11th Congressional District: will NC failing mental health reform become an agenda item?
The following is associated with a discussion that Carl Mumpower, psychologist (R) has been having w/ a blogger. I am passing it on as associated with the ongoing problems that mental health reform has had in western NC, in particular. Dr. Mumpower will be running against Health Shuler (D) in 2008 as associated with the western NC Congressional seat for the 11th District.
The associated blogspot is here: http://themountainblog.blogspot.com/
These are my points of disagreement or query, as per Dr. Mumpower's post, below; my comments are discriminated by a series of ****:
Item 1: "...Brief therapy interventions with ongoing education, medication, periodic maintenance visits and group therapy follow-up options can help contain costs and maintain continuity of care - a crucial component for success..." ****In my experience, 'maintenance visits' seldom work in terms of working on deeper issues. What is required is persistent therapy, depending on the GAF or severity of the problems that the client is having. We have now moved into the place wherein the LME's (the old community health centers) are now acting like the insurance companies frequently have: the non-clinicians assume they know more about mental health than the clinicians. This begins at the top, re: NC DHHS, and continues all the way thru to the LME employees.
Yes, medication can give a critical leg-up but not unless you can obtain it. Yesterday I called the Buncombe County Health Department in order to access a state funded client in Asheville to someone who could simply prescribe an antidepressant and quite possibly an anxiolytic so the client can work and sleep. The Buncombe County Health Department person told me that the client could call on this Thursday, starting at 8 a.m., continuing to call until he could get through the phone line, in order to set up an appointment next month-----maybe. The client had tried and tried to obtain information about an appointment. I tried. I referred him to Good Samaritan Clinic, out of Buncombe county. This mental health care system is BROKEN. *****
Item 2: ".... Bureaucratic overlay and paperwork must be persistently trimmed to assure that caring for patients is a priority over caring for the system...." ******DHHS NC, who is implementing NC mental health reform, with an overviewing, a critical overviewing to be sure, by the State Legislative Committee for mental health reform (Chairs: Verla Insko; Martin Nesbitt) is perfecting a mountainous production of demanded paperwork. Person Centered Plans are now 15-20 pages (whileas the old community mental health center Service Plan which outlined symptoms and treatment was 2-3 electronic pages). No, NC DHHS: it does not matter that you have created a 'person centered plan' if the template must meet criteria set by the LME. It frankly does not matter what the 'person' wants. You simply want us to think that it matters.
A request sent into Western Highlands several weeks ago associated with authorization for a state funded client has still not been attended to. Yes, I have called them about it.
Veering over to Smoky MOuntain Center LME (Western Highlands and Smoky Mountain Center LME are the only 2 LME's in western NC which coordinate mental health care mostly re: state funded consumers), my 17 page Person Centered Plan, a requirement every 3 months for a state funded consumer, has been rejected twice now by (most recently) a non-clinician office person with the admonition that I had not paid enough attention to the client's use of marijuana and street Klonepin. That is not the client's major mental health problem. *****
Item 3: ".... In today's world, leaving addiction treatment out of the mental health equation makes little sense, in that addiction is probably our number one source of mental health issues...." *****Dr. Mumpower seems to have jumped on the bandwagon of 'you've got to treat (what we think is) an addiction first. Outside the abstinence crowd of the 'moral majority right' of the US, drug abuse rather than drug dependence is treated by minimizing harm until the client can avail themselves of mental health treatment such that the abuse recedes into the background as a problem. Where are the statistics that addiction is 'the number one source of mental health issues', Dr. Mumpower? And where is the timely mental health treatment for these clients??
marsha hammond, phd
************************
Dr. Mumpower's outline of the problems w/ mental health reform in NC, particuilarly western NC:
"An accessible, effective, and affordable mental health service system...
We are in the midst of a deteriorating culture. Values, supports, cultures, etc. are shifting in a way that are leaving folks more and more vulnerable and stressed. Addiction, of both legal and illegal drugs, is growing at a frightening rate. By failing to sustain the promise of state supported mental health services, we insure that homelessness, addiction, and other social issues grow exponentially. Mental health and addiction services are a necessary lifeline to insure out ability to pull off the other two legs of this stool.
Solutions - It is too our collective shame that we have allowed our mental health delivery system to wallow in "no man's land" for 6+ years. There should be accountabilities for elected and appointed officials who have at best been passive or complacent with this reality and at worst, complicit in the harms. All new initiatives must be field tested for realism and efficiency before implementation. Costs factors require that treatment modalities be targeted, reality based, and focused on functional improvements over more exotic or costly interventions. Brief therapy interventions with ongoing education, medication, periodic maintenance visits and group therapy follow-up options can help contain costs and maintain continuity of care - a crucial component for success. Bureaucratic overlay and paperwork must be persistently trimmed to assure that caring for patients is a priority over caring for the system. In today's world, leaving addiction treatment out of the mental health equation makes little sense, in that addiction is probably our number one source of mental health issues. We have people in Raleigh and around the state who can fix the mess - if we can develop the will and sense of urgency that our failing mental health delivery system deserves.
Excuse my rush, but this is a quick take on your question. I hope others will jump into the mix and create some productive dialog about these issues. Without a stronger emphasis on this "Community Health Equation" our future slides toward a darker place.
