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Our collapsing mental and behavorial health care infrastructure

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* I’m excerpting too much, but this story is just too important. Go read the whole thing

Sherrie Crabb went without pay for a third of the last fiscal year, laid off members of her staff, cut benefits for those who remained, and finally, closed the only homeless youth shelter in southern Illinois, all because the state legislature and governor couldn’t agree on a budget. […]

Family Counseling Center has closed six different office and residential locations, laid off 36 staff members, and cut holiday and personal time off as well as retirement funding, in addition to draining the agency’s reserve funds and shutting down a homeless youth shelter that had been up and running for a little more than a year. She says the organization is now operating “month to month.” […]

“You have thousands of people who have not been able to access services, you have programs that have shut down and a workforce that will never come back into this field,” says Marvin Lindsey, executive director of the Community Behavioral Healthcare Association of Illinois. […]

According to CBHA’s survey results, 76 percent of the organization’s member agencies have wait lists ranging between two and four months for people in need of a psychiatrist, and 24 percent have wait times from four months to more than six months. […]

Greg Sullivan, director of the Illinois Sheriffs Association, a nonprofit agency that facilitates communication and training between and for state sheriffs departments, says state law enforcement agencies saw an uptick in the number of mentally ill individuals ending up in jail following the closure of psychiatric institutions. That’s “a direct result of the budget impasse,” he says.

“There is nobody to service these people and they end up in county jails,” says Sullivan. “They’re really not criminals. They have a severe mental health problem, and they don’t belong in jail.”

Rauner has said he wants to reduce the state’s prison population by 25 percent over the next decade, but Sullivan says that that’s an impossible goal if Illinois doesn’t adequately fund its behavioral health agencies. […]

Nearly one-quarter of Illinois hospital emergency department visits in the past year were related to behavioral health needs, including both mental health and substance abuse issues, either as the primary or secondary diagnosis, says Danny Chun, a spokesperson for the Illinois Health and Hospital Association.

posted by Rich Miller
Tuesday, Jul 19, 16 @ 10:27 am

Comments

  1. From the trib:

    - “I don’t believe that the state needs to choose between education and human services and art and history,” said Diana Rauner, who chairs the nonprofit association that supports the mansion. “We need to do both.” -

    Comment by Daniel Plainview Tuesday, Jul 19, 16 @ 10:37 am

  2. Great article - helping end stigma and support recovery is a priority issue of our times.

    Comment by Waffle Fries Tuesday, Jul 19, 16 @ 10:38 am

  3. Before everyone starts to bash the current administration, I think it’s important to point out that PQ closed two mental health centers in Jacksonville and one in the South Suburbs. This problem is only going to keep getting worse until it gets better I’m afraid.

    Comment by Almost the Weekend Tuesday, Jul 19, 16 @ 10:42 am

  4. Another example of short-sighted thinking. Save some dollars by squeezing the mental health providers until they go out of business, then spend 10 times more when individuals in need end up in the ER and Corrections.

    Comment by BobO Tuesday, Jul 19, 16 @ 10:42 am

  5. This is an extremely sickening situation. Another example of the damage caused by Rauner’s crusade to kill unions.

    Comment by Norseman Tuesday, Jul 19, 16 @ 10:44 am

  6. Rauner can blame Madigan until the sun goes down — but eventually this will sink in with voters.

    Rauner’s at the top — no matter how much he wants to pretend he’s just a “new” guy.

    I wonder if Rauner privately thinks — and maybe worries, although I doubt it — that he might have gone just a bit too far.

    Comment by Formerly Known as Frenchie M Tuesday, Jul 19, 16 @ 10:51 am

  7. –You have thousands of people who have not been able to access services, you have programs that have shut down and a workforce that will never come back into this field,” says Marvin Lindsey, executive director of the Community Behavioral Healthcare Association of Illinois. […]–

    I get that most people don’t care about the poor, disabled, elderly, addicted or vulnerable. That has been the case time in memorium, but the last part of the sentence is what I want to catch.

