Christine Jordan Sexton
When Chet Bell started in the mental health arena 35 years ago the work, he said, was more akin with the justice system than the health-care arena.
That has slowly changed, said Bell, now a management consultant with Stewart Marchman-Act Behavioral Healthcare, with locations throughout central Florida, including Daytona Beach, St. Augustine, DeLand, DeBary and New Smyrna Beach.
Bell told the crowd at the 2015 Health Care Affordability Summit in Orlando on Monday that there is a “trifecta of serious problems” with the mental health and substance abuse system in the state. The summit, sponsored by the Foundation of Associated Industries of Florida, runs through Tuesday.
Bell said the first problem is the number of those affected by substance abuse or mental health problems: At any given time 18 percent of the adult population has a diagnosable mental illness and 8 percent have a severe substance-abuse disorder. The other two issues with problems in play relate to co-morbidities, either an underlying chronic health problem or a substance abuse problem resulting from self medicating to deal with the mental health issue.
“And here’s the moment of disconnect in this trifecta: Treatment is given a low priority and is not readily available,” Bell said. “Less than 10 percent access care for any type of behavioral illness.”
Florida spends less than $40 annually per capita in state funding for behavioral health care compared with $120 per capita nationally. That places Florida 49th in the nation.
With a spate of headline-grabbing crimes — from a parent throwing his child off an approach to the Sunshine Skyway to a gunman opening fire on the Florida State University campus — Bell said this is the year for the Legislature to improve funding for mental health and substance abuse.
He said adjusted for inflation, it would costs the state $129 million to restore mental health and substance abuse funding to the year 2000 level. While it’s a monumental request the state could implement a funding plan over a period of time to improve funding, beginning with a $57 million infusion this fiscal year.
The Florida Alliance for Community Mental Health Centers has included increased funding in its legislative wish list for the 2015 Legislative Session.
The other way to improve the mental health and substance abuse system is to ensure that treatment for substance abuse and mental health problems is better integrated with medical care and that it must be evidence based. Additionally, care management must become the rule, not the exception.
“Behavioral health must continue to improve the quality of care provided with standard protocols and clear outcomes,” he said. “Behavioral health has lagged the rest of the healthcare system in this regard, to the detriment of patients and our ability to be seen as highly skilled collaborators with the rest of healthcare.”
