Behavioral Health Articles
Local Progress in Meeting Mental health
by Charles T. Capanzano, PhD
A local committee of dedicated consumers and agency personnel is working to educate the public about mental health issues and services, to reduce negative attitudes and the stigma toward those with mental illness, and to remove barriers to seeking services.
As the Cortland Mental Health Director since 1979, I will reflect on progress made--and what still needs to be done.
The availability of mental health services has increased since 1979, when there was one public mental health clinic with four full-time clinicians and a part-time psychiatrist. There are now two mental health clinics (the County Clinic and Family Counseling Services). The County Clinic has a full-time psychiatrist position and a full-time nurse practitioner with prescribing privileges, and there are more than twelve full-time staff equivalent clinic positions; recently the county supported the creation of two new positions. The number of private practice mental health practitioners in the county has tripled.
Cortland County was the first county with under 50,000 population to offer all major mental health continuum of care modalities such as:
- Inpatient care at Cortland Regional Medical Center;
- Emergency psychiatric services, which includes the crisis hotline (756-3771),
- Outpatient clinic care, at the County Clinic (758-6100) and at Family Counseling Services (753-0234);
- Continuing Day Treatment for adults at Horizon House (753-6751) and for youth by the Racker Center;
- Catholic Charities provides community residences and apartment residential services;
- Vocational services provided by the JM Murray Center (756-9913) and others;
- Case Management services are provided by Catholic Charities (756-5992) and others; and services to our jail population.
While most people with mental illness are not dangerous, the behavior of some leads to incarceration. More than 93,000 NYS citizens/individuals were in state psychiatric centers in 1955; currently there are less than 5,000. The percentage of adults in institutions (penal or psychiatric) however, has remained virtually constant: 0.67% in 1953 and 0.68% today. Thus, more mentally ill are in correctional facilities than in psychiatric hospitals.
While capacity has increased dramatically, so has demand for services. A NYS survey of licensed mental health services indicates that Cortland County serves 125 percent of the state average.
Fortunately, high priority referrals (e.g. from emergency services or residential facilities) are seen within one week of referral by outpatient services. A 24-hour, 7-day psychiatric emergency service is available to all area citizens. However, many individuals wait several weeks for non-emergency outpatient services. Planning committees are studying stigma, accessibility, and capacity issues. The passage of Timothy’s Law in 2006 ended insurance practices which discriminated against the mentally ill; this law will increase accessibility and affordability of services.
We continually seek ways to improve. Cortland County has a long history of delivering public mental health services in a cost-effective manner-- it was the first county to operate for a fiscal quarter without the need for county or state mental health aid. In comparative surveys over three decades, Cortland has always delivered more services to more people per dollars spent than state or regional averages. For example, in one 2002 study, conducted by a private consulting firm, the clinicians of the Cortland County Mental Health Department conducted more clinical sessions and served more clients than any other clinic surveyed. In 1979, county taxes supported 25 percent of the gross costs of mental health programs, while 38 percent of the costs were covered by revenues generated by the programs. In 2004, county taxes supported only 4 percent of program costs, while program revenue covered 71 percent.
We can be proud of the dedication and skill of our mental health professionals. We can also be proud of our consumers, for self-directing and advocating for care and finally, we can be proud to live in a community with so many supportive and caring individuals.
Charles T. Capanzano, PhD, is Director of Community Services at Cortland County Mental Health Services.