It's been a fact of life in 2002: economically speaking, these are lean and mean times. In the government sector the flow of tax revenues has fallen sharply; budget cutbacks at the state and local level are being felt across the spectrum of public services and programs. Providers are weathering the storm - by tightening belts and cutting back services. But there's a growing cry that many of the people needing the services are not. That's the message coming out of Cuyahoga County's community mental health system. 90.3's Bill Rice reports.
Bill Rice: That's your first contact if you're calling the Center for Families and Children's for a mental health consultation, as do many of Cuyahoga County's unemployed and working poor. In times past, you'd reach a live person and likely be referred somewhere - either to one of CFC's offices or another agency. But not anymore, says Jan Sanford Russo, who supervises the intake office.
Jan Sanford Russo: We've closed most of our offices to new intakes and cannot accommodate them, so currently we're just taking people who have just come out of state hospitals or who have been referred by mobile crisis, they've stabilized them those case to do ongoing service and follow-up.
BR: Even those who do manage to get a live voice at CFC often get little satisfaction, says intake specialist Janet Hoy.
Janet Hoy: People that call here will tell me they've 2,3,4,5,6,7,8 - many places. There are even people that will call here more than once. They lose track of the numbers of places they've called trying to get help for their children.
BR: Hoy describes her most recent call - from a woman who's child has behavioral problems that she can't handle. A working mom, Hoy explains, who cannot get time away from work and therefore needs to see someone during specific hours.
JH: And we have more availability during the day at that office right now, but we do have a waiting list for the after school times. I was taking a peek to see if there was anything, last minute openings I could offer her, but there wasn't. She's still looking.
Andy Calladine: This is as bad as I've ever seen it and probably worse than I've ever seen it.
BR: Andy Calladine is a long-time employee of CFC, and now an upper level administrator. Like many in the field, Calladine feels mental health services are given short shrift generally. But the problem is particularly acute in Cleveland, a city where a sizable portion of the population is mired in poverty, and mental illness flourishes. With front-line agencies like CFC no longer an option for many, Calladine says, their illnesses fester longer, and they eventually turn up at other social service providers - ones that aren't equipped to handle them.
AC: The spill-over occurs in courts, in jails, in hospital waiting rooms, in homeless shelters… So we're finding that there's going to be all sort of pockets of individuals who should properly be served at mental health agencies now seeking services elsewhere, or losing their housing, ending up on the streets, in homeless shelters, ending up in courtrooms and jails.
BR: Poor funding for the county's mental health programs is nothing new, Calladine says; it's only exacerbated by the recent economic downturn.
William Denihan, the recently hired head of the Cuyahoga County Mental Health Board, agrees that mental health gets less than its due in government funding. He says that's because mental health isn't taken seriously enough at the federal level, where a majority of funding comes from. Brushing aside the problem, he says, just makes it a bigger problem.
William Denihan: Ignoring this issue is far more expensive at the end of An episode of an individual with mental illness if they have to go into a hospital, which costs several hundred dollars and costs tens of thousands of dollars when a twentieth or thirieth of that amount of money could be spent on wraparound services, counseling, prevention activities that would prevent them from getting to that particular point.
BR: So what's to be done? There's general agreement that no new dollars are on the immediate horizon. And there's a consequent push to revamp the system, much of it coming from the top - the county commissioners. Mental Health has been one of Commissioner Tim McCormick's pet issues.
Tim McCormick: Over the last ten to fifteen years we've had terrible - terrible - administration of the mental health system. 3 or 4 directors were removed for cause. So it has been sloppy.
BR: Early this year McCormick asked the state to do an extensive audit of the mental health board. The results are just in, he says, and comparisons with other cities suggest a lot can be improved within the current budget.
TM: Other communities - Columbus, Cincinnati - have decreased the average number of hours billed per consumer, yet the number of people they've been able to serve has increased at the same time.
BR: Mental health costs per consumer in Cleveland were the highest of all Ohio's major cities in the last two years, McCormick says. The audit makes restructuring recommendations, most of which Mental Health Board Chief William Denihan says he agrees with and putting in place. But the audit does little to dispel the doubts of people like Andy Calladine, who sees such efforts, in the big picture, as mere band-aids.
AC: The funding is really an open wound that we need to make even more visible to the whole of the community. And there are no simple answers.
BR: In Cleveland, Bill Rice, 90.3.