COMMENTARY: Good mental health is essential for the success of individuals and communities. In New Mexico, we struggle with untreated mental illness, violence and drug abuse.
This was particularly brought to our attention in 2013, when Gov. Susana Martinez’s controversial audit of mental health organizations resulted in the closure of 15 community agencies, putting tens of thousands of people at risk of hospitalization, homelessness, and being the victims or perpetrators of violence, including suicide and homicide.
Courtesy photo
Charlene Pyskoty
While necessity is the mother of invention, poverty and panic birth creativity. The people of Bernalillo County have stepped up with a 1/8th cent gross receipts tax increase to fund new behavioral health initiatives. This currently includes four areas: crisis services; supportive housing; community supports; and prevention, intervention and harm-reduction.
This constellation of services allows for a multi-pronged, integrated approach to our community’s problems. Taking a public health perspective, these services seek to prevent problems “upstream,” so they don’t require greater money and effort to fix “downstream.”
Behavioral health issues impact many of our social indicators, including crime, education, economy, property values and overall quality of life. We are all impacted by behavioral health issues — and, untreated, we all suffer when citizens lack access to services.
For example, let’s look at mobile crisis teams. Attention-grabbing headlines and costly lawsuits have involved deputy-involved shootings upon persons with behavioral health disorders. As a therapist myself, I am reluctant to give the standard advice to “call 911 if this is a mental health emergency.”
This new initiative, however, which was funded by the county commissioners for up to $1 million per year, sends a crisis intervention deputy out with a master’s degree level behavioral health clinician to a 911 call that involves a nonviolent behavioral health crisis.
The crisis intervention team will arrive within 20 minutes to de-escalate, evaluate and triage the person in their home, rather than at a costly emergency room. Referrals to appropriate services will be made, and follow-up can be made to determine if services are meeting the client’s needs.
This service will ensure that those needing behavioral health attention will be treated appropriately, and that further support and resources will be offered so that the magnitude and continuation of problematic behavior will be lessened. Other effects will be less stress on law enforcement officers to deal with situations for which they are not fully trained, a positive experience with community members, and a decreased risk of personal and financial consequences of encounters gone wrong.
Another initiative I have worked on with my licensing board (the N.M. Counseling and Therapy Practice Board), and is now headed to the governor’s desk for final approval, allows licensed therapists an option to do community service in lieu of some continuing education (CE) hours.
To renew our licenses, we need to complete 40 hours of continuing education every two years. Often, these classes are offered over the internet or by CE mills located out of state. Money spent on CE classes often does not stay in New Mexico.
There are about 4,432 counselors/therapists licensed through the board. (Note: this does not include social workers or other mental health professionals licensed through other N.M. boards.) If each clinician performed 10 hours of community service, at a value of $75 per hour, that would result in $3,324,000 worth of licensed, professional behavioral health services provided to the state at no cost to taxpayers each year.
By completing community services hours, the people of New Mexico receive literally millions of dollars of free, licensed mental health care at no cost to anyone. Places that were never able to hire a behavioral health clinician – such as senior centers and domestic violence and homeless shelters – will be able to have free, licensed care.
Imagine if all behavioral health licensing boards allowed this option — or, more broadly, if all health professions allowed a community service option for license renewal. Our state would receive billions of dollars of free health care. Think Doctors Without Borders, but within our own state. New Mexico would become the leader in something innovative and very good!
Additionally, I have joined with members of the counseling community to form a task force to develop training and certification on prescribing alternatives to opioids for pain management. By shifting to empirically validated, non-pharmaceutical treatments and therapies, we can save lives, money and untold suffering that has come with the opioid epidemic.
Like our water, we must tap our creativity and use our behavioral health resources wisely. Developing effective programs that prevent problems or treat them early will result in a healthier, more prosperous and successful New Mexico downstream. Hopefully, these programs will prove to be cost-effective in improving the lives of individuals and our communities in general, and become a model for our state and country as a whole.
Charlene Pyskoty, MA, MPH, LPCC, is a mental health therapist in private practice and is running for Bernalillo County commissioner, District 5. She has an extensive background in behavioral health, public health and small-business ownership.