February 14, 2016

State of mental health care in Missouri discussed against gun control backdrop

Among both those for and those against new gun control measures are those who say the quality of mental health care must also be considered when discussing violence prevention.  By several accounts, the system in the state of Missouri is under funded, but there is more than one suggestion about how to fix it.

Representative Sue Allen (R-Town and Country) chairs the House Appropriations Committee on Health, Mental Health and Social Services. She says she has thought that mental health is underfunded for years, not just since recent shooting incidents in Connecticut and Colorado.

“I cannot believe there is not money to better fund mental health, and the key is finding out where it is. Now it may be taking it away from somebody else who maybe is a little more capable of meeting their own needs but they don’t have to because they’re entitled to something.”

Representative Tom Flanigan (R-Carthage) was the chairman of that budget committee last year. He also says the Department of Mental Health has received too little funding for years.

“It’s a very small department, budgetarily, and it probably does more good dollar for dollar than any other department in the state of Missouri.”

Flanigan suspects that stigmas about mental health carry over into funding the department. He hopes this discussion will help to change people’s mindsets.

“It may be that mental health becomes one of those issues that people begin to talk about openly, and to talk about it in terms of positive outcomes. That’s what I would like to see that comes out of this whole situation.”

The National Alliance on Mental Illness gave Missouri a “C” grade for mental health care in a 2009 report.  Missouri Executive Director Cindi Keele says improving awareness and treatment is a matter of funding.

“Public awareness campaigns cost money … community mental health centers need money to have people on staff, perhaps experienced family members, who are hired to be a mentor for these families that are going through these troubling situations.”

Keele isn’t impressed, however, with the idea of just looking elsewhere in the budget for places to pull money for mental health.

“I find that very frustrating … we’ve got to have some more revenue coming into this state, in my opinion.”

Keele says one way to improve the state’s mental health system would be to participate in Medicaid expansion.

“If more people had health insurance we could get mental health issues, to a great extent, detected much earlier and treated much earlier.”

Representative Jeanne Kirkton (D-Webster Groves) is a member of the budget committee on mental health.  She says statistically, expanding Medicaid would reach a large number of people with serious mental health issues.

“If we look at the population of mentally ill and those that are poor, say under 133% of the federal poverty level, 1 out of 6 of those will have severe mental illness. So, if we’re going to talk about gun violence and mental illness, expanding Medicaid to that population is a plus.”

Legislative Republicans don’t support Medcaid expansion however, raising questions about how it will be paid for and whether Congress can be trusted to keep its fiscal promises.  Three House Republicans have been studying the issue of expansion looking for an alternative plan.

Kirkton also expresses concern about stigmas regarding mental health. She says she is worried that ties to discussions of gun violence could further those stigmas.

“You look at the data … the people that are most prone to gun violence are substance abusers and alcoholics … that tend to be more violent than the severely mentally ill. It’s a very small percentage of them who are violent.”

Allen adds, she believes the issue of violence extends beyond guns and mental health to things like violence in movies and video games.

“It’s a very invasive issue … it’s societal. What’s the value of life?”

Lawmakers in both parties say they are not aware of legislative efforts to change any policies or practices in Missouri’s mental health care system.

Allen’s committee on appropriations for health, mental health and social services will hear an overview of the Department of Mental Health at a hearing today at 2:00.