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Mental Health Cuts Devastating to Community, Economic Health
by Roy Hitchings and Todd Goodwin
Op Ed in The Herald Gazette and Republican Journal
Appearing March 5, 2010

 We write today to share concerns about proposed mental health cuts now being considered by the Legislature and the devastating impact we believe they would have on communities throughout Knox, Waldo and Lincoln counties.

One proposal is a 10 percent cut to community mental health treatment, like crisis stabilization, adult residential treatment, and child case management services provided across the three-county region by the Mid-Coast Mental Health Center. The other is a 30 percent cut to hospital-based psychiatric clinics, like those at Penobscot Bay Medical Center in Rockland and Belfast, which deliver psychiatric medication and therapy services to thousands of people each year.

With a combined staff of 150 dedicated local people, the Mid-Coast Mental Health Center and the Penobscot Bay Medical Center Outpatient Psychiatry Department serve between 2,500 and 3,000 adults and children from the region each year. Many of our services are lifesaving, including those for severely depressed, addicted, psychotic, and suicidal children, teens, and adults.

Together, our nonprofit programs serve a disproportionate share of MaineCare and uninsured clients, many with serious mental illness complicated by chronic medical conditions. Fifty percent of those we serve are MaineCare beneficiaries, and 13 percent have no insurance coverage of any type.

Our programs also employ the lion's share of the region's psychiatrists, access to whom is already problematic due to a high and increasing necessity for medication-based treatment.

If the proposed state budget cuts were to be approved by the Legislature, the Mid-Coast Mental Health Center and Penobscot Bay Medical Center's mental health clinics would realize a combined revenue reduction of $2 million each year. Such reductions - at best - would force our programs to limit services to at least 500 MaineCare and uninsured clients each year. If our programs were forced to close altogether under the weight of state cuts, thousands of individuals would lose access to services in our region. In addition, approximately 30 more local jobs would be lost.

We believe these proposed cuts would place citizens of the three-county region at significantly higher risk for untreated and under-treated mental health and substance abuse issues, as well as greater reliance on more intensive and costly services, such as emergency room treatment and psychiatric hospitalization. Here's why:

With fewer available services, particularly charity mental health services, the only predictable, reliable mental health treatment alternative for the uninsured and under-insured of our region would be emergency rooms, crisis intervention services and psychiatric hospitalization. All of these services are significantly more costly than receiving care at a mental health clinic.

At Penobscot Bay Medical Center's mental health clinics, for example, an estimated $980,000 in free care is delivered each year to roughly 350 uninsured and seriously mentally ill individuals. Yet this expense is far less than the estimated $2.3 million it would cost to hospitalize each of these 350 uninsured clinic patients just once during the year.

The state budget cuts would also heighten what is already consistently inadequate access to psychiatry and therapy services for the region's uninsured and MaineCare recipients, as reported in the state's own Community Service Network Report of Unmet Needs, and as evidenced by recent and ongoing efforts of the Mid-Coast United Way to improve community mental health service availability and response.

All told, these cuts and their resulting domino effects would result in poorer overall community health, not to mention the impact that losing more than two dozen good-paying jobs would have on our struggling local economy.

As the most comprehensive providers of mental health and substance abuse services in our region, the Mid-Coast Mental Health Center and Penobscot Bay Medical Center have always been and remain committed to ensuring the mental health and well-being of area residents, regardless of their ability to pay for treatment. But we cannot do this under the proposed state budget-cutting scenario.

We understand there are no easy answers in the state's current budget predicament. Still, we encourage legislative and community support to explore alternative solutions that would enable us to continue our charitable mission of service to some of our region's most vulnerable citizens, all while preserving precious jobs that fuel the region's economic vitality.

Roy Hitchings is the chief executive officer of Penobscot Bay Medical Center and Todd Goodwin is the chief executive officer of the Mid-Coast Mental Health Center.


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