Talk to people around Rome, Ga. for a while and the conversation often shifts to the lingering stresses that plague the community after a state mental health facility closed seven years ago.
Homelessness. Drug abuse. People with mental disabilities stuck in jail cells.
The Georgia Budget and Policy Institute team visited Rome earlier this month as part of an ongoing statewide listening tour. In conversations with business leaders, elected officials and people receiving community support services, a recurring theme cropped up throughout the day. The number of people with mental illnesses and substance abuse disorders is growing and many are not receiving treatment.
The consensus from meetings at restaurants, a business incubator and other stops is that the closure of the Northwest Georgia Regional Hospital at the end of 2011 left many people without a place to live and get care. Good intentions preceded the closing of the 38-year-old facility.
A 2010 legal settlement between the U.S. Department of Justice and the state of Georgia aimed to move mental health treatment from institutions like Northwest’s 150-acre campus to smaller community settings. The conditions in the state-run mental health hospitals were sometimes unsafe and some patients were institutionalized when getting services in their communities made sense. This was in violation of a 1999 Supreme Court decision that found people with mental disabilities have a right to live in their community rather than an institution when appropriate.
After settling the federal case, Georgia established 25 community service boards to help move patients out of institutions and into community-based services. The Department of Behavioral Health and Developmental Disabilities still operates five mental health hospitals, but it contracts with the service organizations to deliver the majority of services now in community settings.
The community service boards provide mental health services and substance abuse treatment. Most of the patients are uninsured or covered by Medicaid. Highland Rivers Health is the community service board in Rome. Rome is also home to public-private partnerships designed to help people coping with mental health problems, including the Pine Ridge and Oak Ridge apartment communities that provide affordable housing and coordinate mental health and substance abuse services with Highland Rivers Health. However, the need exceeds the available housing and services. And that need is growing as drug overdose deaths rise rapidly in Georgia.
Northwest Georgia Regional Hospital once served about 2,000 residents with mental illnesses or developmental disabilities, which dropped to 185 residents by the time it closed. The state helped many residents transition to community housing, but some of that was temporary and not enough housing was offered to accommodate everyone displaced. As a result, many people ended up homeless or in unsafe and unstable housing. Some former patients also ended up in and out of the emergency rooms and in jails.
Georgia more recently sought alternatives to jailing the mentally ill through recommendations of the Georgia Council on Criminal Justice Reform. Gov. Nathan Deal signed a criminal justice reform bill this year that allows the state health agency to determine Medicaid eligibility for inmates eligible for parole to attain long-term health services. This is a good start to better connect people in the criminal justice system with mental health services, but a 2017 GBPI report offers additional solutions to better prioritize behavioral health treatment over punishment.
Community leaders in Rome also lamented the economic toll of substance abuse. State funding for substance abuse prevention and adult addiction services fell dramatically during the recession and remains relatively flat despite the economic recovery.
The 2019 state budget the governor signed early this month includes $4 million for substance abuse recovery treatment programs. These new funds help restore funding lost in adult addiction services. However, there were no new funds for adult substance abuse prevention programs. The budget that takes effect July 1, 2018 does contain important additions for child and adolescent opioid abuse and suicide prevention, following recommendations from the Commission on Children’s Mental Health. Also included is $5 million for community-based services such as supported housing for people with mental illness and $1 million to develop a mobile phone application to expand the reach of the Georgia Crisis and Access hotline.
These investments and more seem to be needed to help heal some of the problems in Rome. Some business owners say they can barely find employees who can pass drug tests. Others said family members can’t keep a job or make it through school because of drug addiction. Investing in mental health and substance abuse treatment not only helps families, but also strengthens the workforce and economy.
Stepping up the states’ efforts to invest in behavioral health services is a key pillar of GBPI’s People-Powered Prosperity initiative. The tragedy of people suffering from mental health and substance abuse in Rome affirmed this priority. It is a story to share with state policy makers to make sure they know much work remains to get more people with mental illness and substance abuse disorders connected to treatment services and safe places to live.