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The National Alliance for the Mentally Ill of Massachusetts is a
nonprofit grassroots education and advocacy group dedicated to
improving the quality of life for people affected by mental illness.
The State of Mental Health Services in Massachusetts:
The Impact of Inadequate Funding
Toby Fisher MBA/MSW
Executive Director
Hearing of the Citizens’ Health Care Working Group August 17th, 2005
NAMI-Mass
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NAMI-Mass Legislative Priorities 2005
I. Restore Funding to the Department of Mental Health: 20,000
chronically mentally ill individuals are desperately waiting for DMH services,
of which over 3,645 of them are waiting for residential placement. The lack
of available DMH services severely impacts the care of individuals with
mental illness, gravely affecting families and communities.
II. Save Access to Appropriate Medications: All anti-psychotics,
antidepressants, and anticonvulsants used for the treatment of mental illness
must be made available to optimize successful treatment.
III. Promote Housing for People with Mental Illness:Set aside at least
25% of the developed property value in cash to be used in a housing trust, or
alternately set aside at least 25% of the housing developed from the
liquidation and development of State Hospitals.
IV. Encourage Jail Diversion and Coordinated Re-entry Services
From the Criminal Justice System.
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Massachusetts Picture
• Financial Outlook Bleak Since 2000-just
now improving
• Deficit was in the range of $3 billion
Representing 12% and state budget
• The rate of Medicaid growth is 13%.
• This was on top of flat DMH funding
through the 1990s and extensive wait lists.
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DMH WAIT LIST FY 2000 SERVICE NEEDS
Department of Mental Health FY 2000
Waiting Lists for Residential and Support Services
Service Needed
Adult Residential *
1st
Quarter
2000
2nd
Quarter
2000
3rd
Quarter
2000
4th
Quarter
2000
Change
3381
3339
3163
3320
+157
170
247
177
220
+ 43
13687
14,123
14,103
14,164
+ 61
Child/Adolescent Case
Management
1938
2076
2224
2497
+273
Supported Employment
226
252
258
256
- 2
Turning 22 Services**
100
100
100
100
0
19502
20,137
20,025
20,457
532
Child/Adolescent
Residential
Adult Case Management
Totals
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NAMI-Mass Response to Crisis
•
•
•
•
•
Get to the Table.
Remember some changes are not legislative.
Protect Base Appropriation/Services
Support Tax/revenue Increases
Watch Funding Shifts from Dismantled Agencies
or Reallocation from Existing Agencies
• Look for Increased Efficiencies in Mental Health
Service Delivery (services reduced or combined)
• Monitor Medicaid Benefit
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NAMI Recommends Evidence-based Practices for Severe Mental Disorders in Adults
Evidence-based Practice
Description
Assertive Community
Treatment
ACT is one of the most well-documented services that help individuals with severe and
persistent mental illnesses live in the community and avoid hospitalization. It consists of
a diverse team of mental health care providers who together care for consumers,
reaching out to them in their own communities and providing the full-range of services
needed.
Evidence-based Medication
Decision Making
Various mechanisms can help translate the latest available knowledge about medications
into practice by helping physicians and patients choose the appropriate medication.
Decisions about medication must be made at the individual level, with the full-support of
scientific evidence.
Supported Employment
This employment service is the most effective in gaining individuals with severe mental
illnesses competitive jobs. Working with consumers to identify their interests, supported
employment finds a job for the individual and provides ongoing support as needed on the
job.
Integrated Dual Diagnosis
Treatment
Because individuals with serious mental disorders often have a co-occurring substance
abuse problem, the optimal form of treatment addresses both issues, rather than leaving
patients to be ping-ponged between mental health care and substance abuse service
providers, as is typically the case.
Family Psycho-education
Since family members of individuals with severe mental illnesses often provide support
and care for their loved one, services that help them understand mental illness and how
best to cope with it have been shown to help family members cope better and helps
consumers avoid psychiatric crises. An estimated 50 percent of family members provide
intensive care for individuals with severe and persistent mental illness—and thus should
be receiving psycho education services.
Illness Self-Management
Interventions that help consumers better understand their illness and take charge of their
treatment decrease symptoms and improve outcomes. All consumers with a severe and
persistent mental illness should receive this intervention.
Jail Diversion Services
A variety of programs, including mental health courts, police training, and special
police/treatment professional
outreach teams can reduce inappropriate criminalization6 of
NAMI-Mass
people with mental illnesses.
The National Alliance for the Mentally Ill of Massachusetts (NAMI-Mass)
is a nonprofit grassroots education and advocacy group dedicated to
improving the quality of life for people affected by mental illness.
NAMI-Mass is a vital resource for families and individuals facing the challenges
of biological brain disorders. Since 1983, NAMI-Mass has been highly effective
in building awareness, reducing stigma, providing support, and advocating for
patient rights. We have over 220,000 members nationally with three
organizational levels. Localized affiliate grassroots groups help to insure that
the local area mental health needs are being met. The state office, NAMIMass, provides coordination for the affiliates and NAMI-National coordinates
the efforts of the states. For more information, please contact us.
Phone: 1-781-938-4048/Fax: 1-781-938-4069
Toll Free: 1-800-370-9085/ Web: namimass.org
NAMI-Mass 400 West Cummings Park Suite 6650 Woburn MA 01801
Toby Fisher MBA/MSW
Executive Director
NAMI-Mass
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