J. Clement Cicilline
J. Clement Cicilline is former CEO of the Newport County Community Mental Health Center. Contributing to this commentary are Thomas D. Romeo, former director of the Department of Mental Health, Retardation and Hospitals; Richard C. Antonelli, former CEO of South Shore Mental Health Center; Charles E. Maynard, former CEO of The Providence Center; and Richard H. Leclerc, former CEO of Gateway Healthcare.
Society’s need for mental health services has been extant since the beginning of civilization. But, it would take many years before even the most primitive care was available. Over time, people with mental illness would be sent to asylums, which sadly became “warehouses of humanity” that often resulted in the exacerbation of the illness.
In the earlier years, Rhode Island was no better than other states, providing only marginal treatment to individuals with mental illness. It was either institutional care or languishing on the streets.
Over the years, we saw the advent of more effective psychotropic medications and the development of outpatient mental health clinics. Some services were also available through private psychiatrists and psychologists, but only for those who could afford it.
Later, important developments included coverage for mental health services through private insurance policies and then through Medicaid and the emergence of comprehensive community mental health centers. Rhode Island had taken the proverbial giant step into modern and efficacious care in dealing with mental illness.
In the mid-1980s, Rhode Island was rated as the number-one state in the country in terms of how it addressed mental illness. There was a comprehensive system of care in place, with strong partnerships between and among the community mental health centers, state government, the General Assembly, the general public and family members.
What has transpired in recent years is not only tragic, but also irresponsible and actually immoral. There has been a systematic withdrawal of financial support that has almost decimated this once-vaunted mental health system. State government, governors and legislators have all but abandoned their concern about a segment of our population that relies on a range of services just to sustain themselves day-to-day.
The need for mental health services is at an all-time high. Mental illness, addiction issues and stress are everyday experience for millions of Americans, debilitating them in so many, deleterious ways. Still, people can’t get the services they desperately need. Some reasons include inadequate compensation for mental health staff and woefully poor rates of reimbursement from insurance companies, putting Rhode Islanders in the worst of circumstances. The stigma of mental illness also prevents people from getting services.
Serious action is long overdue. We must ensure that people with mental illness have a chance to live in the community with basic resources such as food, safe and affordable housing, health care, employment opportunities, and the like. Sure, making this happen carries an expense, but what’s life all about if we can’t help one another?
Because government has a moral obligation to serve people in need, we propose that a portion of Rhode Island’s billion-dollar American Rescue Plan funds be dedicated to establishing a modern, comprehensive and sustainable system of mental health care for adults and children. It would be the most humane and fiscally responsible thing to do, alleviating suffering and saving millions.
This is a clarion call to the governor and the General Assembly. We beseech everyone to call them now and implore them to demonstrate this commitment to the common good and to make things fair and equitable. This will truly make for a better world for all of us.