    “never come back into this field”, these aren’t paper pushers. These people are social service professionals, counselors, social workers, addiction specialists, etc. These are decent paying jobs for those who help others for a living. Mr. Rogers said when something goes wrong “look for the helpers”. Well, they aren’t coming back. Thousands of them. Not coming back. You destroy the foundational jobs of a whole segment of our society and we’re in for some huge problems down the line. Rauner and Rauner only took these jobs and financially destroyed the families associated with them.

    Comment by Honeybear Tuesday, Jul 19, 16 @ 10:52 am

  8. Honeybear 100%

    Comment by Anonymous Tuesday, Jul 19, 16 @ 10:54 am

  9. Almost - PQ closed a developmental center that served adults with developmental disabilities in Jacksonville, it was not a state hospital providing services to persons with serious mental illnesses.

    Tinley Park Mental Health Center was closed and additional community supports were funded in an attempt to prevent crisis situations. It probably wasn’t enough.

    The Rauner Administration is pursuing a focus on improving behavioral health services in Illinois. This is crucial and is a good thing, they have great people working on it. It will require investing resources on front-end services & prevention. It will require a budget.

    Comment by Waffle Fries Tuesday, Jul 19, 16 @ 10:58 am

  10. There are commenters on this site that I always defer to for their experience and expertise in certain areas.

    While I have my gut feelings when I read these posts, and I know others share my angst and outrage, I always listen to those who have the facts and can speak to the realities of the crisis.

    Thank you, Honeybear, and stay strong.

    Comment by illini Tuesday, Jul 19, 16 @ 11:05 am

  11. Can the 4.5 mil we’re saving on the Governors House be used for this?

    Comment by Doug Simpson Tuesday, Jul 19, 16 @ 11:08 am

  12. The statement by Danny Chun is interesting. When I spoke to hospital association, they told me that emergency room data was for the last quarter of 2015 and the first quarter of 2016. Before the budget impasse.

    Comment by Anon Tuesday, Jul 19, 16 @ 11:16 am

  13. Spot on, Honeybear. The best and the brightest aren’t going to stay in Illinois. The new graduates aren’t going to come to Illinois. Who wants to work in a kill zone for human services?

    Comment by Aldyth Tuesday, Jul 19, 16 @ 11:16 am

  14. Bruce,

    The Emergency Room is the least cost efficient setting to treat mental health.

    Hope this helps, because I know your last job was dining room manager of the nursing home.

    Love,
    Doug

    Comment by Doug Simpson Tuesday, Jul 19, 16 @ 11:39 am

  15. This is an area where a task force could have a real impact. These issues cross department boundaries. Many of these families are involved with 3 or more state departments. One departments move to cut costs ends up costing the state more in another department.

    That does of course assume that we actually want to help the people with addiction and mental health problems.

    Comment by Last Bull Moose Tuesday, Jul 19, 16 @ 11:50 am

  16. In my lifetime, neither the democrats nor republicans have ever done enough to fund mental healthcare.

    Comment by Groucho Tuesday, Jul 19, 16 @ 12:05 pm

  17. @honeybear

    =I get that most people don’t care about the poor, disabled, elderly, addicted or vulnerable.=

    That’s absolutely wrong, bear. Most people would want to help if the problem had a face on it. The problem is that bureaucracies that run these things often are insular and don’t want to have to justify the good work they do, other than hiring lobbyists.

    The perception out there is that much like the VA, the bureaucracy is there for themselves rather than to serve the public. The perception is that unions only care about lining their pockets even if it hurts those in need.

    These perceptions, wrong or not, need to change if you want people to care. That means not gouging the taxpayers for higher than inflation rate raises in benefits and salaries while cutting services to those “vulnerable” is important.

    Having a bunch of purple shirted SEIU DEMANDING more doesn’t change that perception. Becoming partners with the community does.

