While the impact of state budget cuts on mental health clinics in Chicago and Tinley Park has received a lot attention, smaller, community-based services in the Northwest suburbs say they are also feeling the impact.
Events like the recent closure of the Tinley Park Mental Health Center have a ripple effect on places that provide outpatient services like Maine Center, a nonprofit behavioral health organization providing community mental health and substance abuse services in Park Ridge.
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Dave Billingham, associate director at the center, said the closures mean "one less resource for people," who then turn from inpatient care to outpatient, or spend time in the emergency room waiting for a state bed.
Billingham said the state has been reducing Maine Center's mental health funding for the last six years, but its funding is unchanged this year at $809,000.
However, The Josselyn Center, a community mental health care center in Northfield, is taking a major hit. Four years ago, in fiscal year 2009, the center received $850,000 from the state; in fiscal year 2012, it received $450,000.
"We're going to end up with a $125,000-$150,000 loss this year," said Josselyn Center President Gary Smith.
Illinois ranked fourth in a list of states that have made the largest mental health cuts in recent years, according to a National Alliance on Mental Illness 2011 report. The total general fund mental health budget in Illinois was cut by 31.7 percent, or $187 million, between fiscal years 2009 and 2012, the report said.
The state is focusing on community care and shifting funding and patients away from state-run institutions like the one in Tinley Park. The move will save an estimated $19.8 million a year and improve patients' quality of life, according to a state news release.
But there's fear that with the state's budget problems, sufficient funding will not be redirected to community services, as demonstrated by the situations with Maine and Josselyn.
The Maine Center in 1997 had 36 clinical full- and part-time positions, Billingham said. In 2012, the center employs two part-time psychiatrists, one nurse, and 13 counselors and social workers.
"It's fewer people doing more work," he said.
Reducing employees was not the center's first option, Billingham said.
"Five percent of our funding was cut several years ago," he said. "In order to keep everyone working, everyone took a 5 percent pay cut."
In October 2010, the Illinois budget eliminated support for mental health treatment for people without health benefits, so only those eligible for Medicaid could receive free mental health services at the center, he said.
"We lost about 200 clients that had to go elsewhere," Billingham said, because the state previously had been paying for a significant portion of their care, and Maine Center couldn't provide them services for free, he added.
At the Josselyn Center, "We've had to increase our lowest fee," Smith said, "but even that did not keep our heads above water." The cost of an hour of therapy at the center was increased from $12 to $50, and some individuals simply could not afford to pay the higher fee. Smith said that 94 percent of the clients seen at the Josselyn Center are eligible either for the center's sliding fee or Medicaid.
"We've had people we knew we could help, we could reach out and make their lives better," Smith said, "but we can't because they can't afford it, and we can't see them for free."
Mental health care providers said they feel like they are at a disadvantage in lobbying against budget cuts, compared to much larger groups with bigger lobbies like schools and hospitals.
"It seems a little shortsighted to be cutting Medicaid on the mental health end," Billingham said. The growth in Medicaid is coming from primary health care, with mental health services a small percentage of Medicaid, he said.
"These individuals, when they stop receiving services, end up in situations that are much more costly," such as hospitals and prisons, Smith said. "The state of Illinois is remiss in its responsibility to the mentally ill. And the state is remiss in understanding the impact of its dollar reductions."