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Florida Matters: A Look at Mental Health Funding, Spending

Feb 3, 2015

Florida ranks at or near the bottom when it comes to per capita funding for mental health services in the U.S. 

This week on Florida Matters, we'll take a look at just how that's playing out in Florida, along with the push for more funding -- and smarter spending -- for those services.

Law enforcement officials say that by the time a person reaches to the criminal justice system, the situation is at a crisis-level. Agencies that work with mental health patients say they serve thousands each year, but they are seeing just the tip of the iceberg.  

Our Florida Matters panel includes Barbara Daire, LCSW, president and CEO of Suncoast Center and chairwoman of the Florida Council for Behavioral Health; Linda McKinnon, CEO of Central Florida Behavioral Health Network; and Pinellas County Sheriff Bob Gualtieri, who says he sees the need for more mental health treatment firsthand.

GUALTIERI: A couple weeks ago, we had a woman who came at the deputies with a steak knife, and was trying to stab them. Frankly, the deputies, under those circumstances, when she raised that knife over her head and was charging at them, would have been justified in using deadly force. Luckily, we had an experienced sergeant there, and a CIT-trained deputy, and at their own potential peril, took evasive action, didn’t shoot her, were able to disarm her. And they didn’t charge her criminally; they took her into custody under the state’s Baker Act law, which is an involuntary assessment period.   When she went to the receiving facility, all she did is to see a psychiatric via Skype, and within 72 hours she was released. They gave her a prescription, she never got it filled, she’s back out on the street.

And that’s a hole, that’s a void, that’s a problem within the system. And the laws are in place where they can go to the court and seek that person to stay in custody longer than that assessment period. But so much of it, from where I see it, is crisis stabilization, but there’s that void in long-term care, follow-up after care, the FACT teams being able to go out. This woman got nothing. She easily could have been dead, and the deputies handled it the way it should have been handled, but she didn’t get anything out of the system.

CARSON COOPER: Linda McKinnon, there has been a lot of debate over accepting Medicaid dollars from the federal government under Obamacare. Some are calling for the state to accept that money. A former Medicaid official told lawmakers last year that an expansion would move 200,000 mentally ill Floridians from DCF (Department of Children and Families) to Medicaid, which would free up millions of dollars for community-based treatment programs. Does that sound to you like a feasible approach? Would that actually work that way?

MCKINNON: I believe that if Medicaid were expanded, along with the rates that are paid for Medicaid, that would increase our capacity. About 63 percent of the funds currently that come through DCF are spent on community programs, housing, support programs, wraparound supports, medications that help keep people stable in the community.  Medicaid pays for purely physical treatment services, and the population that we serve, really requires a lot more than just medications and doctor visits, so it would in fact free up those dollars to more successfully wrap around people. However, in Florida, as I said, we also have the third-highest number of uninsured. We have a very large undocumented population who will never be eligible for those benefits, and we have to find a better way or continue resourcing the services to those people.

COOPER: Barbara Daire, Suncoast Center focuses on child abuse, behavioral health and family stability…some school superintendents around the state, say, like law enforcement, they too ought not be the primary providers of mental health services, but schools do play a very important role in  identifying extreme cases and connecting them to mental health resources.

DAIRE: We work very closely with the school system, as many of the providers do in our community and across the state, and actually have therapists in a number of elementary and high schools. And you’re right, it’s not their job to be providing the mental health services, but again, there’s not adequate funding or linkage to those services in order to meet all the needs that are out there in the community.

Hear more about mental health funding this week on Florida Matters on WUSF 89.7 FM on Tuesday, Feb. 3 at 6:30 p.m.,  Sunday, Feb.  8 at 7:30 a.m. and at wusf.org/floridamatters.