Md. must safeguard scarce public mental health funds

November 10, 2010

The National Alliance on Mental Illness of Maryland (NAMI Maryland) strongly supports the state's in-depth review of billing at Baltimore Behavioral Health, Inc. and joins the Community Behavioral Health Association of Maryland not only in its call for more stringent oversight of billing but also better oversight of residential housing. Quite simply, we do not want money being diverted from treatment and supportive services for people with serious mental illness to people who don't need that treatment.

Secondly, the unfortunate reality is that people with a substance use disorder do relapse — sometimes many times — in the course of trying to get and stay free of drug addiction, and allegations of continuing use of street drugs and an inadequate drug testing program at BBH, if true, are of grave concern.

Finally, our hope is that when the results of this investigation are made public, any individuals who may be found to have benefited personally from the delivery of Public Mental Health System (PMHS) funds through waste, fraud or mismanagement will be identified and held accountable.

At the same time, NAMI Maryland recognizes that the potential for backlash exists in the general public's reaction to Scott Calvert's series "Hooked on Treatment" — just as we know that, regardless of the outcome of the state's investigation, a great need for treatment, rehabilitative services and housing for individuals with mental illness or legitimate co-occurring diagnoses will remain. For this reason, we believe it is important to point out that Mr. Calvert's articles illustrate a broader concern as well — and that is the long-standing disconnect in the system of care for substance use disorders and mental illness.

Dr. Brian Hepburn, the Director of the Mental Hygiene Administration, points out in "Hooked on Treatment" that addicts are frequently given a diagnosis that involves either depression or bipolar disorder because the way the system is currently designed, "it is easier to get somebody into services if they have a psychiatric problem." Until this diagnosis, treatment and support services schism is resolved at federal and state levels, the environment for cases of the kind that Mr. Calvert's investigative journalism has revealed in The Baltimore Sun will continue to exist.

NAMI Maryland advocates for best practice treatment, housing and the supportive services needed for individuals diagnosed with severe and persistent mental illness to live well in the community. PMHS funds are very limited and should be spent wisely on individuals who meet the criteria for these services. We hope that the state's investigation will find that most people served by BBH are correctly dually diagnosed and receiving appropriate treatment and rehabilitative services. Whatever the investigation's outcome, we ask that recommended actions for improved oversight be implemented quickly but without the unintended consequence of reducing funding or impeding service delivery by the vast majority of service providers and non-profit organizations who follow the rules.

Constance A. Walker and Kate Farinholt, Baltimore

The writers are president of the NAMI Maryland Board of Directors and executive director of NAMI Metropolitan Baltimore.

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