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EDITORIAL: Searching for answers to state's mental health challenges

Wyoming Tribune-Eagle
Nov 17, 2019

Nov. 17--Back in 2005, Wyoming had a serious problem with mental illness, and treatment programs were grossly underfunded. In an attempt to address these concerns, the state Legislature formed a select committee of lawmakers that met seven times. The result was millions more in state funding for treatment, as well as at least a few systemic changes.

Although those outcomes were positive, unfortunately, nearly 15 years later, about 80% of the same problems exist, says Rep. Sue Wilson, R-Cheyenne, who chairs the House Labor, Health and Social Services Committee. The main ones include:

Inconsistent access to services across the state;

Understaffed providers, including many of the 14 Community Mental Health Centers subsidized by the state that provide services on a sliding fee scale;

A lack of psychiatrists, advanced practice psychiatric nurses and adolescent service providers;

No consistent statewide system for handling people in crisis;

A waiting list at the Wyoming State Hospital; and

A lack of transitional support services, such as housing and transportation.

Which is why Rep. Wilson has proposed the Legislature create another group to study the problem -- a behavioral health services task force.

Normally, we'd roll our eyes, sigh deeply and join the cynics who say "Here we go again" each time the Legislature decides to study an issue. But this time is different, and here's why:

Who would be on it -- As outlined in the bill headed to the 2020 legislative session, the task force would be a manageable 12 people. Three would be members of Wilson's committee and/or the House Judiciary Committee, with not more than two from the same political party. Three more would come from the same committees in the Senate.

Another three would be mental health and substance abuse service providers appointed by Gov. Mark Gordon from around the state. The last three would be the director of the state Health Department or his designee, a law enforcement officer and a member of the public who is a consumer of mental health or substance abuse services, the latter two also appointed by the governor. (We agree with Rep. Eric Barlow, R-Gillette, that the Department of Family Services and Department of Corrections should be included; they could easily replace two legislators on the task force.)

What it's tasked to do -- The task force would update the findings of the 2005 Select Committee on Mental Health and Substance Abuse Services, and "provide recommendations for the delivery of high-quality, cost-effective and accessible community mental health services, substance abuse services and prevention programming to Wyoming's citizens."

Specifically, the group would: look at what has changed since the previous report was written; identify gaps in available treatment throughout the state; see what laws might need to change, such as possibly making it easier for people to become licensed providers; address the issue of recruitment and retention of psychiatrists and other staff; and consider funding issues, including whether a Medicaid behavioral health waiver would increase patient access to services.

The best approach -- Instead of focusing solely on whether enough money is allocated or enough services exist, Rep. Wilson says this group must take a patient-centered approach to the issues. We couldn't agree more. That means taking three or four hypothetical situations and seeing where the obstacles exist for people trying to navigate the public, private, nonprofit and other resources available to them.

Mrs. Wilson also said she hopes the task force can hear from a variety of constituents and providers, then find ways to knock down the silos that tend to make providing services more expensive than necessary.

The potential return on a small investment -- If authorized in early 2020, the task force would exist for, at most, two years, with a preliminary report due Oct. 1. The total cost of the work is estimated to be less than $50,000. This seems like a small investment that could yield major benefits.

Of course, committee sponsorship of this bill is just the beginning. Since 2020 is a budget session, it will take a two-thirds vote of support to gain introduction. And some legislators (like Mr. Barlow) say they plan to bring lots of amendments. Although some may make the task force better, there are plenty of ways this effort could become meaningless. We encourage lawmakers not to make the work more difficult than it needs to be by inflating the group's size or diverting its focus.

Everyone involved knows these are complicated issues, and there are no easy solutions. In fact, state Health Department Director Mike Ceballos told committee members his agency has been working on the problems for 20 years or more, and "This is one of those pigs we need to wrestle to the ground." If done right, this task force seems like a good place to start.

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