    Comment by Illinois Bob Tuesday, Jul 19, 16 @ 12:05 pm

  18. ==When I spoke to hospital association, they told me that emergency room data was for the last quarter of 2015 and the first quarter of 2016. Before the budget impasse==

    The budget impasse began in the spring of 2015 when they were supposed to be finalizing the 2016 budget, which was never signed. The stop-gap budget got passed the last day in June 2016.

    Comment by thoughts matter Tuesday, Jul 19, 16 @ 12:15 pm

  19. ===The Emergency Room is the least cost efficient setting to treat mental health.===

    According to Cook County Sheriff Tom Dart in a piece in the Chicago Tribune

    “Currently, the largest mental health hospital in Illinois is not even a hospital — it’s Cook County Jail, which I oversee as sheriff.”

    While a hospital emergency room is expensive, I would guess that Cook County Jail as probably more expensive than an ER.

    Comment by Small town taxpayer Tuesday, Jul 19, 16 @ 12:31 pm

  20. Last Bull Moose, good idea since we are literally starting over again. We can’t rise from the ashes. This isn’t a phoenix story. It’s going to be a whole new creature that emerges. The systems built up over decades to address, poverty, need and vulnerability are about 80% gone in especially Southern Illinois. As I have said before only “Ball and Gala” social service agencies exist now (Those that have silent auctions for the case of wine, ski vacation, and the like). Although as a side note, I was so pleased that the Womens shelter that we take everything too is still up and going, thank a gracious God. Luckily for them they are surrounded by 5 churches within a block and a half. Sorry I digress.
    Anyway, as I have said a lot before, you can’t apply free market principles to social services. There are no “private” social services waiting in the wings for a fat state contract. There IS NO PROFIT IN IT! When a social service goes down. That’s it. That’s why this next decade is going to be REALLY REALLY bad. People no longer care. People no longer hold religious/ethical principles in their hearts to do something about serious problems plaguing our fellow human beings. We as a society are by and far more like Randian Objectivists actively engaging in building our narcissistic private worlds. Sorry, again I’m going off. Woooweee it’s a soapbox day.
    Regardless, what will arise is a low paid, low professionality, low benefit for all approximation of social services. That is until someone dies. Or actually given the apathy, until a lot of people die, will something be addressed but by then we won’t be able to reassemble it. Just like sports you’ve got to backfill the bench with the younger generation. As colleges are dropping unprofitable social service/human service majors where are the professional workers going to come from? Answer: They’re not. They are gone. Like ministry, music, art, etc. they’re gone or dying off. Social service careers are just the latest victim of the drive towards “Competitive”. But it has nothing to do with Compassion.

    Comment by Honeybear Tuesday, Jul 19, 16 @ 12:31 pm

  21. Please don’t feed Illinois Bob today. At least not on this post.

    Comment by Honeybear Tuesday, Jul 19, 16 @ 12:35 pm

  22. Honeybear, you make me cry.

    Comment by Pawn Tuesday, Jul 19, 16 @ 12:36 pm

  23. @honeybear

    =I get that most people [aren’t impacted directly enough by cuts to services for]the poor, disabled, elderly, addicted or vulnerable [to force the issue].=

    @Illinois Bob
    [Good point], bear. Most people [are unaffected by the problems of the poor, disabled, elderly, addicted or vulnerable. The stopgap budget did not pass until summer road building was threatened and legislators were looking down the barrel of angry parents forced to stay home from work because schools were not going to open.]

    There, I wish that fixed things. But it doesn’t.

