Community mental health services

Urgent Action Items: 

  • The Department of Human Services has proposed new rules for Community Residential Services for persons with mental illnesses.  These rules are linked below.  Advocates may wish to comment on these rules.  

Background

  • Despite many talented and high quality providers, Illinois has never developed a comprehensive community mental health system.
  • Funding for community mental health services has long been inadequate and continues to decline.  We rank no better than 35th in per capita spending on community mental heatlh services despite being the 8th richest state in the country.  (A recent study conducted by the University of Illinois documenting the lack of funding for community mental health services is linked at the bottom of this page.)
  • Persons with serious mental illnesses are regularly discharged from public and private psychiatric hospitals and prisons and jails without a realistic plan for community services because such services are not readily available.   Despite the certain knowledge that a prompt appointment at a community mental health providers following discharge is necessary is necessary to insure continuity of care, the lack of funding requires community agencies to have waiting lists and to delay such appointments. 
  • The state acknowledges the importance of well-researched, evidence-based services such as Assertive Community Treatment (ACT)  However, Illinois has never funded this service in manner designed to insure fidelity to the evidence-based model and that ACT is available across the state to all persons who would benefit from it.
  • Persons with serious mental illnesse regularly become disengaged from community care because providers are not funded in a manner which permits them to provide the level and types of services needed to insure continuity of care.  The results are predictable:  re-hospitalization, homelessness, excessive reliance on nursing homes to care for persons with mental illnesses and even involvement in the criminal justice system.
  •  Cities and counties across the state must bear the human and financial costs of the state's failure to provide a comprehensive system of community mental health services. Chicago is in the process of closing and downsizing some of its city run community mental health facilities due in part to cutbacks in state funds.  Details of the proposed 2010 Chicago budget are linked at the bottom of this page.

Recommendations

  • Develop policies designed to insure maximum capture of federal funding under Medicaid and other programs.
  • Illinois should fund community mental health agencies at a level sufficient to insure that necessary services not covered by Medicaid are available across the state.
  • Illinois should fund community mental health services at a level sufficient to insure that persons who are not Medicaid eligible but cannot afford mental health services receive appropriate services
  • The Department of Healthcare and Family Services and the Department of Human Services should set rates for community mental health providers in a manner which reflects the true cost of providing adequate and humane services (including compliance and administrative costs) reasonably calculated to insure continuity of care and recovery.

DHS community mental health block grant application