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Rosalynn Carter Op-Ed: Fulton Must Avoid Mental Health Cuts

This op-ed by former First Lady Rosalynn Carter was published Dec. 12, 2013, by the Atlanta Journal-Constitution.

The Fulton County Commission must avoid the proposed cuts to Grady Memorial Hospital's mental health services. The loss of the Grady programs these monies fund will be devastating. Emergency rooms at area hospitals will overflow with mental health patients in crisis. With an already inadequate capacity, the regional hospital will have to turn away more citizens in need. The jail population likely will increase as it becomes practically the only alternative for shelter and care. The county may cut the Grady contract, only to end up paying for more expensive psychiatric services at other hospitals.

In metro Atlanta, Grady provides a large volume of inpatient and outpatient mental health services. The clinics of the Fulton County Health Department and a few nonprofit entities, such as Community Friendship and St. Jude's House, back up the Grady system. Last year, Grady opened a walk-in clinic downtown that has helped homeless citizens and longtime Grady patients receive community-based services, including counseling, medications and peer support. This clinic helped divert patients from Grady's and other hospitals' emergency rooms to a less expensive setting where they get better care. Grady serves over 10,000 patients annually, representing more than 66,000 visits.

The hospital is funded in large part by Fulton County through a contract to serve indigent patients from the neighborhoods as well as the Fulton County Jail. Unfortunately, Fulton County faces significant budget pressures, and the county's staff has proposed to cut the Grady contract by up to $25 million. Fulton County also provides the bulk of funding for community mental health services, which also are slated for cuts. The service and financing systems are inextricably intertwined.

Grady has indicated that cuts of this magnitude could force it to discontinue services to Fulton's jail inmates. Furthermore, Grady's support of the overcrowded Georgia Regional Hospital in DeKalb County is threatened.

Georgia has made great strides in moving away from state hospital-based mental health systems to ones rooted in community-based services, an evolution central to supporting a best practice "recovery" model where people who have mental illnesses receive services near home, close to their families and support systems. One reason for our state's significant progress is the settlement agreement between the Georgia Department of Behavioral Health and Disabilities and the U.S. Department of Justice. The agreement requires the establishment of a range of community-based services for Georgians who have been in state hospitals because of developmental disabilities or mental illnesses. Gov. Nathan Deal has proposed, and the General Assembly has appropriated, significant new state funds to pay for the department's efforts.

I worry that the progress Georgia has made will be thwarted in our state's capital and most populous area. Surely, the Fulton County commissioners can find a way to prevent these cuts.


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