The Boston Globe Spotlight series paints a disturbing picture of the current state of mental health care in the Commonwealth. Vulnerable people and their families are left to fend for themselves. Individuals who suffer from severe and debilitating mental illness are often criminalized or lack access to appropriate treatment. Our criminal justice system has become the de-facto provider of behavioral health services. The response of the legislature to tragic stories from our first responders, our courts, and our family members has been anemic at best. Our system does not adequately serve those with severe mental illness, and it is well beyond the time to take bold action.
In January, Governor Charlie Baker announced a significant change to how the state manages Bridgewater State Hospital. His proposal would go a long way in providing necessary resources to provide an environment based on hospital care, rather than a prison sentence.
But we can’t stop there. We must commit to providing the kinds of treatment that will minimize the placement of people with severe mental illnesses in our jails and prisons in the first place.
There are changes we can make now. And while they require an investment, these measures have been proven to save money and, more important, allow people to successfully live in their communities. The changes include:
1. Create a Center of Excellence in community policing that would serve as a clearinghouse for best practices and provide training for police, who are usually the first responders when individuals experience a mental health crisis. These individuals are not criminals, nor does law enforcement want to treat them as such, and they certainly do not belong in jail. Developing a system that properly trains police to de-escalate these situations is a common-sense jail diversion strategy that works.
2. Create a pilot restoration center that would provide resources and services for people experiencing a mental health or substance use crisis and need further care. The refrain we hear most from trained public safety personnel is: “We know what’s needed, but where are the services?” The current options are emergency rooms and jail cells. The center would focus on diverting individuals from lock-up facilities and emergency rooms and into appropriate treatment. The restoration center, which could be based on the Bexar County center highlighted in the Spotlight report, would serve as a model for developing similar centers across the Commonwealth.
While many cite mandated treatment as an assault on an individual’s civil rights, there is nothing more egregious than incarcerating someone because they are sick. We must allow providers and family members to seek mandated outpatient treatment for a mentally ill person who is not competent enough to make informed decisions about their care, has had previous interactions with law enforcement due to their illness, and is likely to get better with treatment and services.
3. Finally, requiring insurers to explain reasons for denying coverage of behavioral health treatment and allowing behavioral health providers to negotiate rates with insurers — similar to how medical and surgical rates are negotiated — would increase transparency, hold insurers accountable, ensure parity, and expand availability of services for those in need. Today, rates of reimbursement are so low that many providers will no longer take insurance. Services become much harder to access, and good programs cannot afford to treat people.
It is critical that the legislature significantly reform our mental health care system, including acting on the governor’s proposal for Bridgewater State Hospital. We must stop using the criminal justice system as the main source of treatment. We can save money and significantly increase the quality of life for many of our residents. We know what we need to do and it’s time we work together and do it.
Senator Kenneth Donnelly represents Massachusetts’ 4th Middlesex district.