Wednesday, January 05, 2011

Mental Illness is COMMONLY Chronic in nature: What NC's DHHS has Missed Regarding Critical Access Behavioral Health Agency Program (CABHA)

Long, long ago, in another galaxy, when NC Mental Health Reform was instituted (in 2000) so that consumers would have a 'choice' regarding providers (this never panned out) and so that 'free enterprise' would losen the bolts of a system disallowing a proliferation of providers (many have gone out of business due to the waxing and waning of funds vis a vis NC DHHS), there was a Service Definition created by NC DHHS called Community Support Services which was to create vital services for people with mental health challenges such that they could 'get back on their feet' ( a rehabilitation model).

However, as could have been expected, there was not enough money to pay for such a model and so it collapsed in 2007 or so. Then NC DHHS attempted to recreate something like this (CABHA)---- with an expanded array of services----to be manned and administered by a increasingly shrinking number of providers (for no one could keep up with the paperwork).

All of the models associated with NC DHHS thinking denies something as plain as the nose on your face: for many people, mental health challenges are chronic and a system that fesses up to this reality and utilizes $$ in an efficient and informed manner----is what is being called for.

The below is excerpted from a recent news article pertaining to the creation of this CABHA.

"....The N.C. Consumer Advocacy, Networking, and Support Organization, led by local advocate Laurie Coker, said its concern with CABHA is that providers "will be largely focused on quick medical fixes for symptoms and not on truly working with a more comprehensive, recovery-focused approach."

"There is nothing compelling CABHA to move toward timely interventions and supports, which reduce crises and promote more self-regulated living....

The state has flipped the switch on its latest attempt at mental-health reform — the Critical Access Behavioral Health Agency program.

Though CABHA has been 14 months in the planning, there has been lukewarm confidence among many advocates, beneficiaries and providers that the program, which took effect Saturday, was going to begin smoothly.....The N.C. Department of Health and Human Services said the purpose behind CABHA is ensuring that critical services in five categories are delivered by a clinically competent organization with appropriate medical oversight.

The categories: case management; peer support for recovery initiatives; community support teams for adults; intensive in-home treatment for children; and day treatment for children and adults dealing with such issues as substance or sexual abuse......

It's a bigger-is-better approach, leading to fewer, but larger, providers. It has reduced the number of statewide providers in those categories from 966 in November 2009 to 161 CABHA qualifiers as of Dec. 23. ..."



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