DRCNH Home > News > Opinion 8-22-2004

Cuts in N.H. mental health program will be detrimental to kids, adults

Published in the Nashua Telegraph Sunday, Aug. 22, 2004

In yet another series of moves further dismantling supports to people in need, state Health and Human Services Commissioner John Stephen eliminated a critical, legislatively mandated program.

The commissioner’s action, supported by Gov. Craig Benson, to terminate funding to the program operated by the National Alliance for the Mentally Ill of New Hampshire (NAMI-NH) will severely impact countless children with severe mental illness and their families.

For 20 years, NAMI-NH has received funds to provide education and support to families with children with severe mental illness.

Trained family members provide support services and teach families how to use their own resources in overcoming problems and to navigate the service systems.

The Legislature recognized the importance of NAMI-NH’s family-to-family programs in 2001 by enacting the Family Mutual Support Services Act.

Stephen’s termination of NAMI-NH’s contract (equaling 57 percent of NAMI-NH’s budget) again demonstrates this administration’s lack of understanding, at best, and contempt, at worst, of promising and evidenced-based practices in treating mental illness and promoting recovery.

This action was followed by Health and Human Service’s abrupt termination of two peer support programs, without providing an adequate alternative for the affected mental health care consumers.

Studies and reports, including President Bush’s acclaimed 2003 New Freedom Commission on Mental Health, have found that peer-to-peer and family-to-family service and support have proven highly effective in keeping families together and preventing hospitalization and other expensive treatment.

Would the governor and his commissioner eliminate innovative and productive new practices in favor of outmoded and unproductive practices for the environment, business, energy, education, and transportation?

What, then, do their actions say about the value they place on individuals with mental disabilities and their families?

In another notable example, Stephen and the governor championed a bill instituting a “preferred drug” system for individuals in the state’s mental health system.

That list will make it difficult to access modern and effective drugs with virtually no side effects in favor of older and cheaper medications, such as Haldol, a drug praised by Stephen at a legislative hearing. Haldol can cause irreparable neurological damage.

In justifying the NAMI-NH contract termination, the commissioner suggests that families will not lose out because these services can be turned over to the mental health centers and the state hospital which can perform these functions in a more “seamless” and “integrated” fashion.

The justification, however, does not square with the 2001 law, which requires the use of “family mutual support organizations” to provide “family mutual support services.”

The 2001 law also gave the family mutual support organization an external, independent advocacy, monitoring, and quality assurance role over the state’s mental health system.

By assigning these roles to the very psychiatric facilities and institutions over which the law intends to create a check and balance, Stephen in defiance of the legislative intent, is removing this external scrutiny over the agencies he supervises.

Stephen also claims that transferring this program saves money. How reliance on professional medical personnel to deliver services previously provided by trained family members and designed to prevent reliance on more expensive institutional modes of care will save money defies logic.

What has not been said publicly, but reported, is that the commissioner’s Division of Behavioral Health, the agency with the expertise in the area, twice approved the contract, the second time after NAMI-NH reduced its budget, only to be overruled by the commissioner with support of the governor.

In vetoing the NAMI-NH contract, it was also reported that Stephen said that he would not give the funding to an advocacy organization.

NAMI-NH, with other organizations, expressed opposition to Benson/Stephen’s bill to cut mental health services to children and seniors.

NAMI-NH and others also expressed concerns over the administration’s preferred drug-list bill.

NAMI-NH also supported peer support programs, the Katie Beckett program and essential services to vulnerable citizens that this administration is seeking to cut.

Unless this action is reversed, NAMI-NH and the many vulnerable families and children it serves will now pay the price for what NAMI-NH is supposed to do - speak up on behalf of the people with mental illness and their families.

The action against NAMI-NH is representative of this administration’s quest to dismantle the human service system, with no regard to what is working and the requirements of the law, and to attempt to retaliate against anyone who would dare oppose them.

Their actions represent bad fiscal policy, bad management, bad science, and are anathema to democratic values and society’s obligation to support its fellow citizens most in need.

Guess what? “Medicaid modernization” has begun. We believe, however, that most of New Hampshire’s citizenry and their representatives will see these types of actions for what they are and stop them before more damage is done.

John Kitchen is board president of the Disabilities Rights Center and Richard Cohen is executive director of the Disabilities Rights Center, New Hampshire’s federally designated protection and advocacy system.