    Comment by 37B Tuesday, Jul 19, 16 @ 12:57 pm

  24. Oh I’m so sorry Pawn. Come on now. Let me give you the other side of my rant.

    True story. I found a small congregation after I got out of ministry to join just a member. I needed care. I hit the congregation just as it started to really grow, become vibrant and actualized. It was wonderful! But unfortunately we got to big for our britches and made financial commitments that we couldn’t afford. The church stumbled and went to pieces. People left and the church got really small. But the miracle that happened was that people who were previously just along for the ride, stepped up and starting working to build a better church. Now those folks are doing a great job and the church is slowly making a comeback. My point it that the human spirit and love is a hard thing to destroy. Illinois will come back. It will be different but we still can have a hand in our future. We all need to be active in the rebuild. The enemy is apathy. What’s the line from Dr. Seuss’s Lorax, “Unless someone like you cares a whole awful lot, Nothing is going to get better. It’s not.”

    So let’s have us a good cry, make ourselves a motivational tshirt (love me a good aspirational t-shirt), roll up our sleeves, get to work, make a bit of progress then fail, rinse and repeat.

    Comment by Honeybear Tuesday, Jul 19, 16 @ 1:06 pm

  25. ==Please don’t feed Illinois Bob today==

    We shouldn’t feed him any day. As I said, cut off the beast of any interaction and maybe he’ll get the hint and go away.

    Comment by Demoralized Tuesday, Jul 19, 16 @ 1:10 pm

  26. Honeybear even the “Ball and Gala” social service agencies are of course laying off now too. Lutheran Social Services Of Illinois which does events around Illinois as Rich has reported has laid off staff.

    But you are right, those social service agencies that had no independent fund raising sections have been heavily wiped out in Illinois.

    Comment by Rod Tuesday, Jul 19, 16 @ 1:13 pm

  27. @Demoralized

    =We shouldn’t feed him any day. As I said, cut off the beast of any interaction and maybe he’ll get the hint and go away.=

    Rich can do that anytime he wants. Then you can just have a circle ____ with those like you who can’t defend their positions against anyone who knows differently.

    Comment by Illinois Bob Tuesday, Jul 19, 16 @ 1:25 pm

  28. Illinois Bob. I don’t mind reading your point of view. It may be a bit over the top On a few issues, but your perspective is different than most who comment. It is obvious that there are many who share your point of view and it is more than evident that the state has serious spending problems. Stay civil in your dialogue and remember that places like North Korea and Turkey don’t tolerate differing opiinions.

    Comment by blue dog dem Tuesday, Jul 19, 16 @ 1:26 pm

  29. –Honeybear even the “Ball and Gala” social service agencies are of course laying off now too.–

    Totally true! AND gives an even greater sense of the depth of destruction. Even the big ones are broadside on to the waves. Another factor hitting large charities is that there are now other vehicles for tax write off like Angel investor credits, donations to EDC’s (those that have gotten 501c3 status, unlike ILBEDC or Intersect Illinois) Economic Development Corps. These are much more interesting than charities. There’s profit in supporting EDC’s. No profit in social services. That is Darth Arduin’s tactic. Kill the “tax consumers” to give tax incentives to big corporations. It weakens the very foundation of our society. We’re a symbiotic system. You can’t devastate a whole segment of society and not pay the piper down the line.

    Comment by Honeybear Tuesday, Jul 19, 16 @ 1:35 pm

  30. I work in social services and two of the six professionals I laid off with the budget impasse said the would “never work in social services again”. One is teaching and the other moved out of state. They were excellent counselors with a passion for the field. The other four, you ask, what are they doing? Looking for a job or “flipping hamburgers”. With the stopgap budget, I can restore the employees I have to their regular pay (they now have a 15% pay cut), but hiring is not an option, despite the fact I have a six-month wait list for counseling. The stopgap only keeps us alive; I know every other service provider is in the same boat…

    Comment by justme Tuesday, Jul 19, 16 @ 1:40 pm

  31. Honeybear, I have a sick feeling Rauner is destroying IL’s public mental health services & drug addiction services in order to privatize those services for a profit.

    Comment by Mama Tuesday, Jul 19, 16 @ 2:15 pm

  32. Seconding Mama’s post. Look what happened to the Lutheran Social Service programs across Illinois. 750 people laid off, then a for-profit nursing home company comes in to takeover the closed senior programs. Even at 1% interest per month, they can wait to get paid and better yet, market their line of senior residential programs to 5000 people at virtually no cost! Guess whose investment firm was big into nursin(sic) homes?

