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Florida's Mental-Health System Could Face $15M In Budget Cuts

Kate Santich
Sentinel Staff Writer
OrlandoSentinel.com
April 20, 2009

Florida's mental-health system -- already ranked 48th among the 50 states by a national advocacy group -- could face $15 million in budget cuts from state lawmakers, with about a third of the reductions hitting programs in Central Florida.

If approved, the cuts would target eight mental-health or substance-abuse treatment facilities in the region. One of them, a program for drug-addicted pregnant and postpartum women, would close.

Other facilities, such as a mental-health crisis unit in Seminole County, probably would have to turn away patients. The unit would lose a third of its 21 beds, even though it has only one more bed than when it opened more than 25 years ago.

As it is, the unit is nearly always full.

"They need to see from my perspective what it would be like if those cuts are made," said William Knox, 40, a Sanford resident diagnosed with bipolar disorder. He checked himself into the Seminole Behavioral Healthcare crisis unit last November feeling depressed and suicidal. "If they didn't have room for me ... I don't think I would be here now."

Jim Berko, president and chief executive officer of the nonprofit agency, said it's an issue of paying a little now or a lot later. "If these people can't come to us, they'll either end up in jail, where it costs $50,000 a year to keep them, or they'll end up in the hospital."

Hospital stays average $1,300 to $1,500 a day for psychiatric patients. A stay at the Seminole facility averages $330 a day.

'The definition of insanity'

Last week, Seminole County commissioners passed a resolution against cutting the crisis unit's funding, calling the program "imperative for the well-being" of the community.

Last month, George Sheldon, secretary of the Florida Department of Children and Families, had stronger words. The state's current mental-health system, he said, is "the definition of insanity" because of its tendency to jail people who need treatment. His remarks followed a dismal evaluation of the system by the National Alliance on Mental Illness, which dropped Florida's grade to a D from a C three years earlier.

"Frankly, there were a number of people who felt it should have been an F," said Marcia Mathes, president of the organization's Florida chapter. "It's a nightmare."

For at least a decade, Mathes and other critics say, the Legislature has ignored the needs of people with mental illness and substance-abuse problems in favor of seeming "tough on crime."

"There is no political will to support [mental-health] innovations in Florida," Mathes said. "Good people are left trying to hold everything together with chewing gum and rubber bands."

The Department of Children and Families is hoping to push through a bill this legislative session that would divert nonviolent criminal offenders who are mentally ill from jails to community-treatment programs, where they would get medication, treatment and help re-integrating into society. In the long run, Assistant Secretary Bill James said, the move would save taxpayers millions of dollars and save people with mental illness needless suffering. Research shows they often get sicker if kept in jail.

But even if the bill passes, as seems likely, it won't save programs now on the chopping block.

Plans for cuts differ

The state's House and Senate differ widely on how much the targeted programs would be cut. The House voted to cut $15 million from the programs statewide, while the Senate voted to leave mental-health programs untouched and to make only a 5 percent cut in substance-abuse treatment.

The matter now goes to a conference committee, though with dire revenue predictions for the state and with parents fighting to restore education funding, no one is optimistic that reductions in mental-health programs can be avoided.

"I appreciate the difficult job the Legislature is faced with," said Todd Dixon, director of community affairs for the Center for Drug-Free Living. "They have to balance the budget. They can't print money like the federal government can. But when you talk about the ever-increasing budget for the prison system, it doesn't make sense in the big picture."

The center's program for pregnant and postpartum women, for instance, helps about 100 clients a year and has been around nearly a decade. Treating women in that setting instead of sending them to jail, Dixon said, keeps their babies out of foster care and helps teach the moms badly needed parenting skills.

It also can prevent women from giving birth to babies with drugs in their system, which can lead to everything from learning disabilities to severe genetic defects. Studies show that, on average, each child exposed to drugs in the womb costs society $750,000 through age 18. That money goes to child welfare, foster care, special education and the juvenile-justice system.

Kate Santich can be reached at 407-420-5503 or ksantich@orlandosentinel.com.

Comparing the costs
$1,300-$1,500 per day: Average cost of stay for psychiatric patients at hospital
$330 per day: Average cost of a stay at Seminole Behavioral Healthcare

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