Thank you,
Carl Mumpower
Asheville City Council
Candidate for the 11th District Congressional Seat"
The associated blogspot is here: http://themountainblog.blogspot.com/
These are my points of disagreement or query, as per Dr. Mumpower's post, below; my comments are discriminated by a series of ****:
Item 1: "...Brief therapy interventions with ongoing education, medication, periodic maintenance visits and group therapy follow-up options can help contain costs and maintain continuity of care - a crucial component for success..." ****In my experience, 'maintenance visits' seldom work in terms of working on deeper issues. What is required is persistent therapy, depending on the GAF or severity of the problems that the client is having. We have now moved into the place wherein the LME's (the old community health centers) are now acting like the insurance companies frequently have: the non-clinicians assume they know more about mental health than the clinicians. This begins at the top, re: NC DHHS, and continues all the way thru to the LME employees.
Yes, medication can give a critical leg-up but not unless you can obtain it. Yesterday I called the Buncombe County Health Department in order to access a state funded client in Asheville to someone who could simply prescribe an antidepressant and quite possibly an anxiolytic so the client can work and sleep. The Buncombe County Health Department person told me that the client could call on this Thursday, starting at 8 a.m., continuing to call until he could get through the phone line, in order to set up an appointment next month-----maybe. The client had tried and tried to obtain information about an appointment. I tried. I referred him to Good Samaritan Clinic, out of Buncombe county. This mental health care system is BROKEN. *****
Item 2: ".... Bureaucratic overlay and paperwork must be persistently trimmed to assure that caring for patients is a priority over caring for the system...." ******DHHS NC, who is implementing NC mental health reform, with an overviewing, a critical overviewing to be sure, by the State Legislative Committee for mental health reform (Chairs: Verla Insko; Martin Nesbitt) is perfecting a mountainous production of demanded paperwork. Person Centered Plans are now 15-20 pages (whileas the old community mental health center Service Plan which outlined symptoms and treatment was 2-3 electronic pages). No, NC DHHS: it does not matter that you have created a 'person centered plan' if the template must meet criteria set by the LME. It frankly does not matter what the 'person' wants. You simply want us to think that it matters.
A request sent into Western Highlands several weeks ago associated with authorization for a state funded client has still not been attended to. Yes, I have called them about it.
Veering over to Smoky MOuntain Center LME (Western Highlands and Smoky Mountain Center LME are the only 2 LME's in western NC which coordinate mental health care mostly re: state funded consumers), my 17 page Person Centered Plan, a requirement every 3 months for a state funded consumer, has been rejected twice now by (most recently) a non-clinician office person with the admonition that I had not paid enough attention to the client's use of marijuana and street Klonepin. That is not the client's major mental health problem. *****
Item 3: ".... In today's world, leaving addiction treatment out of the mental health equation makes little sense, in that addiction is probably our number one source of mental health issues...." *****Dr. Mumpower seems to have jumped on the bandwagon of 'you've got to treat (what we think is) an addiction first. Outside the abstinence crowd of the 'moral majority right' of the US, drug abuse rather than drug dependence is treated by minimizing harm until the client can avail themselves of mental health treatment such that the abuse recedes into the background as a problem. Where are the statistics that addiction is 'the number one source of mental health issues', Dr. Mumpower? And where is the timely mental health treatment for these clients??
marsha hammond, phd
************************
Dr. Mumpower's outline of the problems w/ mental health reform in NC, particuilarly western NC:
"An accessible, effective, and affordable mental health service system...
We are in the midst of a deteriorating culture. Values, supports, cultures, etc. are shifting in a way that are leaving folks more and more vulnerable and stressed. Addiction, of both legal and illegal drugs, is growing at a frightening rate. By failing to sustain the promise of state supported mental health services, we insure that homelessness, addiction, and other social issues grow exponentially. Mental health and addiction services are a necessary lifeline to insure out ability to pull off the other two legs of this stool.
Solutions - It is too our collective shame that we have allowed our mental health delivery system to wallow in "no man's land" for 6+ years. There should be accountabilities for elected and appointed officials who have at best been passive or complacent with this reality and at worst, complicit in the harms. All new initiatives must be field tested for realism and efficiency before implementation. Costs factors require that treatment modalities be targeted, reality based, and focused on functional improvements over more exotic or costly interventions. Brief therapy interventions with ongoing education, medication, periodic maintenance visits and group therapy follow-up options can help contain costs and maintain continuity of care - a crucial component for success. Bureaucratic overlay and paperwork must be persistently trimmed to assure that caring for patients is a priority over caring for the system. In today's world, leaving addiction treatment out of the mental health equation makes little sense, in that addiction is probably our number one source of mental health issues. We have people in Raleigh and around the state who can fix the mess - if we can develop the will and sense of urgency that our failing mental health delivery system deserves.
Excuse my rush, but this is a quick take on your question. I hope others will jump into the mix and create some productive dialog about these issues. Without a stronger emphasis on this "Community Health Equation" our future slides toward a darker place.
Thank you,
Carl Mumpower
Asheville City Council
Candidate for the 11th District Congressional Seat"
posted by Marsha V. Hammond, PhD at 1:47 PM
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