    Comment by BobO Tuesday, Jul 19, 16 @ 3:15 pm

  33. Let’s not forget that this damage was intentional. If you take the governor at his word, he purposely tuned up higher ed and social services to leverage his turnaround agenda.

    Personally, I believe putting much of higher ed and social services out of business was the intention from the beginning.

    You could have given Rauner everything in his agenda this last year, and he just would have come after them again next year.

    “Collectivist” stuff, you know. Like “community,” to the Dartmouth big thinker who made his fortune hustling government pension fund money and busting out Medicaid supported nursing homes.

    –Stay civil in your dialogue and remember that places like North Korea and Turkey don’t tolerate differing opiinions.–

    Is there some totalitarian government censorship in play here, BBD? Is it intolerance to call out someone’s unsupported, shallow nonsense on a discussion blog?

    Should everyone get a participant ribbon and pudding cup, for their self-esteem?

    It’s a grownup forum, dude.

    Comment by wordslinger Tuesday, Jul 19, 16 @ 4:02 pm

  34. Not only is Marvin correct that the workforce is leaving - we started this mess with a workforce shortage in mental health professionals.

    Wealthier areas in larger cities will likely recover, but restoring services will take a very expensive workforce development expenditure to even get us back to the shortage level we started at. (Especially in rural and underserved neighborhoods.)

    We have a bill waiting for the Governor to sign that will allow LCSWs to bill Medicaid but with payment delays soo long not sure how many private practices will even want the hassle. (And even if he signs it - we still has a long way to go before rules are approved.)

    Our association has spent the last two years working on job force training to help social workers transition to other jobs outside of state contracts or agencies. We have to find ways to keep trained professionals to keep one foot in the door - once they leave they usually stay gone.

    Comment by Kyle Hillman Tuesday, Jul 19, 16 @ 4:30 pm

  35. “There is nobody to service these people and they end up in county jails,” says Sullivan. “They’re really not criminals. They have a severe mental health problem, and they don’t belong in jail.”

    Janet Sims died near the Morrison cemetery after she left the Whiteside County jail in 2014. The IDOC investigation cleared Sheriff Kelly Wilhelmi and the jail staff. Good old boys are taken care of in Whiteside and most other rural county jails.

    Guess the jail manual doesn’t cover commonsense stuff like calling next of kin to arrange a ride for a known mentally ill woman. Great work.

    Comment by Anonymous Tuesday, Jul 19, 16 @ 5:53 pm

  36. Or restoring the services will take a change in funding. As I’ve said before, the movement toward
    parity for behavioral health needs in health insurance coverage is ongoing. And it’s important. The ACA is a work in progress and in many ways the work is just beginning. Obviously, the lucrative health insurance industry would like the taxpayer to pick up as much of the bill as possible. And the industry has clout and plenty of cash to pay lobbyists. There are plenty of sinners in the USA health industry, and they are not all named Bruce Rauner. But our political masters not named Rauner would be pleased if we thought otherwise.

    Comment by Cassandra Tuesday, Jul 19, 16 @ 6:10 pm

  37. And yet we’re investing millions to reform the MH system with Medicaid waivers that Rayner destroyed. The behavioral health transformation will turn out to be another boondoggle waste of precious resources that should actually be going toward treatment

    Comment by Johnj Wednesday, Jul 20, 16 @ 9:00 am

  38. Just saw this really disturbing booktalk (The Poverty Industry: The Exploitation of America’s Most Vulnerable Citizens.)
    Is this going on in Illinois? Anyone know?

    http://www.c-span.org/video/?411928-1/book-discussion-poverty-industry

    Comment by TinyDancer(FKA Sue) Wednesday, Jul 20, 16 @ 11:40 am

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