Early Mental Health Treatment Saves Heartache, Cash

From the East Oregonian, June 8, 2013

Treating mental illness early could prevent anguish and heartbreak for millions — and save the government big money.

That’s what mental health experts have been saying for years and now it seems federal and state officials are tuning in. President Obama included $235 million in his budget to pay for such things as training teachers to detect mental illness in students.

In Oregon, senators Peter Courtney, D-Salem, and Brian Boquist, R-McMinnville, introduced a comprehensive bill this session to make the state’s mental health system more proactive. Among other things, the bill would beef up support to the Early Assessment and Support Alliance Program (EASA).

“It’s a SWAT team of mental health people who move in just like that,” said Courtney to his fellow legislators.

The idea is simple. Identifying mental illness early (in this case, between 15 and 25 years old) means less recovery time, fewer visits to the emergency room, less homelessness and more dreams fulfilled.

“Half of all mental illness has its start before age 14,” said Danielle Stolk, case manager with the EASA program in Union County. “Seventy-five percent of mental illness starts before age 24.”

Teenagers face enough chemical and emotional hurdles without schizophrenia — imagine experiencing hallucinations and delusions along with the usual teenage angst.

Only 15 Oregon counties offer EASA, the idea which germinated in Australia, was nurtured by the Mid-Valley Behavioral Care Network based in Salem and spread from there in 2007. The Union County program is the only one east of The Dalles. If the bill passes, the program would expand.

“I believe that in 10 to 15 years from now people will look back at this as one of the most important pieces of legislation to come out this session,” said Sen. Elizabeth Steiner Hayward, D-Beaverton, to her fellow lawmakers.

Mike Gregory, clinical operations manager at Lifeways in Pendleton, feels hopeful.

“Unlike any time in our recent history, federal and state leaders are talking about adequately funding proven mental health prevention and early intervention strategies,” Gregory said.

Other efforts are revving up. In the fall, Lifeways will embed five mental health professionals in west Umatilla County schools in a quest to detect mental illness early.

The pilot project was spearheaded by Greater Oregon Behavioral Health, Inc. (GOBHI), a risk-bearing partner in one of the state’s new community care organizations — the Eastern Oregon Coordinated Care Organization which oversees Umatilla and Morrow counties. The CCOs look after the state’s poorest citizens on the Oregon Health Plan and have free rein to save money by being creative, holistic and proactive.

“We’ve got to diagnose mental illness at stage one or two, rather than four or five,” said GOBHI CEO Kevin Campbell. “If we wait until after people have psychotic breaks, we’ve missed an important opportunity to intervene.”

Other programs are growing legs, too, such as Supported Employment and Assertive Community Treatment. Both are aimed at treating mental illness early on and getting people back to their lives.

Campbell finds the shift in thinking at the state level encouraging.

“For 100 years, we ran the system based on the bottom line — we decided we could only serve the people who were the sickest,” he said. “Now, we have an opportunity to focus on wellness and prevent people from getting so sick.”

The EASA program in La Grande travels on that track inside a converted bowling alley that now houses the Center for Human Development. Director Dwight Dill said youth learn ways to cope and prevail over their illness. The program teams with community partners such as school workers, ministers and medical practitioners who keep their eyes open and refer youth to the program for diagnosis and possible entry.

Campbell argues that money spent on the front end is money well spent. He points to the Oregon State Hospital to illustrate how expensive later treatment can get.

“There are 45 people in the state hospital at a cost of $12 million,” he said. “We’re spending serious money.”