Serving mentally ill | The Salt Lake Tribune

County needs review of its system

This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Salt Lake County Mayor Ben McAdams is doing the right thing in seeking an independent audit of the system that provides mental-health services to county residents. It's a complicated system, and the question of whether it meets the needs of Salt Lake County's mentally ill is one that demands an answer as quickly as possible.

The immediate concern of the mayor and advocates for the mentally ill is that Valley Mental Health has announced it will stop serving 2,200 patients, citing budget cuts by the county.

The organization provides the services under the direction of Optum, a for-profit company that was awarded the county contract to manage Medicaid-funded mental health services two years ago.

Valley explained that it will focus on caring only for those with acute mental illness. Other patients will be referred to other providers. But that should not be acceptable. Bouncing from one doctor or therapist to another is difficult for people suffering from mental illness, and the county has a responsibility to serve all the mentally ill, not merely those who live with acute forms of the disease.

McAdams is appropriately responding to patients and advocates who demand an independent review. While the mayor said he is angry with Valley Mental Health for reducing the number of patients it serves, he should demand an objective review of the whole system.

In 2011, before McAdams took office, the county decided to use the private company to manage the system rather than Valley Mental Health, a nonprofit organization, which for decades had overseen spending of the county's $50 million in Medicaid funds. At the time, there were concerns about the management of Valley Mental Health. But the move to privatize the management of mental-health services now must be evaluated with one goal in mind: helping those county residents who need mental-health care.

When the county cut provider payments 5.5 percent, officials believed patients would continue to be served, despite reductions in state and federal Medicaid funding. McAdams said he only learned about patients being dropped from reading news reports. Valley Mental Health should have communicated better with county officials about its decision to bounce patients to other providers.

Optum is a private company that must turn a profit. An audit should determine how much of the problem lies with the county's decision to privatize services, contracting with a company that, by its nature, has a bottom-line mentality.