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Advocates put faces to budget cuts

Officials paint picture of mental health

A 5-year-old boy who was expelled from daycare for bad behavior after he was sexually abused. A young widow who was overwhelmed raising two children while completing her degree. A man who has learned to live with schizophrenia 35 years after the illness led him to cut his own throat so a demon could escape.

Mental health advocates yesterday presented stories of 100 people who they said would lose access to treatment under the state budget the House will consider this week. The budget would stop services for 3,400 children and more than 4,000 adults with mental illness, according to the New Hampshire Community Behavioral Health Association.

The cuts would leave the state paying for care for people who require the most services to remain stabilized in their communities, said Associate Commissioner Nancy Rollins of the Department of Health and Human Services. Mental health providers yesterday argued that people who receive fewer services or who function more highly still need those services to stay healthy and productive. Without services, the providers said, people with mental illness would not only suffer, but would ultimately cost more money.

"These people will continue to be sick and poor," said Jay Couture, president of the Community Behavioral Health Association. "Some will end up in the courts and the corrections system. Many will get sicker and require care that is more restrictive and more costly to the state of New Hampshire."

The proposals would halt services to children with severe emotional disturbances who are not involved with another state agency, like juvenile justice or special education. The proposed budget also stops services to 3,540 adults with severe mental illness, while continuing services to other adults with severe mental illness who function at a lower level. And it would stop services to 670 adults who have brought their mental illness under control.

The cuts to care for children would save $5.8 million a year, and the cuts for adults $6.7 million a year, according to the Department of Health and Human Services. The department warned lawmakers people in need of care would have a high risk of harming themselves or others and said the cuts likely violate the Americans with Disabilities Act.

Betty Welch, director of behavioral health at Elliot Hospital in Manchester, said people who cannot get treatment in their communities will turn to hospital emergency rooms. There, she said, patients would find longer waits and experience "less than optimal" conditions.

A Loudon woman, Cabrinni Kulish, said she struggled with major depressive disorder for 25 years before receiving proper treatment. Several years ago, said Kulish, a mother of three, she was unable to brush her teeth or get out of bed. Now, she is finishing a fellowship with the University of New Hampshire and preparing to return to work.

"You can get better, and I got my life back because I received the care," Kulish said.

Kulish said neither she nor two of her children who receive mental health services would be eligible for care under the proposed rules.

Chairman Kenneth Weyler of the House Finance Committee dismissed the claims as "scare tactics" driven by politics and self-service. Weyler, a Republican from Kingston, charged that mental health providers encourage people to become "patients for life" to preserve state funding.

"By cutting the amount of help we're willing to offer, we'd like them to discover that some of these people can be cured," Weyler said. "You shouldn't keep them just so you can keep your revenue coming in."

Weyler said if a woman went to a mental health center for help with postpartum depression, the center would keep her as a patient for the rest of her life. In reality, he said, the woman might no longer need services after a year, once her baby became "a little more animated."

There might be problems for the state as a result of the proposed cuts to mental health, Weyler said. But, he said, that would occur if mental health providers decide to make an example by cutting services for someone who really needed them.

"It's up to the mental health practitioners," Weyler said. "If they find someone who is really a danger to themselves and others, but don't try to stabilize them, and they say, 'Aha, this guy is going to go out and do something really strange, but if we turn him away, we can say, ah, we were right, you cheap bums.' "

After past cuts to mental health, Weyler said, people adjusted, and "everything seems to go along normally."

Last year, community mental health centers provided services to 38,124 adults and 13,181 children, Rollins said. Of those people, she said, 20,797 were eligible for Medicaid.

(Karen Langley can be reached at 369-3316 or klangley@cmonitor.com.)