Wyoming’s mental health programs no ‘easy cut’

(Opinion) — I’ve never understood how, on a state or national level, lawmakers find it so easy to cut funding for programs that help the mentally ill. But Tammy Noel helped explain it to me.

“I just think we’re not a contingent of individuals that makes a lot of noise, so we’re a very easy cut,” Noel said. As the executive director of the National Alliance on Mental Illness — Wyoming, she knows what she’s talking about. Her nonprofit agency is about to go out of business, another victim of State Department of Health budget cuts.

The statewide agency based in Casper is set to close at the end of September unless NAMI WY gets a sudden infusion of cash that would help keep the doors open a few months longer until it finds out if any of its grant proposals were successful.

The state of Wyoming hasn’t actually given NAMI WY any money for two years. Its annual budget of $150,000 was completely eliminated, so the agency has been operating frugally using its reserves since 2015. Until now, when the money has run out.

Here’s what will be lost

What will Wyoming lose when the 31-year-old agency goes dark? It now offers several free services and programs to help the mentally ill and their families, and also educate the community about mental illness. Noel admitted the latter has often been frustrating because there’s a stigma in society against the mentally ill.

“A lot of time people are afraid to even say they or a family member has a mental illness,” she said. “We’re kind of where cancer was about 25 years ago, where you sort of whisper about having a child with a developmental disability, even though some people are starting to understand.”

NAMI WY offers a Family-to-Family 12-week education course for families and friends of adults living with schizophrenia, bipolar disorder, major depression, anxiety disorders and borderline personality disorders. It doesn’t offer clinical services; the agency provides caregivers with communication and problem-solving techniques and coping mechanisms to deal with their loved one’s mental illness and its impact on the family.

Another vital program is NAMI Connection, a recovery support group for people living with mental illness that has been expanding throughout the nation. The goal is to provide a place that offers respect, understanding, encouragement and hope.

Crisis Intervention Training brings law enforcement and first responders into the picture by offering a 40-hour class that helps these professionals recognize when they are dealing with someone who has a mental illness. [Full disclosure: I have been a volunteer at Casper CIT sessions.]

“It gives officers an overview of mental illness that’s more in-depth than the two or three hours of training they get at the Wyoming Law Enforcement Academy,” Noel said. “They learn about specific illnesses.”

The statewide organization has affiliates in Campbell, Natrona and Park counties, as well as programs it supports in other counties. The affiliates are separate community-based nonprofits that must raise their own funds, but the statewide agency now helps with their bookkeeping, resource calls and program coordination. That assistance soon won’t be available.

Offering its services for free, Noel said, became problematic for the agency but it is a mandate from the national organization. “We don’t have the opportunity to have a streaming income-based revenue,” she said. “We’re kind of that last little nonprofit group that literally is here for the community, but we need community funds to continue.”

Noel said she could see the end of her agency’s government funding coming. The nonprofit’s budget had been cut by the state a total of 29 percent over the previous four years before the big hammer came down.

“We were very much aware we couldn’t rely on state funding forever,” Noel said. “We knew that. … The problem is that [money] is kind of drained right now, because we are not the only agency in this position. Now you have all of this funneling of everybody going to foundations so it’s kind of like ‘pick a cause’ — oftentimes we’re the last cause because people think people can just get over mental illness.”

That sentiment particularly grates on the director. “They do not understand it’s a brain disorder. It affects one in five people. That’s a huge part of the population. And serious mental illness? It’s one in eight.”

Suicide prevention funds also cut

Compounding the problem, she said, is the fact that the Legislature has made other budget cuts to suicide prevention efforts that impact the mentally ill. A $2.1 million reduction to suicide prevention and substance abuse treatment was made earlier this year, on top of a $2 million cut the Legislature made to the programs in 2016.

“We don’t even have an active suicide hotline in Wyoming — I don’t know how many people know that,” Noel said. “We do have a suicide hotline, but all the calls are answered out of state.”

Wyoming’s efforts to help the mentally ill are going in a dismal, disturbing direction when we can’t even afford to have someone in Wyoming operate a suicide hotline. We can’t afford to fund a statewide program that’s been operating for more than three decades that helps both the mentally ill and their families navigate a complex mental health care system. No one else provides that service, and it can’t be outsourced.

Meanwhile, the state is still looking for answers to continue financing the hugely expensive Title 25 program’s treatment of residents who have been adjudicated as a danger to themselves and others and need to be involuntarily committed. Our Department of Corrections has seen its funding cut for mental health and substance abuse programs for inmates.

If Wyoming’s only recourse is to put released inmates back on the streets without the mental health and substance abuse treatment many desperately need, where do our legislators think they are going to wind up?

This isn’t just a Wyoming problem. Nationally, mental health funding has been in a downward spiral since 2013. President Donald Trump’s proposed Fiscal Year 2018 budget, according to a statement by NAMI CEO Mary Giliberti on the organization’s website, would “ravage Medicaid, the cornerstone of our public mental health system,” by cutting $600 billion over the next decade.

“This will devastate mental health services, especially for children and adults with the most severe mental illnesses,” Giliberti said. The Trump budget also cuts $356 million from the National Institute on Mental Health, “significantly halting life-changing research into the brain and mental illnesses.”

Never miss a Take — subscribe to WyoFile’s free weekly newsletter

I realize the Legislature’s budget crisis requires it to make tough choices, and the Department of Health began the last session staring at a $141 million reduction for the 2017-18 biennium. Not all programs can be saved.

But I want our lawmakers to fully understand the impact of cutting or eliminating mental health programs like NAMI WY and then give them the financial support they deserve and common sense demands. Without this long-running statewide program that trains families, caregivers, law enforcement and others to provide the support they need to cope with others’ mental conditions, more mentally ill residents will slip through the cracks. Nickel-and-diming this need now will only lead to spending more money later. Possibly through the Title 25 program.

It is also literally a matter of life and death. Noel noted that people with severe mental illnesses die at an average age of 55. “That doesn’t bode well,” she said. “But their [lifespans] can be increased if they have the support of the community.”

In the compassionate, caring state we want Wyoming to be, reducing funding that improves the lives of the mentally ill should never be “an easy cut.”