EDITOR’S NOTE: Amid statewide elections this year that will impact the direction of Mississippi for years to come, the Daily Journal continues a series exploring some of the most serious issues facing the state’s future. Upcoming articles will delve into topics related to healthcare and education.
TUPELO • Paul Callens wants to see a day where wait lists are eliminated from mental health care hospitals – but today is not that day.
Callens is the director of the North Mississippi State Hospital, located in Tupelo, and said the facility has 150 beds for patients with mental illness. All of them are full.
There are 23 people on a waiting list trying to get into the facility. Of those 23, only “a couple” are waiting in local jails, he said.
Even though this may not seem like progress, Callens said the hospital has made great strides in reducing wait lists. He hopes the facility will one day eliminate the wait lists and have beds available whenever patients need treatment.
But, according to Callens, the state can only do that by “not throwing the baby out with the bathwater.”
“What I mean by that is those that believe that the community service component is the end all answer to all mental health issues is incorrect,” he told the Daily Journal in his office. “Even people in the community mental health service will tell you there is a need for this hospital.”
Community mental health facilities differ from hospitals. Centers assist patients to function independently in communities and avoid psychiatric hospital admission or long term institutional placement.
Callens’ comments come at a time when more and more officials are calling for greater emphasis on community centers. One of those officials is Lt. Gov. Tate Reeves, a Republican candidate for governor.
Reeves said more funding in general is needed but that more home and community-based treatment systems would provide a good starting point to improve mental health in the state.
“Everyone’s needs are unique, so it is impossible to have one blanket approach,” Reeves said in a statement to the Daily Journal. “I do think, generally, we need to move from an institutional care focus to a community care focus.”
The U.S. Department of Justice is currently suing the state’s department of mental health on the grounds that the department is not providing enough oversight and care to community-based mental health care facilities, and relying too much on state hospitals.
When asked about the lawsuit, Reeves said there is more progress to be made toward helping people dealing with mental health issues but that the state doesn’t need the federal government to “come in and make healthcare decisions” for citizens.
Lifecore Health Group is one of these community health centers and serves seven counties in Northeast Mississippi, including Lee County.
Rita Berthay, the director of Lifecore Health Group said many of the issues presented in the lawsuit stem from a lack of funding and an inability to provide a wide array of services to people in rural counties.
One of the programs she thinks has been a success is the Program of Assertive Community Treatment team, or PACT team, which is a mobile team that delivers service to people in their homes. The team specifically serves people with severe mental illnesses and allows patients to remain in their homes to reduce them from staying in an inpatient environment.
“Our PACT Team is a great service, but we only have it in Lee County,” Berthay said. “I would love to have it in all of our seven counties, but there’s no funding for it.”
Attorney General Jim Hood’s office is defending the state in the lawsuit, but he shifted much of the blame to Reeves for cutting funding to the department of mental health while he was the leader of the Mississippi State Senate.
Hood, a Democratic candidate for governor, said Reeves led the charge “to slash” the department of mental health’s budget.
“Reeves has hamstrung the state’s ability to care for Mississippians who need help,” Hood said in a statement to the Daily Journal. “He has forced local governments and law enforcement to bear the costs of jailing those suffering from mental health problems instead of receiving services.”
Berthay said 86% of the clinic’s funding comes from Medicare and Medicaid, 11% come from state funding grants and 1% comes from county contributions. She said the Mississippi Department of Mental Health even gave them some of its own funding to help the community facilities out.
Even though her clinic’s goal is to keep people out of the state hospital as much as possible, Berthay believes there is a need for the hospital and some people need to be in the hospital.
Callens said the state hospital’s budget has been reduced every year since 2008, sometimes with multiple budget cuts in a single year. The current operating budget for the hospital is around $8 million.
He said the hospital cannot legally bill for Medicaid because of federal regulations, but the facility can bill for Medicare. However, Callens said Medicare isn’t a stable source of income for the hospital.
Velesha Williams, a Democratic candidate for governor, said state officials must go after the “billions of dollars left on the table” from Medicaid not being expanded and increase funding for all health care programs, including mental health care.
“I do not believe that an individual who has a mental disability belongs in jail,” Williams said. “I think that’s a horrendous practice. We have to serve people with love and passion.”
Currently, law enforcement, community mental health centers and state hospitals and group treatment homes all work together to provide care to people with a mental illness. Callen said all of these components are necessary.
If the inpatient system goes away, you have a failed system, Callens said. “If the community mental health component goes away, you have a failed system. If the crisis component on the front goes away, you have a failed system. If the housing component at the end where individuals go if they’re not going home to group homes,you have a failed system. So it takes all parts to be a success.”
State Rep. Robert Foster (R-Desoto) said the question should not be over whether to increase or decrease the amount of funding mental health care gets, but rather a question of redirecting the funds to the right places.
“We’re putting people in jail rather than putting them in a mental health facility,” Foster told the Daily Journal. “I think that’s the biggest problem we face. We need to direct those people that need help from substance abuse and have mental disorders that are not a danger to society but are more of a danger to themselves to a mental health facility rather than a jail.”
Bill Waller, the former chief justice of the state Supreme Court, said he wanted to do a comprehensive review of assets, resources and availability of mental health professionals before he makes any decisions on funding for mental health.
“I want to look at it fully, but I intend to support mental health in Mississippi to make sure we have adequate resources to support it,” said Waller, the third GOP candidate for governor.
Callens said he realizes his hospital is one of the most expensive forms of psychiatric treatment, but he believes it’s critical to the community and would cost more to shut it down than it would to keep it open.
“If you think this service is expensive today, close us down. Close us,” Callens said. “And then in a week or two when your hospitals fill up with psychiatric emergencies, when your sheriff’s departments and jails fill up with psychiatric emergencies … call me back and ask me how much the service is worth.”