Georgia Moving To Reform State’s Mental Health Systems

This week’s Courier Herald column:

Somewhat quietly but very methodically, the issue of mental health and how it is treated in Georgia has become a policy focus for the Georgia legislature.  The topic has long been a bit of a sore spot among the other policy laurels the state has achieved, as well as the subject of ongoing litigation and consent decrees.  Georgia’s leaders are working to change that.

In 2019, the Georgia General Assembly created the Georgia Behavioral Health Reform and Innovation Commission.  It’s an ongoing working group whose original charter extends until 2023. 

24 appointees from Governor Kemp, Lieutenant Governor Duncan, Speaker Ralston, and former Chief Justice Melton have released their initial report and recommendations.  It’s 26 pages of high-level, mostly bullet point findings and recommendations.  It’s not light reading, and truly understanding the context would be optimized by someone working directly in this policy field.

Before I attempt to summarize where the Commission wishes to go from here, I’d like to try to articulate why this is important.  The term “mental health” is overly broad and means many things to many people.  It’s not a topic that most of us have to deal with on a daily basis, especially when used in the context of the most severe cases. 

And yet, as someone who works around politics and policy, I often get calls from friends and associates that when problems arise, they have no idea where to turn.  I’ve received many calls over the years from someone with a friend or family member in crisis, and they have no idea where to start.  I recall the first time I had to call a senior member of Georgia’s Department of Behavioral Health – someone whom I had met but had only known from political ‘grip and grin’ events – at almost midnight. 

My ask was just to be able to tell a friend who he needed to call in order to help his friend, who had very quickly spiraled into crisis.  He instead asked me to have my friend call him directly, immediately.  I again suggested that at that hour, perhaps just a referral to the proper folks that handle these things, and he told me “this is what we do. It’s probably best if I talk directly to him to make sure we get his friend to the right people, as soon as possible.”

That wasn’t the only call I ended up making to him.  I’ve even had to call him a couple of times after he moved on to a different career.  He’s always taken my call, and he’s always helped me help others navigate a complex yet difficult system.

What I’ve discovered from those who have called me is that there are no limits to who might need these services at any time.  They come from “good families”.  They come from all backgrounds and income brackets.  At any point in time, it could be our own family, or any one of us.

What I’ve learned over the years is that it’s not the phone calls that bother me or those that work in this area.  It’s the calls we don’t get that are haunting. 

Too many Georgians that don’t know who to call, don’t recognize they have a problem, or don’t know how to ask for help never do.  We only know there was a problem after they are reported as a hospitalization, a suicide, or an overdose.  We know the statistics on these cases are rising.  We also know too many names and faces to refer to them as “statistics”.

The Commission has outlined five areas and will be working on recommendations for each group.  They include Hospital and Short-Term Care Facilities, Workforce and System Development, Involuntary Commitment, Mental Health Courts and Corrections, and Children and Adolescent Behavioral Health. 

Their work and the legislation that will follow doesn’t lend itself to click-bait news, and much of it will be deep in-the-weeds-level wonky.  I’ll try to revisit it to highlight a few specifics from time to time. 

In the interim, understand this:  Much of the work done by the Legislature doesn’t generate headlines because it doesn’t feed pre-determined journalist narratives or partisan campaign fodder.  That doesn’t mean the work isn’t important.  We all know too many faces that are now statistics to let this group’s recommendations be ignored.