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Report addresses Arizona’s public mental health system

November 02, 2009

Arizona’s billion-dollar public behavioral health system, which serves 150,000 ill residents and their families, is inadequately staffed and struggling under budget cuts and the demands of a 28-year-old class-action law suit.

These were among the opinions recounted in a new report, “Arizona’s Public Behavioral Health Care System: Critical Issues in Critical Times,” which summarizes the views of a panel of leading behavioral health professionals. The report’s release comes just weeks after Gov. Jan Brewer’s call for a major reorganization of the statewide system.

The report was prepared jointly by Arizona State University’s Center for Applied Behavior Health Policy (CABHP) and Morrison Institute for Public Policy. It draws from a discussion among policy experts held at the July Summer Institute conference hosted annually by CABHP, and offers insights into key system strengths, vulnerabilities and potential solutions

The panelists, all professionals in behavioral mental health policy, agreed that Arizona’s system has a commitment to community-based care that keeps most patients out of institutions. They also applauded the system’s commitment to patient recovery. Among the vulnerabilities cited by some panelists were:

• 35 percent of Arizona adults with serious mental illness do not qualify for AHCCCS/Medicaid, primarily because they are working poor and uninsured, and thus are at risk for inadequate treatment

• Funds for housing and food to support patients’ recovery are essential, yet are not provided to even patients covered by AHCCCS/Medicaid because they are not considered "medically necessary."

• Budget pressures put Arizonans at risk through cuts to crisis services, which not only avert suicides and drug overdoses, but provide vital assistance to local hospitals and local law enforcement officials.

The report concludes by calling attention to what most panelists said is a fundamental misalignment between Arizona’s behavioral health statutes, its executive decision-making and its state funding – particularly for non-Medicaid/AHCCCS-eligible individuals and families. Positive system change is unlikely without a resolution to the decades-old Arnold v. Sarn lawsuit, panelists said, but it is vital to preserve funding levels for mentally troubled Arizonans in order to avert a human and fiscal crisis of major proportions.

Read the report and comment on its findings at