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Home / Articles / News / Local News /  Insane System
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The $1 billion Behavioral Health Collaborative partners with state prisons and county jails.

Insane System

Budget cuts hit the psych wards of last resort

June 30, 2010, 12:00 am

Every year when the New Mexico State Legislature convenes, the Roundhouse rotunda fills for “behavioral health day.”

The idea is to put warm bodies into folding chairs, a show of support for the New Mexico Behavioral Health Collaborative. The BHC, a controversial $1 billion entity, was created in 2004 to dole out state funds for everything from heroin addiction to schizophrenia.

At last year’s event, BHC officials congratulated 16 people who “have overcome serious behavioral health issues,” according to a state newsletter. Each BHC “star” got a button and a bag “filled with miscellaneous goodies.” They also received certificates signed by Gov. Bill Richardson and BHC Chief Executive Linda Roebuck Homer.

Kiko Funmaker of Peñasco was among last year’s star award recipients. In a photo, Funmaker stands unsmiling in the back row.

The event may have been a “ringing success,” as the newsletter claims, but the same cannot be said for the state’s approach to mental health care.

Last week, Funmaker was booked into the Santa Fe County Jail on charges of indecent exposure and disorderly conduct.

It was at least his second arrest since the state’s top mental health bureaucrats trotted him out as a success story. Three months after behavioral health day, 2009, Funmaker was booked on charges of battery and disorderly conduct.

Prosecution was evidently left up to tribal authorities. Funmaker does not have a listed phone number and did not respond to an email. SFR was unable to determine what, if any, mental health care he received while in the county lockup.

In any event, his apparent relapse shows the futility of saddling police officers and prison wardens with the responsibility of caring for the mentally ill. In New Mexico, which ranks near the bottom in nationwide surveys of access to and quality of mental health care, jails have long substituted for psych wards.

“It’s an incredibly inhumane way of dealing with mental health,” Lauren Reichelt, past chairwoman of the local BHC for Santa Fe, Los Alamos and Rio Arriba counties, tells SFR. “You would never say to someone who was severely diabetic, with stage four cancer, ‘Oh, your tumor’s better, we’re going to throw you back in jail now.’” Needless to say, Reichelt says, a jail cell is “not a very healing setting.”

The same applies to state prisons, where recent studies have shown up to two-thirds of the population has some mental illness. Nevertheless, the New Mexico Corrections Department cut $4 million from its budget for inmate medical and mental health care in the next fiscal year.

Such cuts won’t help reduce recidivism, a longstanding goal of the BHC and state prison officials. Nine months ago, NMCD hired Bernard Lieving to be its reentry and prison reform czar. Lieving wasn’t given an office; when SFR tried to call Lieving, his phone had been disconnected.

It turns out Lieving is already leaving for a new job. He tells SFR in an email that his last day will be July 7, and that he will not be replaced.

Asked for parting thoughts, he writes, “we need to stop putting people who are mentally ill in prison” and instead fund The $1 billion Behavioral Health Collaborative partners with state prisons and county jails.

local mental health programs.

It’s old advice. Why hasn’t it been fol lowed? In a word, money.

Reichelt, who chairs the Rio Arriba County Health and Human Services Commission, says the state’s “fee for service” approach to health care creates an incentive for hospitals, doctors and other contractors to do the least amount of work in the shortest possible time.

“If what you’ve got to do is give a bunch of 15-minute ‘increments of service,’ you’re going to skip the homeless. You’re going to skip people who cycle in and out of jail. You’re going to skip the severely mentally ill, because they don’t show up for appointments,” she says. “That takes a lot of time away from services you can bill for.”

Reichelt believes the state would be better served if the BHC paid hospitals based on how their patients fared after treatment.

It’s not likely for such a dramatic change to take effect before July 31, when the Santa Fe County Commission must deliver its next budget.

Commissioners hope to cut $6 million from the budget for the next fiscal year. The several million dollars set aside for inmate medical services—including mental health care through Christus St. Vincent Regional Medical Center—are on the table.

 

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