It doesn’t take long for a bump in the road to become a crisis — especially in today’s economy, experts in Wyoming’s community mental health centers say.
A spouse loses his job. The financial stress mounts and he begins to fight with his wife. The couple, distracted, pays less attention to the children, who begin to have problems at school. That causes more tension in the home.
But the family, or an individual, can get help at one of 20 community mental health and substance abuse treatment centers, which have facilities in all of the state’s 23 counties.
The nonprofits treat anyone who needs help, regardless of ability to pay. They are the safety net — the place where people who lack health coverage or receive Medicaid show up in crisis — as many private clinics will not treat people who lack private insurance. The centers allow people without coverage to pay on a sliding scale.
The community mental health center have contracts with the state to provide mental health and substance abuse services. And whenever there is a difficult situation, people look to the centers for help.
“When there is a shooting, when there is an accident, when there is a crisis in the community, the community mental health center is called,” said Erin Johnson of the Wyoming Association of Mental Health and Substance Abuse Centers, which represents the 20 centers.
But new cuts are going to make the jobs of the community mental health centers tougher, Johnson said.
As part of $248 million in reductions to the state budget over the next two years, at least $15 million is being cut from the contracts the Wyoming Department of Health has with community mental health centers. That amounts to a 12 percent hit, said Kim Deti of the Wyoming Department of Health.
The cuts began Friday.
In their wake, the centers are being forced to make tough decisions on how to balance their budgets. A group home is closing. Clinic hours are being reduced. Beds for addicts and mentally ill people to receive residential treatment are going away, Johnson said.
Staffs are being slashed and caseloads are increasing at the centers.
“The irony is those who are providing to the people in crisis are now in crisis,” said Brandon Wardell, interim CEO of Casper’s Central Wyoming Counseling Center, one of the 20 centers, which is losing at least $690,000.
The Central Wyoming Counseling Center serves over 4,000 people a year. It has 86 beds for residential substance abuse treatment for people in Natrona and surrounding counties. But that number is decreasing, Wardell said.
Budget cuts are forcing the center to cut 11 beds, he said.
Seven additional beds are going to be used in a crisis stabilization unit that the center is creating to fill a gap in local mental health services, Wardell said. In the unit, people who are a harm to themselves or others can receive services such as talk therapy and obtain medications to stabilize, Wardell said. Currently, there areis no local option for people who need help, but not the level of medical attention to warrant psychiatric hospitalization.
The center’s leadership has planned and saved for the unit for years as the number of people in what’s known as the Title 25 system of involuntary hospitalization has increased.
“There will be 18 beds that are no longer for substance abuse treatment,” said Johnson of the association. “What happens to those people when they are court-ordered to treatment? Will they just stay in jail?”
Being locked up is not the same as substance abuse treatment, which teaches addicts how to face life’s ups and downs without using, she said.
That will likely be the most noticeable difference in Casper. Its state contract is being reduced by 8.4 percent. The center also obtains revenue through some insurance companies, grants, fees and community partnerships.
At the Volunteers of America Northern Rockies substance abuse treatment center in Sheridan, six people are being laid off. Benefits for remaining staffers are being cut, Johnson said. Wait times in Sheridan, which are currently up to four months for women and up to six months for men, will increase to eight months for women and seven months for men.
Outside of Sheridan, up to two dozen other positions are being cut, or full-time positions are becoming part-time. That includes psychologists, nurses and case managers, Johnson said.
In the Big Horn Basin, money for transitional housing for people receiving mental health and substance abuse treatment is being eliminated.
Peak Wellness Center in southeastern Wyoming is cutting hours of some Albany County programs. The Haven group home in Cheyenne, meanwhile, is closing Aug. 1, Johnson said.
Carbon County Counseling Center’s office in Saratoga is closing. Staff has been reduced.
Wait times for outpatient services provided by High Country Behavioral Health will double from about 80 to 160 people. The center — which has offices in Evanston, Pinedale, Kemmerer and Afton — has also cut staff.
Southwest Counseling Services — which operates in Uinta, Sweetwater and Sublette counties — is cutting four beds in programs that help people with mental health issues and seven substance abuse transitional living beds. SCS also reduced some outpatient services in Sublette County but will continue to operate there. Eight positions are being eliminated.
Throughout the state, peer specialist programs are being all but eliminated. The programs pair someone who has achieved significant recovery from addiction with people new to recovery, Johnson said.
“Research shows the use of peer specialists allows states to save mental health program dollars by reducing hospitalization and other emergency interventions, and increases people’s participation in the community,” she said.
Research shows that when someone experiences stress, mental health and substance abuse issues more frequently arise, said Wardell, interim CEO of the Central Wyoming Counseling Center.
That includes job loss, which has become a fairly common as a result of the downturn in the state’s energy industry.
“Stress in someone’s life will exacerbate anything else that is going on,” Wardell said.
Throughout the state, staffs at the community mental health centers have worked hard to create enough flexibility in their schedules so that if someone in crisis needs to see a counselor for a mental health issue, they can get an appointment that day. A second appointment usually occurs within five days, said Johnson of the association representing the centers.
It’s going to be difficult to maintain that flexibility as caseloads increase due to the budget cuts, she said.
Wardell said he’s combed the Casper center’s budget in case additional reductions are handed down from the state.
“I don’t know anywhere more we could absorb cuts,” Wardell said.
Johnson said that other centers are in the same situation. The community mental health centers have born a number of cuts since the administration of former Gov. Dave Freduenthal, she noted.
Right now is a time when people are suffering. Mental health seems to be the last place the state should cut, Johnson said.
“I don’t know where the bubble’s going to burst,” she said.