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Hope for the best and expect the worst

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The state Office of Mental Health’s listening tour stop in Ogdensburg last week didn’t offer us much more insight into what will happen to the St. Lawrence Psychiatric Center than we already had.

We will still have to wait for news of its fate. Acting Commissioner Kristin M. Woodlock said she hopes to have a plan for regional centers of excellence in place by Monday, but even if the plan comes about that quickly, OMH will have to get the blessing of Gov. Andrew M. Cuomo before any announcement is made. That could take a while. I don’t recommend that anybody hold their breath.

What’s really frustrating is that it’s clear OMH has a plan that it’s just not sharing. Nobody could put together a sweeping overhaul of the state’s mental health system in five days. OMH officials have obviously been working on their plan right along and already had it pretty well finished by the time they arrived in Ogdensburg.

On the positive side, Wednesday’s session did provide a little more detail about the state’s plans to revamp its mental health care system, and gave community members the opportunity to say what was on their minds. It was, at the very least, a cathartic exercise for anyone who cares about the psychiatric center.

Mrs. Woodlock also had a positive message about the state’s vision for the future of mental health services. Our system is antiquated and needs an overhaul. More people would have a chance to live productive, positive lives in the community if they have the supports they need to make it on their own. Fewer people would be stuck in institutional care. The state wants parity between coverage and access for behavioral health care and the coverage and access already available for primary health care.

That is music to the ears of anyone who has been through the mental health system themselves or has a loved one who has gone through it. And the phrase “center of excellence” has a beautiful ring to it.

But those intimately familiar with the current system are understandably skeptical. They’ve heard it before, back in the 1980s when the state gutted its inpatient institutions and decided community-based care was the wave of the future. The problem was that only a small fraction of the money saved from downsizing institutional care actually went to community supports. The rest was absorbed by the state’s general fund and spent on everything under the sun but community-based care.

Funding was not enough to care for the people who suddenly found themselves on their own back then, and that has never changed.

This latest glowing vision for the future only works if OMH can guarantee that it will dedicate sufficient money, manpower and programs to meet the increased demand for outpatient services that downsizing inpatient care will create.

Glenn Liebman, CEO of the Mental Health Association of New York State, hit the nail on the head when he told me that the state needs to reinvest every last dime of the money saved from downsizing inpatient services into community-based services.

OMH cannot be expected to do that through policy decisions alone. It’s high time the state Legislature recognized that the funding it allocates for mental health services is woefully inadequate and does something to fix it.

The state has a long-standing commitment to caring for its most vulnerable. The mentally ill and those getting alcohol and substance abuse services have not been included in that commitment, and that needs to change. Their voices have been ignored for too long.

All we can do at this point is hope that OMH will do right by its clients, its employees, and the communities in which it plays a prominent role, and that state lawmakers will act to give the department the tools it needs to follow through on its promises.

Time will tell if everybody does the right thing. We will be watching.

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