DBHDD responds to Carter Center Conversation on Georgia's mental health system

February 16, 2010

ATLANTA – A discussion of Georgia’s mental health system was held this evening at the Carter Center in Atlanta, Georgia. Since the Georgia Department of Behavioral Health and Developmental Disabilities, the state’s lead agency in charge of policies and programs for people with mental illness, developmental disabilities, and substance use disorders, was not invited to participate in the discussion, the agency provided the following additional information.

Dr. John Gates, board member of the Rosalyn Carter Institute for Caregiving, Georgia Southwestern University, said that his belief was that the majority of people with mental illness, developmental disabilities, and addictive diseases can be treated in their own communities.

In fact, approximately 93% of the people served in the state’s services in 2009 were served in community-based settings. Of the 177,000 people served, approximately 12,000 were served in hospitals. Many of those represented those with the most critical needs.

Andrew Penn of the Bazelon Center for Mental Health Law and Dr. Gates both said that most of the state’s resources should go to community services.

In fact, the state in 2009 spent 50% more on community-based care than on hospitals: $527,145,000 v/s $351,706,000.

Dr. Gates suggested that the behavioral health system in Georgia lacks a clear idea of what needs to be accomplished and a specific plan to implement it.

In fact, DBHDD, in existence for just eight months, has developed a detailed plan to improve the safety and effectiveness of hospitals and is working to evaluate community service needs to address that area as well. The hospital plan has already resulted in the development of improved incident management and risk management systems, physical and nutritional management programs, policies and procedures for seizure disorders and medical emergency responses, and weekly and monthly progress notes to help provide better care. Dozens of additional concrete steps to achieve better safety in the hospital system are currently underway.

As DBHDD puts in place better data-tracking and completes a statewide needs assessment, its plans for improving the state’s behavioral health system will only expand and gain additional detail.

Dr. Gates suggested that there was a lack of support among state leaders for behavioral health improvements.

In fact, in 2009, Governor Perdue proposed and the General Assembly created a stand-alone agency – the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) – to focus solely on policies and programs for people with mental illness, developmental disabilities, and substance use disorders. DBHDD launched on July 1, 2009, and has made significant progress in improving services statewide. In the 2010 legislative session, Governor Perdue provided an additional $20 million for DBHDD’s current-year budget and $50 million for the budget year that will begin July 1, 2010. DBHDD is the only agency to receive an increase; other agencies sustained cuts. Clearly the state’s leadership has the political will to improve its behavioral health system for the people it serves.

Dr. Gates suggested there was a need for independent oversight of the behavioral health system.

In fact, the state of Georgia now has a Behavioral Health Ombudsman, in addition to the national accreditation and certification that its behavioral health facilities must regularly meet.

Dr. Gates also suggested that there should be discharge planning at the time of hospital admissions.

In fact, DBHDD is currently implementing such procedures at all of the state’s psychiatric hospitals, increasing the integration of community and hospital services.

Penn also suggested that a key to improving behavioral health systems is to break down divisions between agencies and to get them working together.

In fact, the new Behavioral Health Coordinating Council is an inter-agency organization focused on practical results to the long-standing problems in the state’s behavioral health system. Led by the Commissioner of DBHDD, it includes the commissioners of the departments of Human Services, Corrections, Juvenile Justice, Community Health, and other agencies.

Penn also spoke about the need for supported housing.

In fact, DBHDD and Governor Perdue’s Behavioral Health advisor have been meeting frequently with Georgia advocates to develop solutions for supported housing. In addition, the Behavioral Health Coordinating Council is has asked the legislature to add the Department of Community Affairs to the group to better address issue of supported housing.

Penn pointed out the need to maximize federal dollars to support community services.

In fact, DBHDD is using additional resources provided by Governor Perdue to develop and apply for Medicaid waivers that will leverage federal dollars to allow more mental health consumers to be served in community settings.

Contact Information: 
Tom Wilson (thwilsonk@dhr.state.ga.us)