State Leadership Conference

With 2003 state budget deficits in excess of $60 billion, and even larger deficits expected for 2004, state governments are making deep cuts. One area where the lack of funding could hit especially hard is serious mental illness (SMI), according to Richard H. Hunter, PhD, chair-elect of the Committee for the Advancement of Professional Practice (CAPP) Task Force on Serious Mental Illness and a panelist at "Current initiatives in serious mental illness: the landscape for state psychological associations" at the March State Leadership Conference.

In fact, said Hunter, with money for those with SMI in peril, the role of psychology in their treatment could be in question. Because of budget cuts, seriously mentally ill patients are getting inadequate care.

Hunter added that even the psychologists who are working in public systems could be in danger of being downsized. "In many cases, psychologists are seen as expensive social workers and are being eliminated," he said.

But Hunter doesn't blame insufficient care solely on a lack of resources. "We are not looking at behaviors, coping strategies or environmental factors of people with serious mental illness," he said. "The belief is that if we successfully medicate them, their behaviors will fade away. We're keeping people in chemical restraints. Even psychologists are buying into chemical solutions for everything." Psychology can offer much more in terms of psychological rehabilitation methods that can lead to recovery for people with SMI, Hunter said. Psychology can provide other interventions and can play an important role in the management of medications. And, noted the speakers, psychologists can work in conjunction with physicians for people with SMI.

To respond to the needs of the seriously mentally ill, Hunter and the CAPP task force are working on several projects to improve services and enhance the roles of psychologists in treatment, including:

  • Developing training modules for use in continuing-education programs.

  • Working with legislative bodies and regulatory agencies to reduce the use of restraint and seclusion in psychiatric settings by implementing psychological and behavioral interventions.

  • Developing a proficiency petition on assessment and treatment of SMI.

  • Providing links with the National Alliance for the Mentally Ill (NAMI) national and local chapters.

Speaker Richard Birkel, PhD, a psychologist and executive director of NAMI, agreed that state NAMI chapters--there are 52 state organizations and 1,068 affiliates, he noted--and state psychological associations should work together to improve care for people with SMI. Noting the great need for mental health services for the approximately 10 million adults and 5 million children with SMI, Birkel said, "The opportunities to work together are tremendous. State NAMI leaders need to know about effective psychological interventions and psychologists need to be advocates for the field."