the presentation

Creating Dynamic
Policy Change in
Mental Health
Thomas Bornemann, Ed.D.
Director, Carter Center Mental Health Program
 Carter Center Mental Health
 Affordable
Care Act: Mental Health and Addiction
 Current Issues
in Mental Health
 Case Study: Georgia’s
 Conclusions
Mental Health System
Carter Center Mental Health Program
 Founded
in 1982; led by Rosalynn Carter
 Active internationally, nationally, and
 The
within Georgia
Rosalynn Carter Fellowships for Mental Health
 Liberia
 Public Policy
 Georgia
Affordable Care Act (ACA) :
Behavioral Health
 Dynamic policy environment
 Milestone in
health care policy
 Expands preventive
services and integration with primary
 Hurdles
will arise in implementation but will ultimately
greatly expand access to mental health and addiction
 Parity issues
Current Issues in Mental Health
Current Issues in Mental Health
Children and Adolescents
 Foster care
and adoption services
 Comprehensive screenings and routine checkups
 Collaborative partnerships with therapists and other
invested parties
 Support for families who adopt children in the child
abuse and foster care system
 School-based
health centers can provide behavioral
health services and early screenings for low-income
 Juvenile
Justice reform
Current Issues in Mental Health
Special Populations
 Transitional
age children
 Many mental health disorders begin in adolescence
 Providing solid transitional services will prevent young
people from exiting the mental health system
 Community services should
include efforts to address
disparities in racial minorities, LGBT individuals,
developmental disabilities and other populations with
unique needs
 Veterans
 Older
and their families
Current Issues in Mental Health
Policy Issues
 Department of
Justice settlements in New Jersey and
North Carolina and ongoing lawsuit in New Hampshire
and other states under scrutiny
 From 2009
to 2011, states collectively cut $1.8 billion for
children and adults with mental illness (NAMI)
 Cuts have
reduced mental health services and shifted
the burden of first response for people in crisis to law
enforcement officers and emergency room physicians
 Workforce
Policy Investment in Mental Health
 Policy can lead
to concrete, measurable results
 Nonprofits have
flexibility to accomplish policy changes
that government agencies and clinicians do not have
 Investments in
policy can affect large numbers of people,
and are potentially sustainable, long lasting, and cost
Case Study: Georgia’s Mental
Health System
Case Study: Georgia’s Mental Health System
A Hidden Shame: Death in Georgia’s
Mental Hospitals
Sarah Crider, died at fourteen
-Atlanta Journal-Constitution
Case Study: Georgia’s Mental Health System
GA Mental Health System Under Scrutiny
August 2008—Carter Center Mental Health Program (MHP) gets involved in
case against the state of Georgia
January 2009—Conditional settlement reached between Department of
Justice and Georgia re: CRIPA
February 2009—MHP and other state and national stakeholders entered as
amicus curiae
July 2009—Department of Behavioral Health and Developmental Disabilities
created (DBHDD)
January 2010—Second suit filed addressing community services/Olmstead
October 2010—Final settlement addressing both suits finalized
May 2011—Carter Center releases draft of Vision Report
May 2013—Governor signs Juvenile Justice Reform Bill (HB 242)
Case Study: Georgia’s Mental Health System
Creation of Community Services
Case Study: Georgia’s Mental Health System
Progress and Results
 Complete reform
of Georgia’s mental health system in
five years despite recession
 Georgia mental health services
are a model for the rest of
the country
 Narrow policy intervention
led to significant change
 Leveraged a community-based crisis system into a
community-based treatment system
 Learning
Collaborative for Integrated Care
Case Study: Georgia’s Mental Health System
Keys to Success
 Investments from
local foundations allowed The Carter
Center to take a leadership role in the settlement
 Strong leadership by
the state government
 Trust
 Engaged
all parties - not weighted in any one direction
 Transparency
Funders for our Georgia Activities
 The
J. B. Fuqua Foundation (GA Urgent Model Project;
C&A due diligence grant)
 The
Tull Charitable Foundation (GA Urgent Model Project)
 The
Betty and Davis Fitzgerald Foundation (GA Mental
Health Activities – Vision Document regional meetings)
 Healthcare Georgia
Foundation (Integrated Care, Health
 The
John and Polly Sparks Foundation (GA Mental Health
 Mental health is
a national concern with heavy emotional
and financial costs
 There
are opportunities for investment in multiple areas:
children, older adults, trauma survivors, etc.
 Investment in
policy creates long-lasting, wide spread
changes with a high economic and social return on
Thank you
Thomas Bornemann, Ed.D.
Director, Carter Center Mental Health Program
[email protected]
(404) 420-5165

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