CLEVELAND, Ohio – Ohio Gov. Mike DeWine’s budget recommendations increase funding for mental health and addiction treatment services that have been vital throughout the COVID-19 pandemic.
The proposals have garnered the support of organizations addressing the challenges created by the pandemic. But do they go far enough to address the potential mental-health fallout of the crisis, which experts say could last even longer than the pandemic itself?
Advocates said the budget recommendations are a significant step. They’re grateful to see an increase amid the crisis, though they say more investments could be needed to create long-term stability for services that have traditionally gone underfunded.
Investing in mental health and behavioral health is critical for Ohio’s “return to normal” after the pandemic, said Scott Osiecki, the CEO of the Alcohol, Drug Abuse and Mental Health Services Board of Cuyahoga County. Issues like anxiety, depression, stress and grief could linger well after the coronavirus vaccine is widely available.
“It’s a basic need, like housing,” Osiecki said. “Behavioral health is really important to the overall health of the community.”
The cleveland.com series “Coping Through COVID” aims to help Northeast Ohio residents manage the stress of COVID-19 by examining by examining the mental health aspects of the pandemic. The series tells individuals’ stories and explores various challenges and coping strategies with experts.
DeWine’s budget recommendations include a 10.9% increase in funding for the Ohio Department of Mental Health and Addiction Services in fiscal year 2021, and another 1.9% increase in FY 2022. The state legislature could alter any of the recommendations before approving a final budget.
Terry Russell, the executive director of the National Alliance on Mental Illness (NAMI) for Ohio, said he is “cautiously optimistic” the legislature will adopt the DeWine’s recommendations. But he cautioned that reducing the proposed level of funding could leave Ohio scrambling to address the fallout from the pandemic.
“Any reduction of that would be a disaster,” he said. “It would literally put the mental health system in crisis.”
For examples, experts point to domestic violence programs. They say the pandemic has created a “perfect storm” of risk factors for domestic violence, and more than half of Ohio’s domestic violence programs have reported an increase in the number of people seeking shelter or requesting services.
DeWine’s budget includes $1 million per fiscal year for domestic violence programs, but the Ohio Domestic Violence Network is lobbying for an increase to $5 million per year, the organization’s executive director Mary O’Doherty said.
Domestic violence programs have been hurt by recent cuts to grants from the Victims of Crime Act, the federal program that provides money for therapy and other services. Ohio’s domestic violence programs lost $7.7 million for the next fiscal year, and have seen budget reductions of nearly 40% over the past two years, O’Doherty said. The network is asking the state to provide more money to make up for those losses.
“We are a pretty critical part of the social safety net, and we just need to do a better job of funding these programs,” O’Doherty said.
Addressing the issues exacerbated by the pandemic
Advocates have long argued that mental health, addiction treatment and domestic violence programs have been underfunded in the U.S., resulting in limited access to treatment in many communities. The problem has been exacerbated by the pandemic because many providers were forced to limit in-person services and switch to telehealth.
Some of DeWine’s budget recommendations target the issues that have been a focus during the pandemic. For example, the recommendations include $2.25 million per year to help parents, pediatricians and teachers identify signs of mental health conditions. Experts say that could be critical, because it’s unclear how children will be affected by taking classes from home for a full year.
The recommendations maintain funding in several key areas for the ADAMHS Board, Osiecki said. The Northeast Ohio collaborative – which includes the ADAMHS Boards in Cuyahoga, Lorain, Lake, Geauga, Summit and Medina counties – could get $7.5 million for withdrawal management and crisis stabilization funding.
The recommendations also increase the state’s continuum of care budget from $76 million to $82 million; the line item pays for services like suicide prevention, crisis response and treatment and recovery services, Osiecki said. The ADAMHS Board is hoping the final budget approved by the legislature includes an increase of closer to $15 million instead of just $6 million, he said.
