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Out in the open on mental health [Editorial]

The Aegis

One of the most pressing needs in Harford County, as with the overwhelming majority of communities nationwide, is for behavioral health programs and facilities.

Last week, Lyle Sheldon, chief executive of University of Maryland Upper Chesapeake Health, Harford County’s largest health care services provider, said his organization is working with Harford County officials to develop a “public-private partnership” to handle pressing behavioral health needs.

That’s certainly welcome news, but it again raises a question that has gone unanswered since the forced deinstitutionalization of behavioral/mental health patients beginning in the 1980s: Whose responsibility is it to organize and pay for these services?

Counties can’t afford it and neither, so it seems, can states, except in a very narrow concept of ministering to the needs of their poorest citizens with behavioral health issues, and not very well at that. The federal government? Forget it. That’s why the United States is in the bad state it is with regard to mental health, because the feds dumped everything back on the state and locals at a time when they could least afford to pick up the pieces.

Upper Chesapeake’s Sheldon discussed what he called an ongoing “behavioral health crisis” in Maryland during the Harford County delegation’s annual pre-legislative session meeting held Nov. 1.

He said noted the crisis will also be part of the Maryland Hospital Association’s legislative agenda when the Maryland General Assembly’s 2018 session begins in January.

Upper Chesapeake Health plans to open a freestanding medical center in Havre de Grace, which would be designed to provide inpatient and outpatient mental health services, but that facility is still “three-and-a-half years away,” Sheldon said. The health system seeks approvals to establish a “special psychiatric hospital” as part of the Havre de Grace campus, he said.

“We felt there was a need to really try to move quicker,” Sheldon said, citing conversations he has had with representatives of the Harford County Sheriff’s Office and other county agencies that are affected by people with behavioral health issues such as drug addiction.

The public-private partnership would involve Upper Chesapeake Health, the Harford County government, the county Health Department and the nonprofit Healthy Harford, Sheldon said.

The partners would marshal financial and capital resources, as well as staff and/or volunteers, to create a facility in the Bel Air area, where 24/7 behavioral health “triage” services, a walk-in crisis center and “crisis residential beds” would be available, according to Sheldon, whose presentation was covered in last Friday’s editions of The Aegis and The Record.

He said the partnership “very, very nicely complements” the plans for the new Havre de Grace medical center, “but we also recognize that speed is important.”

He noted significant increases in the number of deaths in Maryland in recent years related to drug abuse, as well as an increase in emergency room visits for mental health issues. The number of psychiatric beds in medical facilities statewide has been slashed during the past 35 years, Sheldon said.

Sheldon said he worked over the summer with a group of about 45 people to evaluate behavioral health services in Harford County.

He said the group identified three “gaps” in the system, including access to immediate care, coordination of patient care and public education. The partnership is set up to help mitigate those gaps, Sheldon said.

While we credit Sheldon and all the other people involved with confronting the mental health services availability and charting a course to do something about it, we’re talking about millions of dollars that need to be spent in Harford and everywhere else in the United States. A year of inpatient drug rehab runs $30,000 to $40,000 a year, a leader of the Edgewood Boys & Girls Clubs who works for the U.S. Postal Service pointed out last year. Most employers and their insurance plans probably don’t cover anywhere near that much, if at all.

Behavioral health has been the elephant in the room when it comes to the national health care debate. It’s time for all of us to acknowledge it is there and demand attention to it. Harford’s resources, public or private, aren’t enough to go it alone.

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