/a> that Florida lawmakers created in 2021 to push for reforms of the state\u2019s patchwork of behavioral health services for uninsured people and low-income families.<\/p>\n

What\u2019s most troubling about the group\u2019s findings? They aren\u2019t new.<\/p>\n

More than 20 years ago, the Florida Legislature set up a commission with the same name<\/a> to examine the same issues and publish recommendations on how to improve mental health care in the publicly funded system.<\/p>\n

The echoes between the two groups \u2014 over two decades apart \u2014 are unmistakable. And Florida isn\u2019t the only state struggling with the criminalization of mental illness<\/a>, a lack of coordination<\/a> between providers, and insufficient access to treatment<\/a>.<\/p>\n

Last year, the national advocacy group Mental Health America said Florida ranked 46th among the 50 states and the District of Columbia for access to such care. Arizona, Kansas, Georgia, Alabama, and Texas were worse off, according to the nonprofit, which based its rankings on access to insurance, treatment, and special education, along with the cost and quality of insurance and the number of mental health providers.<\/p>\n

Conversations about mental health are at the forefront nationwide amid the proliferation of mass shootings<\/a>, pandemic-related stress,<\/a> rising suicide rates<\/a>, and shifting viewpoints on the role of police<\/a> in handling 911 calls.<\/p>\n

\u201cIt comes down to how much investment, financially, legislators are willing to put into building a system that works,\u201d said Caren Howard, director of policy and advocacy at Mental Health America<\/a>, a nonprofit just outside Washington, D.C.<\/p>\n

In Florida, the 1999 Commission on Mental Health and Substance Abuse was launched when Jeb Bush was governor. In a 74-page report released in 2001<\/a>, the group called the state\u2019s treatment system \u201ccomplex, fragmented, uncoordinated and often ineffective.\u201d<\/p>\n

<\/figure>\n

The commission found that jails and prisons were Florida\u2019s \u201clargest mental hospitals\u201d after \u201cdeinstitutionalization\u201d<\/a> began \u2014 the 20th<\/sup>-century movement to shutter state psychiatric facilities and treat people instead through community services.<\/p>\n

The report also blasted Florida agencies<\/a> for not sharing patient data with one another and being unable to track whether those with severe mental illnesses like schizophrenia were truly getting needed help.<\/p>\n

\u201cA lot of the things that we\u2019re finding now, they found back then,\u201d said Charlotte County Sheriff Bill Prummell, a member of the latest commission who served as the chairperson for about 18 months.<\/p>\n

The similarities raise questions for the group about whether its work will also end up on a shelf, collecting dust, as Florida lawmakers continue to wrestle with the same challenges again and again.<\/p>\n

\u201cAre they really going to take us seriously?\u201d Prummell asked.<\/p>\n

\"A
A copy of the 2001 report released by Florida\u2019s 1999 Commission on Mental Health and Substance Abuse rests on a shelf in David Shern\u2019s home office.(Ivy Ceballo \/ Tampa Bay Times)<\/span><\/figcaption><\/figure>\n

Dropping the Ball<\/strong><\/p>\n

After hosting public meetings across Florida, the 1999 commission urged a slate of reforms, including expanding jail diversion programs like mental health courts<\/a>.<\/p>\n

But the group\u2019s key recommendation was to set up a \u201ccoordinating council\u201d in the governor\u2019s office to lead the system and develop a strategy for care.<\/p>\n

That never happened.<\/p>\n

David Shern, chairperson of the 1999 group and former dean of the University of South Florida\u2019s Louis de la Parte Florida Mental Health Institute, said he thinks Bush\u2019s office dropped the ball.<\/p>\n

The Republican governor, known for his spending cuts<\/a>, didn\u2019t want to add staff to his office, so the coordinating council was never created, said Shern.<\/p>\n

That\u2019s \u201cwhere the plan really fell apart,\u201d he said.<\/p>\n

Instead, lawmakers established a <\/a>work group<\/a> in the Department of Children and Families to review how Florida could improve its behavioral health system and submit a report to Bush, among other leaders.<\/p>\n

The work group disbanded in 2003. That same year, the legislature created a not-for-profit corporation<\/a> to oversee the system, but it was dissolved in 2011, according to state business records<\/a>. When the Tampa Bay Times recently asked for the work group\u2019s report, Laura Walthall, a spokesperson for the Department of Children and Families, said it couldn\u2019t be found. Bush didn\u2019t respond to emailed questions.<\/p>\n

