Tax Reform is Desperately Needed in Kentucky !

The Commonwealth of Kentucky approved its budget for FY ’11, and it leaves a lot to be desired. I’m not criticizing the legislators, since they have only so much to work with. Let’s face it. There just aren’t sufficient dollars to pay for everything the state needs. Now is the time for state tax reform to increase revenues; currently, the tax burden falls on the middle class and working poor. Folks who earn between $15,000 and $47,000 pay nearly 11% in state and local taxes – while the wealthiest citizens pay only 6.1% of their income in state and local taxes!

Desperately needing some of that additional funding are community mental health centers in Kentucky, which are struggling to meet the demand for services.

Did you know that Kentucky was ranked 42nd in the country in funding mental health services in 2006? In its report, Grading the States 2006, the National Alliance for Mental Illness (NAMI) ranked Kentucky 42nd in per capita spending on mental health ($51.27), with total mental health spending at $210,000,000. By comparison, Indiana’s ranking in 2006 was 28th in per capita spending on mental health ($72.37); its total mental health spending was $448,000,000.

In NAMI’s 2009 Grading the States Report, it’s noted that little progress has been made in Kentucky. It reports, “The community mental health centers haven’t received a cost-of-living increase in their state contracts in 12 years.”

Without greater funding, more stress is put on other areas. Without outpatient treatment, folks end up in hospitals, where costs are greater. Seven Counties’ costs per day, including outpatient and medication services, are about $204 a day; the average cost for one day of treatment in a psychiatric hospital is $700 per day.

Without outpatient treatment, jails fill up with individuals whose major crime is that they have a mental illness. Between July 1, 2009 and April 30, 2010, Seven Counties – using a $183,000 grant – saved Metro Corrections $1,726,289 (figuring the cost of one day in jail is $68.00) by keeping individuals out of jail. Think how many people could be diverted from jail if more funding were available!

Until the state makes a committed investment to bolster its community mental health centers, everyone will be paying a higher price in emergency, inpatient and corrections services. Contact your state legislators and let them know that tax reform is needed now – not only for mental health but for all the other areas where Kentucky is coming up short.

Let's Talk About It! by Dean Johnson, Vice President - Community Relations

Mental health can be a tough subject to talk about. Admittedly, it’s not usually in the top ten on the water cooler or cocktail party conversation menus. But it needs to be. Mental illness issues affect us all in some way, shape or form. National statistics say that about one in four adults suffer from a diagnosable mental disorder in a given year. Look around you – right now. See three other people? Get the picture?

Human experience tells us that when we don’t talk about something, we generally get it all wrong.

Misconceptions about mental illnesses are abundant. No, they are not character flaws. No, you can’t just make yourself feel better. Contrary to popular opinion, it’s not “just a mood thing.” And all the will power in the world isn’t going to make you better without professional help to go with it.

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. They do to the mind what diabetes, heart disease and cancers can do to the body.

Remember a few years back when Tom Cruise said on national television that Brooke Shields – who had just gone public about her battle with post partum depression – should just take some vitamins and “get over it”? He claimed there was no such thing as depression. He was wrong.

Fortunately, Brooke sought treatment (and she did, actually, “get over it”, but not by her own will alone).

Not talking about something has another negative consequence – stigma. Research shows that the stigma associated with mental illnesses is the number one reason people don’t seek treatment. People are afraid – of judgment, of misunderstanding, of loss of friendships and loss of love. Just imagine the health of our country today if the same stigma and reluctance to seek treatment was associated with cancer or heart disease? What a tragedy we’ve created – because we do not talk about it.

Glenn Close, who has a sister with bi-polar disorder, has become an active stigma fighter lately. The actress says, “There is nothing to hide…We are all connected, and none of us should ever feel marginalized, stigmatized and alone.”

Mental illness is just an illness, although a serious one. It can be treated with therapy and, when needed, medication. So, let’s talk about it. Let’s be open about it. Let’s make it not just OK, but the expectation – that people with mental illnesses will be treated and they will recover.

Guest Blog by Dean Johnson, Vice President - Community Relations, Seven Counties Services

“Oh Behave!” - Certainly one of Austin Power’s more famous lines. In case you don’t know Austin, he’s the swinging English bachelor created by comedian Mike Myers. If you’ve seen any of the movies, you can probably hear his inflection and picture his facial expression just at the thought of the words. You also know that “Oh Behave!” was his admonition to others to control their flirtations.


I recently participated in a round table discussion with other behavioral healthcare professionals, advocates, parents and consumers from our community. One of the parents, who has been active in advocacy for many years, asked a question that left most in the room looking to one another for the definitive answer: “What exactly is behavioral healthcare and why do we call it that?” She’d heard the term and references to it throughout the years, but even someone so deeply involved in the field wasn’t sure she knew exactly what to think of when she heard those words. She wasn’t – and isn’t – alone.

