MORE THAN 100 PACK MENTAL HEALTH HEARING

Frustrations Voiced To Lawmakers

State lawmakers tapped into a deep vein of frustration Wednesday as dozens
of people came to a special hearing to voice their complaints about
Georgia's public mental health system. More than 100 people packed the
meeting room at River Edge Behavioral Health Center. A few of them praised
the services they are receiving in mental health, mental retardation or
substance abuse programs. But most who spoke said the system isn't working
as it should.

"This is the lowest point I've seen in 30 years," said Dr. David Harvey,
chairman of the community service board that operates the Phoenix Center in
Warner Robins. "It's evident we're in a spiral down."

Speakers detailed a litany of problems:

* A fragmented system that allows too many people to fall through the cracks.

* Caseworkers too burdened by paperwork to spend time with clients.

* People with mental health problems ending up in jail instead of treatment.

* Regional boards that are supposed to provide oversight, but too often
seem to be a costly and ineffective level of bureaucracy.

* Funding mechanisms that are depriving local mental health centers of the
resources to do their job. Cynthia Bemis, a midstate resident who has a
mentally ill relative, said she once complained to a community mental
health worker about the quality of services and was told, "What do you
expect? This is public mental health."

Cathy Minton, 46, of Houston County, said high staff turnover at the
Phoenix Center has made it difficult to get consistent help. After years of
living with schizophrenia and anxiety, she has found relief through modern
medications. But she said in the past four years she has had eight case
managers and six therapists.

"They say they're leaving because they have too much paperwork," she said.
Minton also fears that Medicaid cuts could force her to stop taking her
medicines. Under the current system, she pays only pennies a month, but she
said it could cost more than $1,400 per month if she had to buy the
medications herself.

Georgia's mental health system actually serves people with three kinds of
disabilities: Mental illness, mental retardation and substance abuse. The
system includes state hospitals as well as public community treatment
centers and private companies that contract to provide services.

In 1993, Georgia lawmakers decentralized the system, putting power in the
hands of regional boards. The move was hailed as a way of giving consumers
and their families more input in the way services are delivered, and
redirecting funds from hospitals to community services.

The system costs taxpayers close to $1 billion each year. According to the
state's Division of Mental Health, Mental Retardation and Substance Abuse,
the state Legislature appropriated $832 million in state and federal
MH/MR/SA funds in the current fiscal year. Of that total, about $339
million went to hospitals, $468 million to community services, $15.3
million to run the division office in Atlanta and $9.8 million to run the
regional boards.

Many of the speakers Wednesday say they once supported the regional
concept, but discovered that in practice it turned out to be different from
what they expected.

"The regional boards, as far as I can tell, do absolutely nothing. They sit
there and put their OK on what comes out of Atlanta," said J.W. Zetterower,
a retired Dublin dentist who has served as a volunteer on a local mental
health advisory board for more than 30 years.

Since the 1993 legislation was passed, he said, he has seen workers
drowning in a sea of paperwork that takes away time they could be spending
with consumers. He and others said that while accountability is important,
too much paperwork prevents front-line workers from serving the people
they're supposed to help.

Johnny Luke of Wilcox County, a former county commissioner who served on
local and regional mental health boards, said "Every year the paperwork
gets worse. ... It seems the auditors are auditing the auditors."

Bibb County Sheriff Jerry Modena identified one of the most serious
side-effects of the changes in the system: People who wind up in jail
instead of finding treatment. Not only is this inappropriate for the
clients, he said, but it is costly to taxpayers.

"We've begun to have a 'shadow hospital system' in the jails across
Georgia," he said. "This is a statewide problem. It is not getting better."

Modena said the jail now holds 140 people with psychiatric problems,
substance abuse problems or a combination of both. That puts a strain on a
facility with a 585-bed, court-imposed occupancy limit, he said.

Modena said the county now is paying $262,000 for psychiatric services
provided by River Edge Behavioral Health Center, plus $100,000 a year to
transport prisoners to Central State Hospital in Milledgeville, nearly $1
million a year for medications and more than $1 million a year just to
house the prisoners with mental health problems.

They typically go to jail for minor offenses such as trespassing or
shoplifting. Many are homeless.

"The real people on the street are in dire need of help," he said.

House Majority Leader Larry Walker, a committee member who hails from
Perry, asked Modena how lawmakers can reconcile a conflict: Community
mental health centers face financial penalties if too many clients are sent
to the state hospitals, yet county jails rely on hospitalization to move
psychiatric patients off the jail rolls. In effect, easing the jails'
burden puts a heavier burden on the community centers' budgets.

"People I respect on both sides are telling me different things," Walker said.

Modena replied, "This should not be a totally local problem. ... It's
something that's going to have to be a collaborative effort."

Committee Chairman Roger Byrd, D-Hazlehurst, said he is certain that the
committee will introduce legislation to address the problems. He said it is
essential to introduce more accountability in the system.

One possibility: Providing funds to staff an ombudsman's office for the
MH/MR/SA system. The position was created last year but not funded.

He also said it appears that support for the regional concept has eroded in
the past eight years.

"I don't think the regional board system is working," he said.