Former state Rep. Sandra Murman, however, said that what happened is just a reality of bureaucracy.<\/p>\n

\u201cIt\u2019s the same with all commissions,\u201d said Murman, a Tampa Republican who was part of the 1999 group. \u201cThe life cycle of any big report that comes out is probably about five years.\u201d<\/p>\n

Lawmakers leave Tallahassee because of term limits. Agency heads step down. New officials get elected. Priorities shift.<\/p>\n

\u201cThey come in with their agenda, and you won\u2019t see social services ever at the top,\u201d she said of Florida legislative leaders.<\/p>\n

\"A
David Shern holds a copy of the report his mental health commission released in 2001. A recent report by a new state commission reached similar conclusions.(Ivy Ceballo \/ Tampa Bay Times)<\/span><\/figcaption><\/figure>\n

But some state lawmakers focused on mental illness in the wake of the 2018 shooting that left 17 students and staff<\/a> members<\/a> dead<\/a> at Marjory Stoneman Douglas High School in Parkland. Amid mounting public demand for more drastic gun control measures, such as an assault weapons ban<\/a>, the Republican-controlled legislature instead approved more limited restrictions, like Florida\u2019s \u201cred flag\u201d law<\/a>, along with steps unrelated to gun control, allocating about $400 million for mental health and school safety initiatives<\/a>.<\/p>\n

Before the massacre, Parkland shooter Nikolas Cruz<\/a> received mental health services through several public and private providers, splitting the future gunman\u2019s medical history, according to a 2019 report<\/a> from the Marjory Stoneman Douglas High School Public Safety Commission.<\/p>\n

\u201cNo single health professional or entity had the entire \u2018story\u2019 regarding Cruz\u2019s mental health and family issues, due, in part, to an absence of communication between providers and a lack of disclosure by the Cruz family,\u201d the report said.<\/p>\n

The vast majority of people with a mental illness are not violent<\/a>, according to the nonprofit National Council for Mental Wellbeing<\/a> in Washington, D.C. And they are more likely<\/a> to be victims of violent crime than perpetrators.<\/p>\n

In 2020, a grand jury<\/a> investigating school safety issues related to the shooting called Florida\u2019s mental health care system \u201ca mess.\u201d<\/p>\n

\u201cDeficiencies in funding, leadership and services,\u201d the grand jury said<\/a>, \u201ctend to turn up everywhere like bad pennies.\u201d<\/p>\n

The panel said it didn\u2019t have enough time to conduct a full review of the system and urged state lawmakers to set up a commission to do so.<\/p>\n

The latest commission reported that the system remains splintered and suffers from \u201cenormous gaps in treatment.\u201d And there\u2019s still no centralized database on patients.<\/p>\n

<\/figure>\n

The group, just like its predecessor over two decades ago, has suggested that Florida create more jail diversion programs and that state agencies share patient data. The commission has pitched new ideas, too, like a pilot program in which one agency manages all public behavioral health funding in a geographic area, including state money and local dollars, so providers can focus more on care and less on complicated billing processes.<\/p>\n

\u201cThis isn\u2019t going away, and if we don\u2019t address it, it\u2019s going to get worse,\u201d Prummell told a House subcommittee last month<\/a>.<\/p>\n

Solutions to Florida\u2019s problems are not headline grabbers, which makes it tough to generate political support, said Holly Bullard, chief strategy and development officer at the Florida Policy Institute<\/a>, an Orlando nonprofit.<\/p>\n

\u201cBuilding good government, it can get technical,\u201d she said, \u201cand sometimes it\u2019s hard to communicate the importance of it.\u201d<\/p>\n

Will Anything Change?<\/strong><\/p>\n

\"A
David Shern with a copy of the report his mental health commission released in 2001.(Ivy Ceballo \/ Tampa Bay Times)<\/span><\/figcaption><\/figure>\n

There\u2019s been some progress in Florida\u2019s mental health care system since 2001, said Jay Reeve, the new chairperson of the latest commission and CEO of Apalachee Center<\/a>, a behavioral health provider in Tallahassee.<\/p>\n

