It’s hard to argue against the notion that David Ralston, the longtime speaker of the House in the Georgia General Assembly, is the most powerful member of the legislative branch of state government.
As such, he has a great influence on what does, and doesn’t, win approval by lawmakers when they gather annually for the state’s legislative session. Normally, Ralston is content to allow other members of the House to introduce legislation for debate, but occasionally an issue is of such personal interest to the speaker that he will submit a proposal himself.
That he did so this week with a sweeping plan to revamp mental health care in Georgia is indicative of Ralston’s intent to see passage of the long-overdue reforms. We have to applaud him for championing the effort and lending his considerable political clout to winning passage for the proposed changes.
“Reform” is a word often used within the state government as plans are put together to fundamentally change the processes involved in a particular area of concern — education reform, health care reform, judicial reform, welfare reform. It’s not a word that’s often been applied to efforts to change mental health care in the state. We hope that by the end of the current session, use of the descriptor will be appropriate.
As Ralston and others noted in discussing the package of multiple legislative proposals, most of which were recommendations of a study committee formed in 2019, there’s little about the existing state of mental health care about which Georgia can feel good.
Mental Health America, a nonprofit that annually compiles a state-by-state ranking based on a number of different statistical criteria, found Georgia to be sorely lacking in many areas in 2021. Compared to other states and the District of Columbia,
- Ranked 51st overall in access to mental health care
- Ranked 47th in terms of mental health care workforce needs
- Ranked 50th for youth suffering from depression and not receiving treatment
- Ranked 46th for uninsured mentally ill adults
- Ranked 48th for mentally ill adults who did not receive treatment
- Ranked 51st for adults with cognitive disabilities who could not see a doctor due to cost
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For a state that normally prides itself on the numbers — such as those showing it’s the best place to do business in the nation year after year — the rankings on issues related to mental health care are an embarrassment and reflect a lack of commitment to helping those who suffer from a host of mental health problems.
The legislative package being championed by Ralston addresses the issue from a variety of perspectives.
Among other things, it forces insurance companies to cover mental illnesses the same way they do other illnesses; requires those insurers with whom the state contracts for programs involving low-income and disabled residents to spend a minimum amount of money on care by limiting profit margins; provides incentives to get more people involved in providing mental health care; increases options available to first responders in handling mental health calls; and provides more options for the courts.
We will find out more about the comprehensive effort to change mental health care as it works its way through the legislative process, but already there are indications the legislative package is likely to have strong bipartisan support, a true rarity in the modern world of politics. Gov. Brian Kemp also has endorsed the effort and has indicated he will support its passage.
Still to be resolved is the issue of what it will all cost and the sources from which the money for funding will be allocated. But the state’s coffers are very healthy, and money is there.
Considering how poorly the state handles the mental health care crisis, no single reform effort will solve all problems that have to be solved. But the pending proposal is a powerful effort toward getting the conversation started and focusing on the urgent need for something to be done.
The mental health umbrella is huge, covering everything from drug and alcohol addiction to depression, from suicidal tendencies to a host of psychiatric diagnoses.
Georgia does not have enough care facilities, meaning those who need institutional care are often warehoused rather than properly treated.
It does not have enough properly trained mental health professionals (the same MHA study found the state was last in number of mental health professionals per capita).
It does not have enough training nor options for first responders, who often are called to the scene of a mental health crisis only to find there is little they can do to help.
The system is beyond broken. The legislative package that has been introduced is a powerful first step toward repair. We are anxious to see something done.