The Fresno County Board of Supervisors will conduct a public hearing Tuesday on possibly creating a Behavioral Health Board, through the consolidation of the Mental Health Board and the Alcohol and Drug Advisory Board.
Last June, in its annual report to the Board of Supervisors, the Mental Health Board recommended the creation of a Behavioral Health Board. After further discussions among ourselves and with representatives from the Drug and Alcohol Advisory Board in September, the Mental Health Board voted 7-2 to support the creation of a Behavioral Health Board through a merger of the boards that deal with clients of the Department of Behavioral Health.
It is the responsibility of the Mental Health Board to review and evaluate the services provided by Behavioral Health to meet the mental health needs of our community, to report to the Board of Supervisors and to advocate for improved services. The Alcohol and Drug Advisory Board has a parallel mission.
Because substance abuse and mental health services are being consolidated at the state level, because both mental health and substance use disorders are divisions of our own county Department of Behavioral Health, because all counties now administer their own mental health and substance use funding, because many of the clients served are the same individuals, and because the two boards work directly with Behavioral Health to fulfill their missions, it seems logical to have one Behavioral Health Board to better serve the Board of Supervisors, Behavioral Health, and most importantly, our community.
Throughout the country, mental health and substance abuse services are being consolidated. Since 2008 the Substance Abuse and Mental Health Services Administration (SAMHSA) has focused on the integration of mental health and substance abuse treatment, settling on “behavioral” health care as the name for both.
With funding changes at our state level, each county administers its own mental health and substance abuse funds. Mental health and substance use services are being consolidated into departments of Behavioral Health to treat the whole person and not isolate one disorder from the other.
Some treatment providers are concerned about maintaining a strong focus on substance use disorders with the consolidation, but with the concerns in our community regarding substance abuse, there is little doubt that a strong emphasis will remain on the treatment of substance use disorders.
In addition, many of the clients served are the same individuals. More than half of those diagnosed with a mental disorder also have an alcohol or other drug-related disorder. Some estimate this number to be as high as 82%.
Some members of the mental health community fear that with the added focus on substance use disorders that a single board would not have time to deal adequately with mental health services. In reality, both boards currently are dealing with programs affecting both mental illnesses and substance use disorders — just not so well as would be possible with a combined board.
Much stigma is associated with mental illnesses and substance use disorders, which might be another underlying reason for the reluctance of some individuals to consolidate our boards.
Until we are willing to work together, not only to erase this stigma, but also to treat the whole person, individuals diagnosed with these disorders will not receive the care that they deserve.
Mental illnesses and substance use disorders are chronic brain diseases. Recovery always is the goal, but at this point, there is no cure for either disease.
It is the responsibility of board members, appointed to serve all residents of Fresno County, to advocate for better services, and to make recommendations to the Board of Supervisors. To do this more efficiently and more effectively, we must work together toward goals of wellness and recovery for all clients of the Department of Behavioral Health.