Broad effort to reform Georgia’s mental health treatment underway

The state’s Behavioral Health Innovation and Reform Commission met for the first time Monday in Decatur to start a four-year examination of Georgia’s mental health treatment system, which remains under federal oversight following a 2010 court settlement.

The 24-member commission is created by a bill sponsored earlier this year by state Rep. Kevin Tanner, a Dawsonville Republican. Gov. Brian Kemp appointed Tanner to chair the commission in September. Members include doctors, judges, sheriffs and mental health experts appointed by the governor, Lt. Gov. Geoff Duncan, House Speaker David Ralston and Georgia Supreme Court Chief Justice Harold Melton.

The commission is charged with determining the factors that block access to the state’s mental health services and the ways behavioral health problems send people into the criminal justice system. It is also assigned to take a full inventory of the state’s mental health facilities and collect data from state agencies. The commission is supposed to wrap up June 2023 and its recommendations could spur legislation, funding and new regulations, Tanner said at Monday’s meeting.

 “We’re looking for ways to improve the system, not just political wins,” Tanner said. “It won’t be rushed.”

Its creation comes as the decade-old settlement agreement with the U.S. Department of Justice continues. The federal government ordered Georgia to halt state psychiatric hospital admissions, which state officials have done. A federal monitor recently praised the decreased hospital population in the state’s five psychiatric hospitals, but warned the state needs to boost stable housing to keep mentally ill people from cycling through crisis treatment and jail stints.

Local mental health advocates are also concerned the state falls short in keeping mentally ill people housed once they leave hospitals or jails. Housing largely falls to two dozen community service boards that hold state contracts to act as local safety net providers for mentally disabled people. Last year, the boards served nearly 180,000 people for housing, health and crisis services, said commission member Cindy Levi, CEO of Avita Community Partners. The organization provides 13 counties in northeast Georgia expertise in behavioral and developmental disabilities. Many more Georgians could be helped with funding and staff hikes, Levi said.

“There are really more people that need services than can be served,” Levi said Monday.

Threats of limited funding and a shrinking workforce pose the biggest challenges to Georgia’s mental health services, said commission member Judy Fitzgerald, who heads the state Department of Behavioral Health and Developmental Disabilities. She pointed to a September report from the nonprofit Mental Health America that ranked Georgia worst among all states for the access mentally ill adults have to treatment. She also flagged a lack of health insurance as a big problem.

“We’re not going to rush to throw things on the wall,” Fitzgerald said at Monday’s meeting. “These are problems that have been developing over a long period of time.”

Funding increases could be a tough sell since the governor ordered the agency in September to trim its budget by more than $21 million through next year. The state invested more than $270 million into mental health services since 2010, even while other state agencies struggled to recover from the Great Recession.

The new effort should focus on tightening the state’s existing mental health services to reach more people, said state Rep. Mary Margaret Oliver, a Decatur Democrat and commission member. Then it might be time to consider the case for more funding.

“We know we’re spending a lot of money and we don’t know if we’re serving people in the right way,” Oliver said after Monday’s meeting. “So this is hugely important.”

The new commission is reminiscent of former Gov. Nathan Deal’s Council on Criminal Justice Reform, which was instrumental in generating legislation that overhauled the state’s inmate re-entry program and created the accountability courts. Better mental health services are a critical solution to reduce the state’s inmate population in a way that the Deal-era council was not able to include in its final recommendations, said Michael Boggs, a Georgia Supreme Court justice who served on the criminal justice council and is a member of the new commission.

“I think it is the next intuitive step in criminal justice reform,” Boggs said Monday. “But you have to be pragmatic about what is politically palatable.”