Criticism of Care Propels Study of Georgia's MH System

Georgia Gov. Sonny Perdue (R) ordered a study of state services for residents with mental illness in August. The effort follows critical media reports and the launch of a federal investigation.

The study will be carried out by the state's Mental Health Service Delivery Commission, which will examine “conditions, needs, and issues associated with the services to those with mental illness and substance abuse,” according to a statement issued by his office.

The commission will address long-standing concerns about “perceived or actual lack of sufficient funding, inadequate staffing and service delivery systems, overcrowding, treatment practices that unnecessarily separate consumers from their families, and the need for ongoing and effective advocacy on behalf of those children and adults living and receiving behavioral health services.”

Creation of the commission in early August followed a Department of Justice announcement in July that it would inspect Georgia state psychiatric hospitals in September to see whether poor conditions violate patients' civil rights.

“It is critical that we take a comprehensive look at Georgia's delivery of services to citizens who live with mental illnesses and substance abuse,” Perdue said.

The commission also was appointed in the wake of media reports concluding that more than 100 state psychiatric hospital patients died under suspicious circumstances from 2002 to 2006, and nearly 200 other patients were physically or sexually abused.

Earlier Perdue had vetoed a similar commission approved by the Georgia General Assembly because it did not include members of the executive branch, who oversee the state's hospitals and the mental health system. Supporters of the commission said they thought that including officials from the Department of Human Resources, which operates the state hospitals, would create a conflict of interest.

Nora Haynes, president of the board of NAMI Georgia, met with Perdue in August to discuss the turmoil in Georgia's mental health care system.

“Things have been pretty bad around here, and I don't think the governor realized how bad things were,” Haynes said in an interview with Psychiatric News.

Mental health advocates have questioned the large number of state officials placed in charge of reviewing the problems and offering solutions, Haynes said, but they have withheld opposition in the hope that the governor's effort will improve the system.

Among the leading problems in the state's publically funded mental health system, according to Haynes, is that the responsibility for the care of people with psychiatric conditions is split among many government departments.

“There's a lot of money out there, but there's not a lot of coordination,” she said.

The governor's commission will have the authority to recommend changes during next year's legislative session, and it is supposed to submit a final report by next June.

The commission's charge includes identifying the “best use of public and private resources to relieve overcrowding in state facilities and to further consider methods to develop a full continuum of services and effective supports so that Georgia's citizens who live with mental illness and substance abuse may live and work when possible close to their families.”

Haynes said she hopes the commission will address Georgia's lack of a community-based mental health system to offer alternatives to hospitals, jails, or homelessness.

The public mental health system will never improve, she said, without better pay for its nurses and physicians. Better compensation is needed to raise Georgia's near-bottom rank as 44th nationally in state spending on mental health, according to NAMI.

The order establishing the commission also directed it to report on the sufficiency of health insurance coverage for those with mental illness, including substance abuse.

The panel's work will coincide with the Department of Justice investigation of the state hospitals. The federal inquiry is investigating allegations of civil rights violations at the seven state psychiatric hospitals.

The state's human resources commissioner separately ordered a team of high-level government officials to take over management of the state psychiatric hospital in Atlanta in mid-August to reverse clinical problems that critics said have contributed to patients' deaths.

The new management team's tasks includes setting new performance standards for employees, arranging for enhanced training and supervision, and creating methods to track progress.

Information on the Mental Health Service Delivery Commission is posted at<www.gov.state.ga.us/press/2007/press1505.shtml>.▪