There seemed to be a general agreement that behavioral healthcare has two components: treatment of mental illnesses and treatment of addictions. Individually, the two components enjoy a fairly widespread, if superficial, understanding by John and Joan Q. Public. But the term coined to identify the two together - behavioral healthcare -is not widely understood. Ask 10 people on the street what it means and I’d bet you an instant lottery ticket that the majority wouldn’t even come close.

One of the consumers in attendance said she didn’t like the term. An individual active and successful in recovery, she said she thought the term conveys the idea that people can control these illnesses through their own determination: they just have to “behave.”

The word “behave” has its origin in 15th Century Middle English (probably one of Austin’s distant relatives). Merriam-Webster says its primary meanings are “to manage actions of oneself in a particular way” or “to conduct oneself in a proper manner.” The first definition might find a home in the recovery models of both the mental health and addictions fields. The second definition is a bit more open to interpretation.

The common understanding does imply a level of management and control that exceeds the comfort of many. So what do we mean? More importantly, what are we conveying to the public when we use the term “behavioral healthcare”? We know what Austin would say. What do you say?

TV Show Highlights that Treatment Works

Did you see the TV show America’s Got Talent on Tuesday night? If you didn’t, you missed, as host Nick Cannon said, the most emotional moment in the program’s history.

A dozen or so adults took the stage to perform. The choir, calling itself New Direction, was entirely comprised of veterans – sailors, marines, soldiers. All of them had been homeless at some point after their discharge. One man told the audience that he had been homeless for 25 years, but, one day, he loaded up his shopping cart and walked several miles to a treatment facility. It was, he said, the beginning of his life.

Let me paraphrase what the spokesman of the group said: “In the past, you might not have wanted to see us, but our being here shows that people can change.”

People can change – with the right kind of help. Too many vets are afraid to ask for help – they were in the military, for heaven’s sake, you think, and nothing should scare them! – but they’re afraid to ask for help. More and more vets are returning from horrific conditions in the Middle East, and many of them, for one reason or another, will end up on the streets.

If you know a vet, let him or her know that you’re there for them. If they appear to be struggling, encourage them to seek help and let them know that asking for help isn’t a sign of weakness. If you see a homeless individual on the street, you can be relatively certain that he or she has a mental illness (in the case of veterans, possibly post traumatic stress) and is likely abusing alcohol or drugs. Many homeless individuals were in the military; they helped protect our country. They were there when we needed them. They deserve better than this.

There needs to be more money available for treatment. But more than that, there’s a bias against the homeless. You see someone who is tattered, talking to himself, weaving along the sidewalk or asleep on a park bench, and you think “homeless bum”. You don’t think about what brought him to this point, to this place. You don’t wonder if he’s a veteran of this country. You just think about him being a bum.

And the group New Direction? How’d they do last night in their audition? They got a standing ovation from the audience. They deserved it. They were good.

People can change. Treatment works.

Mental Illness Impacts Entire Families

My father-in-law had a bipolar disorder, which, I’m sorry to say, he seemed to enjoy. His disorder manifested itself into grandiosity – he was important, he knew important people, he knew best, he was always right. I remember a sister-in-law telling me that, one night at the dinner table when she was small, her mother told him that one of the children desperately needed to go to the dentist. My father-in-law didn’t even hesitate. “No,” he said, “I need new shoes. Her teeth will have to wait.”

My father-in-law wasn’t unfeeling or uncaring, but his illness got in the way. In fact, when he was finally diagnosed (years after his children were grown) and began taking Lithium, his entire demeanor changed. He was more thoughtful, more affectionate and empathetic, much less likely to dominate conversations and actions, and more understanding.

It was his children who paid. Being raised by a loving mother and a dictatorial father who was prone – during their childhood – to periods of anger or depression or hyperactivity was very confusing to them, and profoundly affected them into their adult years. Well into middle age, one son reacted angrily to just about everything. The other son employed adult temper tantrums (which his father had so successfully used his entire life) to get his way. One daughter will, to this day, leave the room if anyone raises a voice. Another daughter has bipolar disorder too, and she has decided that she doesn’t need medication, continuing the sad cycle through another generation. All four married very young just to get out of the house and away from their dad.

If you have an untreated mental illness, it is impacting your interactions with the people you love, and you’re impacting them in ways you can’t foresee. Particularly, I think, in the case of children, you’re altering their personalities and views of themselves just as readily as though you were deliberately cruel or abusive.

If you have been diagnosed with any mental illness, please seek treatment from a qualified mental health professional. The road to recovery may not be easy; it’s full of potholes and temptations to just say, “Forget it.” But it’s not just your health and well being that could be at stake; there are others who love you who will be forever impacted by your negative symptoms. By taking the steps to recovery, you’re helping those you love move forward, too.

For more information about services for behavioral health issues, go to sevencounties.com.