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Florida Must Create Just and Effective Mental Health Services

October 20, 2015 - 11:00am

It is no secret that Florida’s mental health system is chronically and significantly underfunded. Throughout the past decade, Florida has maintained one of the lowest per-capita mental health expenditures in the nation. 

According to the most recent available data from the Kaiser Family Foundation, Florida has a state mental health agency per-capita mental health services expenditure of $37.28, giving it a rank of 49th for mental health funding in the United States. This lack of sufficient funding has proven a formidable barrier to accessing and improving the quality of the state’s mental health services.

Additionally, there are numerous distinct state agencies, organizations, and districts through which Florida’s mental health funding is dispersed, resulting in fragmentation, uneven access to resources, inconsistent systems of care, and inefficiency. Gov. Rick Scott’s acknowledgement of the state’s fragmented mental health funding system and his executive order to review and coordinate Florida’s mental health services are critically important first steps in addressing these challenges.

Floridians with mental health issues do not receive adequate care, and too often these individuals end up in emergency medical units or jail. We now have a very large and growing number of incarcerated individuals in need of mental health services. This creates a vicious and economically draining cycle, especially on the state’s limited mental health services budget. 

Florida’s scarce inpatient psychiatric beds are often used for individuals facing criminal charges, in order to help restore them to competency before they stand trial. Far too many of these individuals enter the criminal justice system when they experience a crisis and are not given access to adequate mental health services. Once these individuals with mental illness are driven through the criminal justice system, they are often placed back in the community without access to further mental health services, creating a very costly and ineffective pattern of inappropriate responses to their true needs.

Mental health resources are often not readily available in Florida, especially for individuals residing in rural areas; integrated behavioral health services and coordination of care could allow for these restricted resources to better serve those in need. 

Early recognition, diagnosis and treatment of mental disorders could greatly benefit from the monitoring of mental health care received in traditional medical settings (e.g., emergency departments and primary care centers) and increased collaborative efforts between mental health and physical health providers. Coordination of these integrated networks with additional community-based mental health services could help individuals with mental illness receive necessary resources beyond just psychosocial and pharmacological treatments, such as supported employment and housing.

As mentioned, many Floridians with mental health issues who do not receive adequate care end up in jail. Investment in successful jail diversion tactics is essential for the proper care of these persons. Integrated behavioral health care modeling can also be applied to jail diversion programs. 

For example, the San Antonio Restoration Center in Texas is an efficient jail diversion program that has resulted in major cost savings and is a model for similar improvements across the country. The Restoration Center is an integrated complex with 48-hour inpatient psychiatric care, sobering and detox centers, outpatient primary care and psychiatric services, a 90-day recovery program, housing for people with mental illnesses, job training, and a program to help individuals transition to supported housing. According to Kaiser Health News, this Center is saving San Antonio more than $10 million each year. This is the kind of program that should be explored for implementation in Florida.

The need for mental health reform in this state is long overdue. A thorough review of Florida’s mental health funding and services by the Governor’s Office and others will provide a more informed perspective on the condition of the state mental health system and can highlight areas where greater cost-effectiveness and efficiency are required. However, it is important to note that even if the current Florida mental health budget were to be spent more efficiently, substantially greater funding in the future will still be necessary to increase access to quality mental health services for the growing number of Floridians who need mental health care.

Kacey Heekin is a research associate at the Claude Pepper Center at Florida State University. Her research focuses on the mental health system, with special attention to mental health and aging, and long-term care. Learn more about Heekin and the Claude Pepper Center at http://claudepeppercenter.fsu.edu.

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