Many ideas to address behavioral health crisis, no coordination

By Robert Nott, The Santa Fe New Mexican The initiatives look promising on paper. One bill would create a $10 million fund to fill vacant behavioral health provider positions. Another calls for $20 million to provide substance abuse treatment for homeless people. A third would give law enforcement the right to take people displaying signs […]

Many ideas to address behavioral health crisis, no coordination

By Robert Nott, The Santa Fe New Mexican

The initiatives look promising on paper.

One bill would create a $10 million fund to fill vacant behavioral health provider positions. Another calls for $20 million to provide substance abuse treatment for homeless people. A third would give law enforcement the right to take people displaying signs of a mental health crisis to a triage center rather than jail.

Lawmakers have introduced more than two dozen bills aimed at addressing behavioral health, mental health and substance abuse problems — initiatives advocates say would aid in the state’s fight against crime. 

New Mexico’s rising rate of violent crime is a high-priority issue in this year’s 60-day legislative session, and one that intersects with the state’s struggling behavioral health system.

A group of about a dozen people including lawmakers, advocates and public defenders met Monday at the Capitol to discuss a strategy to help prevent those with behavioral health challenges from becoming entangled in the criminal justice system. Advocates said they were pleased to see so many bills — lawmakers from both major political parties in both legislative chambers have introduced proposals to chip away at the state’s behavioral health woes.

But there’s also a big dilemma: No coordinated effort to address the crises as the session nears its final days and the state budget for the next fiscal year is essentially complete.

“If they were coordinated, they would be more effective,” said Neal Bowen, director of the Behavioral Health Services Division of the state Human Services Department.

The outlook is grim for many of the behavioral health initiatives and reforms at this point in the session, said Sen. Jerry Ortiz y Pino, D-Albuquerque, who spoke in an interview after the meeting. “We’re late on all of this,” he said. “The budget is already finished. Hope for any of these initiatives getting additional funding is pretty dim.”

Advocates should start prioritizing behavioral health during interim committee hearings in the months between this year’s session and next year’s, Ortiz y Pino said.

Researchers have found connections between mental health conditions and criminal justice. A recent report from the Stanford University Institute for Economic Policy Research says, “American prisons house a disproportionate number of mentally ill inmates, making them some of the country’s largest providers of mental health care.”

Within two years of losing access to health care, people with a history of mental illness “are more likely to be incarcerated,” the report adds.

In many areas of New Mexico, a large, rural state with remote communities, residents lack access to behavioral health services. An August 2020 brief from the Legislative Finance Committee noted “behavioral health access and outcomes are … dependent on where people live, with more services provided along the Rio Grande corridor.”

Rural communities are now reaching out to state lawmakers for help funding treatment centers to improve access for their residents, said Connie Elizabeth Vigil, president of the Greater Albuquerque Business Alliance and a member of the Bernalillo County Prevention/Intervention Committee.

She cited House Bill 29, which seeks $1.3 million to open an integrated substance abuse disorder program in San Miguel County, and Senate Bill 379, which requests $39 million to build a behavioral health facility in Curry County.

House Bill 92 would appropriate $859,000 for a long-term residential treatment facility in Doña Ana County.

Such projects could serve as role models for other communities to consider, Vigil said, but they also illuminate the lack of a larger statewide solution.

“Every community is addressing it on its own,” Vigil said in an interview after the meeting. “There’s no real [legislative] support for statewide facilities. That’s a huge problem.”

Noting the roughly 30 bills addressing various aspects of the state’s behavioral health problems, she told the group at the meeting, “It all says emergency; we’re in a crisis. The key is bringing all these initiatives together.”

With fewer than 20 days left in the session, such a move seems improbable, however. It’s too late to introduce new bills or make serious amendments to any of the existing ones, Sen. Bill Tallman, D-Albuquerque, told the group.

Some people said they believe the sheer number of bills working their way through the session makes it more likely at least a few will make it to the finish line.

As of Monday, a few had cleared more than a couple of legislative hearings. HB 29 is on the agenda for a House floor vote, but it’s unclear how soon that may occur.

Vigil said the scattershot approach is drawing attention to the crisis and raising awareness among state leaders and the public. 

Rep. Bill Rehm, R-Albuquerque, said the issue requires multifaceted approaches. 

“You could attack this from a lot of different angles,” said Rehm, who is co-sponsoring a bill that would require judges to order an evaluation for defendants who might need mental health treatment and, if necessary, to order treatment while a criminal case is pending or after a conviction.

“We’re all trying to accomplish one end — to treat individuals for mental and behavioral health problems,” Rehm said. 

Efforts to get people from different agencies talking about behavioral health problems started in the past few years and are slowly gaining attention and support, said Bennett J. Baur, head of the state Law Offices of the Public Defender. 

“This is not a short-term process,” Baur said in an interview. “It’s really complex. And it’s going to take years. This is why we have the Legislature and our agencies working on this stuff.”

Vigil said she believes the public is watching the debate on ways to alleviate crime through treatment services. Many state residents have family members and friends dealing with substance abuse and behavioral health problems.

The state pays a price for not adequately addressing the issue, Vigil said, pointing to the state’s crime rate.

She added, “You pay for it in the death rate, you pay for it in the ER — and most importantly of all, we pay for it with youth. If we don’t get youth into prevention and treatment programs for these problems, that is going to take down our whole population in New Mexico.”

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