The Transylvania Times -

Mental Health


There is an undeniable need for mental health services these days. Anti-depressant prescriptions have increased 400 percent since 1988. In 2013, suicides were the 10th leading cause of death in the U.S. Yet, many of the mental services that people need are not readily available.

Locally, County Commissioner Page Lemel recently pointed out that there are no residential treatment centers in the county, it’s difficult to place people who need treatment, and there are a lack of services for young people. Due to the lack of funding, many people who need mental health services are sent to the local hospital or public safety facility, neither of which are designed to handle such patients.

There are numerous reasons that those who need mental health services are not receiving them, but two major reasons are a lack of government funding and government funding being siphoned off for administrative expenses. These reasons represent the two conflicting views of government operations: Government does not have enough money to properly administer programs versus administrative misuse of government funds. An argument can be made that both sides are partially correct.

The state budget for 2015-16 decreases the amount for mental health services by $110 million. The state Senate proposed cutting $185.6 million from mental health services. The state House proposed adding $2 million for mental health services. The Senate won the negotiating battle, resulting in the $110 million budget decrease. And there has been a proposal to cut another $152 million in the next budget. Given the increase in need for mental health services, to cut funding is irresponsible.

“We can’t do this again,” Republican Rep. Chris Malone of Wake County, one of the health budget authors, told the Daily Tarheel. Malone knows that the state, which has typically underfunded mental health services, needs to increase funding for mental health care.

But there is no guarantee that increasing funding will have a corresponding increase in the provision of mental health services. The potential problem lies with the eight regional mental health agencies that administer funding.

County commissioners made it clear earlier this month that they are not pleased with the services being provided by The Smokey Mountain Center, which oversees funding for mental health services in 23 counties in Western North Carolina, including Transylvania. Smokey Mountain Center has a budget of $369 million, of which roughly $40.6 million is spend on administrative fees.

Not only do the administrative fees seem high, but The Smokey Mountain Center has been, at this point, less than responsive regarding complete transparency. Commission Chairman Mike Hawkins said the county is not receiving quarterly reports from The Smokey Mountain Center. Commissioner Jason Chappell proposed the county not sign any documents related to The Smokey Mountain Center until the commissioners receive full, detailed reports.

The commissioners are correct in taking this stance. All too often government money is funneled through agencies (some of them non-governmental) to provide services, such as mental health. Since many of these agencies represent regional areas, it is difficult to determine if the funds are being spent appropriately. Local representatives are only looking at their small piece of the pie, not the entire regional picture. From that perspective, it’s difficult to tell if the money is being well spent regionally. Maybe it is: maybe it is not.

Under present circumstances, those who suffer most are those needing mental health services. If the state miscalculates the need for mental health services and underfunds those services, then those who need the services do not receive them. If, however, the state correctly calculates the need for mental health services and cuts spending, there is no assurance that the fat, which may be found in the regional administrative agencies, will remain untouched. Too often the fat remains while the muscle, those providing the actual services, is cut. Again, those needing the services are ones who suffer the most.

There are thousands of individuals and dozens of organizations in this state that are doing the best they can to provide mental health services. The state needs to refine the system so that it properly calculates the amount of money needed to provide those services and see that those funds reach those who directly provide mental health services. They need to build muscle while cutting the fat.


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