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Mental health funds diverted

The County Account

The state made available to Dutchess County funding to build up community mental health in the wake of the Hudson River Psychiatric Center closure. The amount offered was $1.875 million, with $1.5 millon renewing annually, restricted to “diversionary” programs to reduce hospital admissions and arrests. This month the collective will of county government voted to “divert” and pervert the actual intention of such monies.

The County Legislature voted to accept the funding, but not with the mentally ill in mind. Just about half -— $900,000 — will go not for the furtherance of mental health services, but will be “diverted” to replenish the county’s all but depleted rainy day fund balance (the 2012 budget was balanced using $26 million of the $29 million fund). The remainder will go toward preserving union jobs in the county workforce that were cut in the 2012 budget providing mobile crisis response services to aid law enforcement at rates higher than nonprofit professionals could provide.

A small pittance will boost services at Saint Francis Hospital and People Inc. (my employer, meaning I was barred by legislative rules from voting and participating in floor debates). Seemingly forgotten are those once served by the Hudson River Psychiatric Center.

Historically Dutchess County has welcomed the mentally ill from across the state. It did so in connection with the state-administered Hudson River and Harlem Valley psychiatric centers and the Taconic Developmental Disabilities Services Office (DDSO) even before the 1934 reforms to the state Constitution enshrined social welfare, including those suffering from mental disorder or defects. These changes, ratified during the Great Depression, required the state to assume a major role in social welfare, alongside counties.

With this change came new funding with the growth of state financing of health-related initiatives. In 1938, the state paid just $5.8 million annually in health-related expenses compared to $77 million just 30 years later. At the same time counties grew statewide from $23.4 million to $64.9 million. Then came advances in psychotropic medications, the deinstitutionalization movement and, in the modern day, economic recessions.

Today the movement is afoot to defund and downsize government funding of mental health services. The state did it in the early 1990s, and it did so again in 2011 in budget decisions that privatized mental health funding (in progress for completion in 2013) and locally closed the Harlem Valley Psychiatric Center, and now the Hudson River Psychiatric Center.

The 2011 state budget also diminishes the powers of counties in delivering local care, with a shift in policy toward privatization. Amid this movement to privatize health care, the county’s vote this month to grow the mental health budget — already twice as high as Westchester, which has triple the population — is senseless. It is senseless unless, of course, one considers that the purpose in accepting the money had little to do with community mental health, but with balancing budgets, settling labor disputes and bolstering law enforcement.

Michael Kelsey represents Amenia, Washington, Stanford, Pleasant Valley and Millbrook in the Dutchess County Legislature. Write him at KelseyESQ@yahoo.com.