Carrie Seidman: New mental health dollars? Spend them wisely
The Herald-Tribune - 2/25/2020
Feb. 25--Recently, I wrote in support of the mental health special tax district commissioners are considering for Sarasota County. If all goes as planned, residents will have an opportunity to vote for the establishment of this revenue-generating vehicle on the November ballot. (And if you haven't yet filled out the survey on the county's website, you have until the end of this week to do so.)
If voters get behind this proactive step, we'll have a more reliable funding stream for local service organizations who don't get much help from Tallahassee, which spends less per capita on mental health than just about every other state government in the nation.
What I didn't previously address is how, if the referendum passes, that money will be disbursed and spent. And, at least at this point, the commissioners, who would be in charge of setting an annual millage rate and distributing the budget to local providers, don't seem unified in their vision.
More than once Commissioner Charles Hines has referred to the possibility of using the money as dedicated support for the recently approved pilot program for an in-house jail treatment facility. Commissioner Nancy Detert has urged that substance abuse treatment be an essential target. And every social service organization in town is plotting how to vie for a slice of the pie.
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But if the residents footing the bill are to get the most bang for their buck, the commission needs to have a "bigger picture" in mind, as well as some consensus on the best and most effective current practices in delivery of services and treatment.
For decades, our attention and funding has been funneled to the crisis/emergency end of the mental health spectrum, an approach that is expensive and often produces short-lived results. Putting more money into stopgap measures, or fragmented and disconnected systems of care, will only perpetuate an existing "revolving door," where those in need enter and exit the system cyclically, with no real improvement over time.
Neglecting the root causes of our mental health crisis has not only fueled societal ills, from homelessness to burgeoning prison populations, it has immeasurably escalated our costs. Yet it has also brought us, I believe, close to a tipping point of cultural understanding, a realization that ignoring the catalysts of our cumulative pain has been a grave mistake.
"When the behavioral health system was first developed, we didn't know what caused mental health problems, and we didn't think they were preventable," says Andy Blanche, one of the founders of Sarasota Strong, a year-old grassroots organization (of which -- full disclosure -- I am a member) devoted to making Sarasota a "trauma-informed" community. "Since then, we've learned that the vast majority of behavioral health problems are a response to toxic stress and trauma."
Thus, Blanche adds, "the two most important things we can do to strengthen our community mental health system are to invest in prevention and to ensure that all treatment and supports are trauma-informed."
In other words, we must intervene early and build our support systems around a sensitivity to and deep understanding of the mental and physical impacts of trauma on the human organism.
Like a lot of psycho-jargon, being "trauma informed," has become a buzz phrase. I often hear it described -- over-simplistically -- as approaching mental health from the perspective of "What happened to you?" rather than "What's wrong with you?" But it's more than that.
Being trauma-informed means that in our every interaction -- whether as a parent, a teacher, a health care provider, a government official, a friend or even a stranger -- we are guided by empathy rather than judgment; eager to support and empower rather than demean or dominate; and cautious not to re-traumatize.
Being trauma-informed means equipping our children, from the earliest possible age, with the tools and practices to understand and regulate their emotions and providing them with easy and comfortable access to adult allies when they are struggling.
Being trauma-informed also means focusing our community efforts on addressing the roots of perpetuated cycles of generational trauma, whether from poverty or racism, and changing systems that have become traumatizing in and of themselves.
In short, it means overhauling not only our approach to mental health care, but our conduct as community residents and human beings. It accepts as a given that preventing, healing and (when possible) eliminating trauma is our best hope for a healthier, happier and more equitable community, a community that, as Sarasota Strong envisions, "cares for itself."
These are some of the considerations I hope commissioners will keep in mind if a special mental health tax district is established. There are proven best practices for preventative and trauma-informed care and local experts who can help guide their choices. The deliberate care with which they make their decisions will determine the resulting impact and whether residents' investment will be richly rewarded.
Read more stories by Carrie Seidman
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