The recommendations also begin to address some of the state’s long-term needs, advocates said. NAMI Ohio has been advocating for years for funding for people with a debilitating mental illness who often wind up in jail or a homeless shelter.
The budget also provides funding to help people living with debilitating mental illness. That group, which Russell estimated to include 50,000 people living in Ohio, have often lacked the community support they need. The result has either been an increased burden on their families or homelessness or jail time, he said. The governor’s recommendations include $5.5 million per year to help various systems coordinate to meet their needs, and $6 million per year to improve residential facilities for adults with a serious mental illness.
Domestic violence services struggle for funding
Advocates acknowledged that money is tight during the pandemic, but there are certain areas where they’d like to see more investment.
Domestic violence services have already seen budget cuts of roughly 40% over the past two years and are expecting another 30% cut in VOCA funds next fiscal year, O’Doherty said. The result is that many shelters have been forced to lay off staff, reducing the number of workers and counselors who are available to assist women and children in crisis.
Domestic violence programs could use additional funding to hire more staff, O’Doherty said. Staffing limitations are causing many programs to struggle to meet the needs of women in crisis who are seeking help.
“Right now, our programs turn away people every day,” O’Doherty said. “It would help us meet the need.”
O’Doherty said part of the issue with funding domestic violence could be that it often goes underreported, so it’s difficult to pinpoint how prevalent it is. But a U.S. Centers for Disease Control and Prevention survey from 2015 found one in five women experience severe physical violence from an intimate partner during their lifetime.
During the pandemic, many advocates have worried that women being isolated at home with an abuser led to a decrease in calls to domestic violence hotlines early in the crisis. O’Doherty is hopeful that attention to the issue could persuade some lawmakers to increase support.
“It’s a significant social issue that families live with day in and day out. It’s just like substance abuse or mental health, or any other kind of social issue society deals with,” she said.
To meet the state’s long-term mental health needs, NAMI Ohio is primarily focused on changing the way the money is used, Russell said. He believes services should take an individualized approach to care, rather than a one-size-fits all approach to mental illness.
“We need to be looking at the individual with the mental illness, and not the system,” he said.
Advocates are also focused on the employees and counselors who provide services, because the strain on the workforce isn’t unique to domestic violence programs. Agencies that provide mental health and addiction treatment services have also seen significant turnover during the pandemic.
Investing in a pipeline to train and retain workers could be critical for the long term, advocates said. That would help reduce turnover and help agencies provide better services.
“The workforce was struggling even before this,” Osiecki said. “There’s not enough people to provide services. And this is throughout the whole state. Actually, the whole country.”
Are you, a family member or a friend in crisis? or do you need mental health or substance use services? Here’s a list of agencies that can help.
- Frontline Services: 24-hour crisis hotline 216-623-6888
- Suicide prevention hotline: 800-273-TALK or 800-SUICIDE
- Cuyahoga County suicide prevention, mental health/addiction crisis, information and referral hotline: available 24 hours at 216-623-6888
- National Alliance on Mental Illness (NAMI) Greater Cleveland: Non-crisis hotline 216-875-0266 (Monday through Friday, 10 a.m. to 4 p.m.)
- Alcohol, Drug Abuse and Mental Health Services (ADAMHS) Board of Cuyahoga County: Online new service finder tool
- Ohio Department of Mental Health and Addiction Services: Online resource for COVID-19 related information and services available amid the pandemic
- Ohio CareLine: Emotional support call service from the Ohio Department of Mental Health and Addiction Services. Toll-free at 1-800-720-9616
- Ohio Crisis Text Line: Text keyword “4HOPE” to 741 741
- Find Substance Use Disorder and Mental Health Treatment: https://findtreatment.gov
- Disaster Distress help line: available 24/7 at 1-800-985-5990 or TTY at 1-800-846-8517. Also available by texting “TalkWithUs” to 66746; Spanish-speakers can text “Hablanos” to 66746.