Responses to NAMI-DE from John Carney

2008 Questions for Candidates

In response to abusive and unacceptable conditions at Delaware Psychiatric Center (DPC), legislative and executive task forces have issued legislation and recommendations to address problems in the mental health system both at DPC and in the community. NAMI Delaware supports these recommendations and welcomes the opportunity to partner with elected officials and state agencies to effect a transformation of mental health care in Delaware.

No more falling through the gaps. No more inadequate services or failing institutions. Delaware deserves a mental health system that offers the highest-quality care both in DPC and in the community. There must be a partnership between the state hospital, state agencies and community mental health providers, all of whom should offer an effective and evidence-based best practices and recovery-focused services. These should be provided to consumers (persons diagnosed with a mental illness) regardless of ability to pay.

Question 1.

People with serious mental illness have been entrusted to the care of Delaware Psychiatric Center, where many have suffered from abuse and neglect. As Governor, what are your plans to implement the recommendations of the Governor’s Task Force and House Investigative Committee and do you plan to privatize the State hospital?

Answer 1. Like most Delawareans, I was outraged at the reports of neglect and abuse at the Delaware Psychiatric Center. We have a responsibility as a community to care for those among us who need help.

I take the recommendations from the Governor’s Task Force and the House Investigative Committee very seriously. Patients at DPC and their families should be assured of quality care with direct and strong oversight. Part of this process will be open and accurate reporting by the Department of Health and Social Services about patient needs and steps being taken to correct the current problems. The DPC situation is not just about quality care for those with serious mental illness. It’s an issue of public trust. As Governor, I will hold my DHSS Secretary accountable for addressing the needs of patients at DPC and giving accurate reports to the public on the progress.

A hospital must be part of the continuum of care for people with mental illnesses. But, our efforts need to go much further. We need to provide better and more comprehensive services for people with mental health problems, including affordable housing, employment opportunities, care management, and treatment. DPC should not and cannot be the primary first option for the long-term care of people with mental illness. We need to do a better job of making sure we help people stay and function in the community.

Question 2.

A quality community mental health care system that provides excellent services is needed to ensure that consumers can be successfully discharged from the DPC and to minimize the need for re-hospitalization. However, the community mental health system lacks uniform standards of care, lacks crisis centers in each county, lacks rates that reflect the cost of care, and lacks funding to implement evidence based best-practice programs for persons with serious mental illness. What will you do to develop and fund a comprehensive and effective community mental health system?

Answer 2. As Governor, I will work towards building a quality community-based system of care that addresses people’s needs at each stage in life. Children, adolescents, families, and adults in Delaware all deal with mental illness, so we need to provide a continuum of services where people with disabilities live, work, learn, and receive care.

As Chair of the Delaware Health Care Commission, I formed the Mental Health Committee to analyze our system of care and identify gaps that need to be addressed. One of the most prominent is reimbursement rates for community-based providers. Non-profit organizations are essential to building a community-based system of care, but we need to find a better way of reimbursing them for their services. I will make it a priority to develop a fair and consistent measure of both costs and service outcomes to help recruit and retain the high quality workforce that is needed.

Question 3.

Lack of appropriate and affordable housing and supportive employment are two of the most significant barriers to living in the community for people with serious mental illness. Currently there are insufficient housing and employment opportunities for people with mental illness. What will you do to ensure appropriate and adequate housing and supportive employment for people living with mental illness?

Answer 3. I’m committed to providing affordable housing options for people with mental illness. As I outlined in my housing proposal, I will work to create 300 new beds of permanent housing for the chronic homeless, including those who are living with mental illness.

We also need to focus on creating housing options for young people who are entering adulthood and independence, particularly those living with mental illness. Many are aging out of our foster care system and have limited or no options. Often, these young adults need on-site support services so they can start to live independently.

State government should also be a leader in providing employment opportunities for people with mental health problems. As Governor, I will expand existing programs at the State Personnel Office to help people living with mental illness gain employment. We need to form partnerships with advocates, providers and the private sector to identify supportive employment opportunities for people living with mental illness.

Question 4.

People with mental illness are ending up in jail and prison, instead of getting the treatment and support they need to live successfully in the community. What will you do to divert people with mental illness from ending up in our criminal justice system?

Answer 4. On average, Delaware’s court system has been successful in working with juveniles, recognizing those with mental illness and getting them help without prison time. However, there is still room for improvement, and I support expanding that system to maintain a continuity of care and ease more young people’s transition into adulthood.

However, at the adult level, we need a comprehensive plan to help people with mental health problems get the care they need without ending up in prison. This will take collaboration between the Dept. of Health and Social Services, the Dept. of Corrections, the Dept. of Justice, the State Police, and the Courts. I have a track record of bringing people together to solve difficult problems, and I will make this a priority as Governor.