The system is more responsive to regional issues, partly because of state contracts with seven \u201cmanaging entities\u201d<\/a> \u2014 nonprofits that oversee safety-net services for the uninsured, he said.<\/p>\n

There\u2019s also been an increase in initiatives like mobile response teams<\/a>, which help people in mental health emergencies, and crisis intervention training<\/a> for police officers, in which they get trained on de-escalation techniques and psychiatric diagnoses so they know when to get residents into treatment instead of arresting them, Reeve said.<\/p>\n

The Department of Children and Families used to spend about $500 million a year on community-based behavioral health services such as outpatient treatment, case management, and crisis stabilization units, the 1999 commission reported. Now, its budget for such care is $1.1 billion.<\/p>\n

Pockets of innovation exist at the local level, too, as in Palm Beach County, where an initiative called BeWellPBC<\/a> aims to boost the area\u2019s mental health care workforce, among other things, said Shern, senior associate in the department of mental health at the Johns Hopkins Bloomberg School of Public Health<\/a>.<\/p>\n

But challenges remain.<\/p>\n

Nearly 3 million Florida adults have a mental illness<\/a>, according to Mental Health America. That\u2019s about 17% of the state\u2019s population of those 18 and up. An estimated 225,000 youths experienced at least one major depressive episode in the past year, the nonprofit reported in October.<\/p>\n

In 2020, Florida ranked last among states for per capita mental health care funding, the Parkland grand jury said. In 2021, the Miami-Dade County jail system was the largest psychiatric institution in the state<\/a>, according to the 11th Judicial Circuit.<\/p>\n

\u201cAs long as you keep things siloed, accountability is easier to dodge,\u201d said Ann Berner, a member of the 2021 commission and CEO of Southeast Florida Behavioral Health Network<\/a>, a managing entity.<\/p>\n

Political will is needed to enact major reforms, Shern said. So is follow-up on the commission\u2019s work, said Murman, who works at Shumaker Advisors Florida<\/a>, a lobbying firm.<\/p>\n

\u201cIn this case, it probably is something that has to be revived every five years to really make an impact,\u201d she said.<\/p>\n

Rep. Christine Hunschofsky<\/a>, a Parkland Democrat on the 2021 commission, said there\u2019s bipartisan support to improve the system.<\/p>\n

But during the current legislative session, the Tampa Bay Times on March 13 could find only one House bill and a matching Senate bill based on the commission\u2019s 35-page interim report: a proposal to study Medicaid expansion for some young adults age 26 and under. (Republican leaders in Florida have refused to expand the federal-state health care program<\/a> under the Affordable Care Act, which became law in 2010.)<\/p>\n

Hunschofsky said she thinks the legislature will take more action once the commission releases its final report, which is due by Sept. 1<\/a>.<\/p>\n

Republican Gov. Ron DeSantis\u2019 office referred questions to the Department of Children and Families, where officials didn\u2019t answer them.<\/p>\n

Senate President Kathleen Passidomo didn\u2019t respond to a voicemail and interview requests made through a spokesperson. Nor could House Speaker Paul Renner be reached for comment.<\/p>\n

After more than 20 years, Shern is frustrated.<\/p>\n

\u201cIt\u2019s time to move on these issues,\u201d he said. \u201cWe\u2019ve spent literally decades thinking about them, talking about them.\u201d<\/p>\n

\"A
David Shern in his home office.(Ivy Ceballo \/ Tampa Bay Times)<\/span><\/figcaption><\/figure>\n

This article was produced in partnership with the <\/em>Tampa Bay Times<\/a>.<\/em><\/p>\n<\/p><\/div>\n

Read More<\/a>
\n Sam Ogozalek, Tampa Bay Times<\/p>\n","protected":false},"excerpt":{"rendered":"

Thousands of people struggle to access mental health services in Florida. The treatment system is disjointed and complex. Some residents bounce between providers and are prescribed different medications with clinicians unaware of what happened. Jails and prisons have become de facto homes for many who need care. These problems and more were identified in a<\/p>\n","protected":false},"author":1,"featured_media":620895,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1502,231],"tags":[],"class_list":{"0":"post-620894","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-little","8":"category-thought"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/620894","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/comments?post=620894"}],"version-history":[{"count":0,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/620894\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media\/620895"}],"wp:attachment":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media?parent=620894"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/categories?post=620894"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/tags?post=620894"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}