COMMENTARY: Why is New Mexico’s mental health system in such a distressed state? Yes, the suspension of funding to 15 large, long-standing outpatient provider agencies under allegations of fraud was a major blow to the system; however, the systematic dismantling began long before that time.
In 2012, the Human Services Department (HSD) announced that it would change the system of care from a “carve-out for behavioral health” to a model that moved all mental health services under the medical HMOs.
HSD also announced that they had designed a system that would require the HMOs to hire hundreds of licensed, qualified mental health professionals to be care managers.
The New Mexico Provider’s Association, which at the time included all agencies that HSD later accused of fraud, tried to explain to HSD why this was a big mistake.
Historically, New Mexico has had a shortage of licensed, qualified staff to provide direct services, especially in rural areas. The design that HSD put in place resulted in the behavioral health service provider agencies having to compete with the HMOs for the same pool of licensed, qualified mental health professionals. It was extremely difficult for the behavioral health provider agencies to compete with the HMOs, which offered jobs that were in administration with more desirable hours, provided higher salaries and better benefits, with the added benefit of little or no risk to individual licenses due to allegations or complaints.
The design was so flawed that I likened it to a financially struggling company deciding to move most of its production staff into administration in order to save money and then wondering why production was negatively impacted. Consequently, an already struggling mental health system was further compromised due to the inability to hire enough licensed, qualified mental health professionals.
Of course, the sudden and unwarranted actions taken by HSD in closing long-standing behavioral health provider agencies across the state served only to further weaken and destroy a system that will take many years to repair.
What ultimately does that mean to the average taxpayer?
With fewer outpatient behavioral health agencies, costlier services are utilized, such as inpatient hospitalizations, as well as the incarceration of the mentally ill in our jails and prisons.
Sadly, it also results in the increased probability of suicides, homicides, and abuse. It is like a balloon. When squeezed, the air must go somewhere. And, if squeezed to much… it will burst.
Roque Garcia is CEO of Southwest Counseling Center, one of the 15 behavioral health organizations whose Medicaid funds were frozen by the state in 2013. An investigation by the Attorney General’s Office later cleared Southwest Counseling Center of any criminal wrongdoing.