Politics of health care reform, cuts impact mental health, substance abuse treatment

Published: Friday, Sept. 20 2013 6:30 p.m. MDT

Barry Rose, crisis services manager for the University of Utah’s Neuropsychiatric Institute, said funding cuts and the uncertainty over ACA and Medicaid expansion present challenges, but he believes UNI’s community-based services are extending the reach of precious prevention and treatment dollars.

UNI is a contract provider for OptumHealth, which manages the county’s mental health treatment resources.

UNI’s crisis line handles some 3,400 calls a month, Rose said. Its mobile outreach team, which helps police handle calls that involve people with mental health issues and also makes house calls to assist people in crisis, averages 200 "outreaches" a month, he said.

UNI’s receiving center, meanwhile, offers 23-hour stays that give people time and services such as meeting with mental health professionals and prescribers who can help them to work through a crisis.

The center's overriding goal is to reduce numbers of hospital admissions. Only 5 percent-6 percent of people who receive care at the receiving center require hospitalization, he said.

While psychiatric hospital stays are sometimes needed to ensure the safety of the patient and the community, “people are much better served out in the community,” Rose said.

As elected officials quibble over the politics of the Affordable Care Act and Medicaid expansion, the best the mental health community can do is demonstrate that it is treating patients in a cost-effective manner, Rose said.

“There’s a lot up in air. We’re going to try to show people the value of doing it the right way,” he said.

After 25 years working as a mental health professional, Rose said people who lack access to treatment because of a lack of health care coverage suffer as individuals and impact other systems such as emergency rooms and jails.

“What happens is, we all pay for caring for those people one way or another,” he said.

Norman Longshaw, who is homeless and undergoing substance abuse treatment at St. Mary’s, agrees.

“Do they want to spend a little now or a lot later on prison or jail? What’s the most cost-effective?”

Longshaw said his substance abuse has reached the point that he is ready to do the hard work of committing to a treatment program.

“You have to be ready to do it. It gets to the point you’re just tired,” he said.

Longshaw is aware of the funding crunch that has made it more difficult for nonprofit organizations such as St. Mary's Center for Recovery to fill its available treatment beds. Because he has been turned down for Medicaid coverage in the past, he said he’s keeping a close eye on what the state decides on expansion.

For now, he’s simply grateful there was county funding available for his treatment bed at St. Mary’s.

“I just feel fortunate I got one,” he said.

Email: marjorie@deseretnews.com

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