More local recovery funding needed

A recent series of articles in the Marietta Times described the raging epidemic of drug and alcohol abuse and addiction in Washington County. Perhaps less visible but greatly concerning is the number of county residents who need treatment for a mental illness, but do not receive it. An 8% national historical estimate applied to the 2010 population census suggests as many as 4,000 county residents aged 12 or older may not get the care they need. A 2015 study estimated only one mental health provider for every 1,426 county residents, about half the Ohio overall average of one mental health provider for every 716 residents. Effective behavioral health programs are not available for many county residents, or are not adequate for their recovery and reintegration into the family, workforce, and community as functioning, productive citizens.

Substance abuse, addiction, and mental illness destroy individual lives and families and increase hospitalization, unemployment, poverty, crime, and incarceration rates, which affect everyone in the county in some way–including employers. A 2016 survey of local employers found that many had trouble hiring, managing, or retaining employees due to use or misuse of various substances, both legal and illegal. Most had issues with employee job performance due to a variety of personal, family, and other reasons. A majority had observed behaviors in their workplaces that suggest the possibility of mental illnesses among their employees. Many had negative impacts of behavioral health issues on productivity, profitability, safety, absenteeism, turnover, and costs of hiring, training, healthcare, and insurance. Employee Assistance Program services are currently available for some employees and family members, and additional services may be needed.

Ohio law requires the Washington County Behavioral Health Board to establish a continuum of care that provides for prevention, treatment, support, and rehabilitation services and opportunities. Essential services include locating persons needing addiction or mental health services and referring them to available resources and benefits, and assisting persons receiving services to obtain necessary services to meet basic human needs for food, clothing, shelter, medical care, personal safety, and income. Essential addiction and mental health services include outpatient and residential treatment, partial hospitalization and inpatient care where appropriate, sub-acute detoxification, intensive and other supports, recovery support, and prevention and wellness management. Essential services also include an array of treatment and support services for all levels of opioid and co-occurring drug addiction–including at least ambulatory and sub-acute detoxification, non-intensive and intensive outpatient services, medication-assisted treatment, peer mentoring, residential treatment services, recovery housing, and twelve-step approaches.

Other essential elements of the continuum of care include emergency services and crisis intervention; community psychiatric supportive treatment services that incorporate continual individualized assistance and advocacy to ensure that needed services are offered and procured; as well as an array of recovery services–assistance for persons receiving addiction and mental health services to obtain vocational services and opportunities for jobs; services designed to develop social, community, and personal living skills; access to a wide range of housing and the provision of residential treatment and support; support, assistance, consultation, and education for families, friends, persons receiving addiction or mental health services, and others; recognition and encouragement of families, friends, and neighborhood networks, especially networks that include racial and ethnic minorities, churches, community organizations, and community employment as natural supports for persons receiving addiction and mental health services; and grievance procedures and protection of the rights of persons receiving addiction or mental health services.

By law the board must maintain and expand prevention, treatment, and recovery services for mental illness and addiction disorders of county residents. In recent years federal and state funding has been reduced significantly and local funding has been minimal. Prospects for future increases in federal or state funding seem poor, given current political leadership goals of reducing federal and state budgets and taxes. To continue current behavioral health services and implement new services to  meet the growing need, the board must seek additional funding from local sources.

Given the likelihood of continuing reductions in federal and state funding for mental health and addiction services and continuing growth in local needs for these services, the board will need more local funding to meet the needs. Unlike federal and state taxes, local taxes would support behavioral health recovery of county children, adolescents, and adults directly, and would contribute to reductions in hospitalization, unemployment, poverty, crime, and incarceration rates indirectly. As noted earlier, these rates affect everyone in the county in some way–including employers. The new taxes would be spent mostly in the local economy, support new job creation, and increase the local tax base, while addressing critical recovery needs.

James Raney is a member of the Washington County Behavioral Health Board. Behavioral Health Matters appears on the Opinion page on the last Saturday of the month.