Getting behavioral health care in New Mexico has never been easy. The system that cares for people with things like mental illness, addiction, and developmental disabilities is still recovering from a shakeup a few years ago, and our new governor will have to continue picking up the pieces.
KUNM visited several service providers to hear what the next administration can do to ensure people get the help they need.
In 2013, outgoing Republican Governor Susana Martinez’ administration accused 15 behavioral health service providers of billing fraud and froze their Medicaid payments. Some went bankrupt.
The administration has insisted it was following federal law on how to manage the Medicaid funds, but later investigations found no evidence of fraud. Five years later, Patsy Romero is still angry.
"The people we’ve lost – I mean seriously lost, people have lost their lives – because of this irresponsible decision by this administration, is unconscionable and it’s unacceptable." said Romero. She is the executive director of Easter Seals El Mirador in Santa Fe, which serves people with intellectual and developmental disabilities and severe mental illness.
Romero, who has worked in behavioral health in New Mexico for more than 30 years, says the manufactured crisis undid decades' worth of work in communities across the state. "For example, there aren’t enough services in Carlsbad," she said. "In Roswell, people are trying to rebuild and it’s been a very slow process. You have to start from the ground up."
Of the five Arizona providers brought in after the shakeup, three have already left the state. One, Valle del Sol, is now filling gaps in northern New Mexico after Tri-County Community Services closed this summer.
The biggest challenge for all new providers starting up is that there’s no substitute for local knowledge and experience. That’s something I heard from nearly everyone I spoke with, including Roman Sanchez in Española. He’s a peer support worker at Inside Out Recovery, where people can drop in to get group therapy, classes, food, clothing, and other assistance.
Sanchez has been clean for seven years now, thanks to Alcoholics Anonymous, peer support and his faith. He runs support groups in Española and Taos, and he says what his clients need most from the state is more residential detox and treatment centers.
But, he says, addiction looks different in different communities, so the needs are going to differ too.
Sanchez recently gave a training to other peer support workers in Shiprock and Farmington on addressing the heroin epidemic. "They were all like, we don’t really have that here, it’s alcohol," he recalls. "Then as a while went on, they said, oh, we mix alcohol with oxycontins, that’s what they do a lot here. So that right there was the opiate epidemic unrecognized, no?"
Often, local needs are best addressed by local entities. But the vast majority of behavioral health funding in New Mexico comes from the federal government and flows through the state’s Medicaid program.
"New Mexico is data rich, but information poor," said Fred Sandoval, executive director of the National Latino Behavioral Health Association. He says the state collects data on who’s using behavioral health services and how much they cost, but doesn’t use that data to inform better policy. For example, he says, the governor’s Behavioral Health Planning Council could be more useful if they had better data.
"It should inform us about how our resources are used," said Sandoval, "but particularly it needs to be targeting: where are we going to get additional resources to address these problems?"
At Easter Seals, Patsy Romero agrees. "The state is refusing to give us the data about the most at-risk individuals, who, in my opinion, have been lost," she said. "What happened to the severely mentally ill? Right now, in our system of care, we don’t know."
Nearly a third of New Mexicans are on Medicaid, and that program is going through some changes that will affect the future of the state’s behavioral health system. That’ll be part of what our new governor has to deal with. But no matter who wins the governor’s race, Romero is hopeful that they’ll do a better job than Susana Martinez.
Support for KUNM’s Public Health New Mexico project comes from the W.K. Kellogg Foundation, the McCune Charitable Foundation, the Con Alma Health Foundation, and from KUNM listeners like you.