Mental Health Services Struggle

May 29, 2010

Published: May 29, 2010

When President Obama signed the health care bill into law in March, the legislation was hailed in some parts of Virginia as a major step toward giv ing Americans and small businesses more control of their health care. The landmark legislation builds upon what works in our current health care system and lays a strong foundation for continued efforts to improve access and quality of care for all Americans, particularly for the 2 million people in Virginia currently without health insurance.

What may have been overshadowed in the noise around the bill’s passage are some of the benefits that the legislation will have for people with mental health problems. The disorders themselves often get overlooked and go unnoticed, even though they are as common and as life-threatening as many physical ailments. In fact, an estimated 32 percent of Virginians age 18 and older — about one in three adults — currently suffer from poor mental health.

With May being Mental Health Month, mental health organizations across the nation have been celebrating the bill’s many positive provisions for people with disorders. However, there are still many challenges we face. While health coverage in the bill will not go into effect for several years, Virginia and other states across the country are enacting drastic budget cuts on mental health services that are taking a heavy toll on consumers, families, and provider agencies.

With $2.3 billion in Virginia’s recommended budget cuts, health and human services are facing financial reductions of more than $650 million. These cuts will have a significant impact on the amount of mental health funding provided by the state. Simultaneously, community mental health centers and other providers are reporting a substantial increase in demand for mental health and addiction treatment services.

The reality is that as Virginia drastically reduces community-based services for those living with mental health disorders, the cost of care rises. Did you know that if we were to invest in early intervention services, the state would realize a savings of $7 for every $1 spent? Instead, affected individuals wind up in more expensive treatment, with their chances of recovery much lower while the costs associated with their treatment remain high.

Additionally, more than 90 percent of the developmentally disabled population of children, adolescents, and adults that my organization serves experience a co-occurring psychiatric condition. The reality of dual diagnosis and co-occurring conditions must be recognized as the rule rather than the exception. All too often, payer and provider systems function as condition-specific “silos.” This approach makes a comprehensive multidisciplinary assessment and treatment process difficult. Thankfully, the importance of integrating systems of care delivery is rapidly gaining a stronger national recognition.

While we wait for provisions in the federal health care law to go into effect, we must remind our state legislators of the 2.5 million Virginians living with mental and developmental disabilities. Virginia’s budget cuts are rapidly cutting away our state’s mental health safety net just when it is most needed. The right care, at the right time, at the right price is the formula for saving costs without compromising quality.


Jim Gaynor is president and CEO of Grafton, a private not-for-profit behavioral health care organization with four locations in Virginia. Contact him at