The only way to ensure full access to mental health care and solve our boarding crisis is to expand our community-based outpatient mental health system.
Inpatient beds are a critical and important first step. While the Supreme Court’s psychiatric boarding decision draws attention to the inpatient crisis side of the system, we know our outpatient mental health system is not equipped to fully care for the influx of patients who need access to care.
We need to follow through with a full commitment and legislative funding for the outpatient services that prevent our neighbors living with mental illness from ever reaching a crisis point.
As frontline mental health workers, we will be meeting with and urging legislators to prioritize mental health and new revenue.
Necessary steps to fully invest in inpatient and outpatient care:
INVEST IN PEOPLE: RESTORE FUNDING TO OUR COMMUNITY MENTAL HEALTH SAFETY NET
While expanding crisis inpatient beds, we must also seek to reduce the number of patients escalating to crisis:
• We must fund programs that keep people stable in the community by restoring and increasing non-Medicaid support for evidence-based practices like homelessness outreach, supportive housing, and job assistance.
• We must increase the Medicaid reimbursement for wage pass-throughs as was done in 2007 to address the workforce recruitment and retention crisis and reduce caseloads. High turnover among frontline care and service providers is getting in the way of providing the continuity of care our patients and clients need. This will provide appropriate, long-term therapeutic relationships that support recovery and reduce costs by stabilizing and growing the workforce to meet demand and address public safety concerns.
PROVIDE SAFE STAFFING FOR EVERY PATIENT: INCREASE FTES AT THE STATE HOSPITALS
Our state hospitals Western State Hospital (WSH) and Eastern State Hospital (ESH) are dangerously understaffed resulting in reduced levels of quality care, failure to help patients meet restoration and treatment outcomes and increased overtime costs. We need to meet appropriate staffing levels through the following immediate interventions: increase the core staffing at WSH by at least 12 RN FTEs in order to appropriately meet patient care needs at one of the most dangerous worksites in the state, implement a permanent float pool of 24 RN FTEs at WSH to ensure safe staffing for all patients; increase staffing coverage by 15 RN FTEs to ensure ESH and WSH RNs receive their continuing education and mandatory training.
REBUILD LIVES: CREATE MORE CAPACITY FOR HOUSING AND BEDS
We need to invest significantly in not only additional inpatient evaluation and treatment beds—expanding upon investments made in the last biennium and the recent Supreme Court stay—but significantly expand supportive housing through the capital budget. Supportive housing is critical for genuine recovery and keeping patients in their communities.
RECRUIT AND RETAIN STAFF FOR QUALITY CARE: PROMOTE TRAINING AND EDUCATION
We stand with the rest of the healthcare industry in calling for full funding for the Health Professional Loan Repayment program and for its expansion to mental health professionals. This is a patient care priority necessary to start addressing the workforce recruitment and retention and capacity issues faced in the system.