"And we are seeing the emergence of some services in local communities, even if they are at the wrong end of things--like jail diversion programs, and both pre- and post-booking evaluations at the court level. We are seeing communities come together in partnerships and meaningful coalitions to respond to these people. Sheriffs, peace officers and jail administrators are emerging as their strongest allies," Honberg said.
Miller is less sanguine. "Things have been pretty critical for the last few years. Further cuts could do considerable damage to the safety net, not only in the mental illness delivery system, but in other social services as well. The safety net is dramatically fraying, and there is nothing else to pick up the slack.
"If Medicaid continues to reduce eligibility and disenroll people, we may be heading for a 'perfect storm' in health care," Miller added. "It is critically important that health care reform be debated in elections this year in the context that we have a real serious health care crisis--premiums are increasing by 10% to 12% a year, overall spending is increasing, and the uninsured population is growing and may increase by another 2 million this year.
"It really is time for this nation to have serious dialogue and discussion about health care reform--how are we going pay for public and private sector programs? Health insurance coverage is the key ingredient: How we as a country can increase health insurance coverage and slow down the rate of inflation in health care spending and the increases in premiums. Unless we get handle on costs, it will be difficult to address the needs of vulnerable populations, like people with severe mental illness who are in need of coordinated care."