Responses to NAMI-DE from Jack Markell

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. State government has a responsibility to care for its most vulnerable citizens, and the Minner-Carney administration has failed the residents of the Delaware Psychiatric Hospital. The media coverage, federal investigation and the ensuing task force reports have exposed sickening cases of abuse, neglect and other misconduct.

As Governor, I will personally ensure the residents of the hospital are treated with care and respect they deserve. The task force recommendations generally outline a good starting point in terms of hiring properly trained and qualified staff and building a new hospital, but I will charge my Secretary of Health and Social Services with turning the hospital into a first-class institution.

To make this change happen, the state (including the governor’s office) must have direct oversight and responsibility for the hospital. That’s why I do not support privatizing the DPC.

The residents of DPC deserve a governor who will fight for them. I will be that governor.

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. Last month I released a detailed plan to ensure that Delawareans with disabilities lead full and active lives. The proposal is largely designed to move Delawareans from institutions to community-based treatment options. I call for supporting the five-year plan of the Commission on Community-Based Alternatives, especially the Money Follows the Person legislation to ensure funding flows to the proper areas.

Ensuring adequate funding is available for the community treatment providers is essential. Without it, we could have a race to the bottom to see who can provide services at the lowest cost, which will damage quality and does not serve the patients. In many cases, Delawareans with disabilities can lead full and productive lives if someone is around to remind them to take their medication, for example. But if low funding limits the availability of that assistance, the state will be forced to spend much more to house those individuals at DPC.

I agree with NAMI that to develop a comprehensive community mental health system is to assess the current care delivery system to determine where there is need for improvement. I would support a detailed analysis of our current system in order to lay the groundwork for the creation of a game plan for improvement. I also agree that it is crucial for people in the midst of a mental health crisis to have access to immediate, comprehensive and professional care—no matter where they live. We need to upgrade the services we currently have, and expand their reach.

As Governor I will fight to ensure that these facilities be free of the distinction or stigma that often accompanies psychiatric care. We also need to equip our community service providers and all others who care for the mentally ill with the appropriate resources to do their jobs.

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. Delawareans with disabilities cannot live full and productive lives in the community without a job and a place to live. My disabilities plan called for the Medicaid Buy-in to be funded, and I am glad that has finally been accomplished. I am also calling for the state to help more companies start programs such as the one MBNA began last year, which has been continued by Bank of America and now employs about 200 individuals.

My proposal also includes provisions to increase housing for Delawareans with disabilities by providing information on ways the disability community can participate in housing policy decisions, exploring options for funding new units of housing for persons with disabilities as well as eliminating barriers to existing low income housing that prevent access by persons with disabilities, develop a simple one-page summary of housing options available for those with disabilities who are seeking housing, creating an inventory of housing stock accessible to people with disabilities and help match individuals with disabilities with appropriate housing options, advocating for an increase in federal housing assistance and targeting state controlled block grant resources to those in most need.

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. This is a tragedy that must end. Treating someone with a mental illness as a criminal shows a fundamental lack of appreciation for what mental illness is.

We have to make sure all children who need mental health treatment receive it so they can receive the help they need to stay on the right path and provide funding for wraparound services such as medication, transportation, case management and employment so Delawareans with mental disabilities living in the community can receive the help they need to live full and productive lives.

As Governor, I will also consider expanding the state’s Mental Health Court so more people with mental illness get the necessary treatment instead of just being warehoused in a prison.