STATE MENTAL HEALTH DIRECTOR VISITS

Changes in Medicaid and the increasing growth of managed care will affect the delivery of mental health services, the state's top mental health official and two lawmakers said Friday.

Private-sector, managed care programs could improve mental health funding and services, said Dr. Roy Wilson, director of the Department of Mental Health.

Managed care could lead more private hospitals to offer mental health services, he said.

But Wilson, who has headed the department since January, and two state lawmakers expressed concern about possible changes in Medicaid funding.

Wilson and state representatives Tom Marshall of Marshall and Patrick Naeger of Perryville met with about 30 mental health professionals and interested citizens in Cape Girardeau Friday afternoon at the Community Counseling Center.

The center is one of 25 facilities around the state that provide mental health services through contracts with the Department of Mental Health.

Marshall and Naeger serve on a House appropriations subcommittee that deals with mental health.

Marshall said Medicaid dollars are an important source of funding for mental health services.

Many mental health patients qualify for Medicaid. "If Medicaid is cut back drastically, that is a lot of our mental health program," he said.

Congress is considering a block grant system that would allow each state to set up its own Medicaid program. Another option calls for capping the growth in federal Medicaid spending.

Marshall said the whole Medicaid issue will be a topic of discussion in the legislature next spring.

The Missouri Department of Mental Health operates on a $574 million budget. Some $415 million of that comes from the state's general fund.

Federal revenue, largely Medicaid, rounds out the budget.

Medicaid funding totals about $2 billion in Missouri, but most of that comes under the Department of Social Services, Wilson said.

The mental health department provides services to about 100,000 Missourians each year. The department has three divisions: psychiatric services, mental retardation and developmental disabilities, and alcohol and drug abuse.

The biggest share of the budget, some $297 million, goes for psychiatric services.

Naeger said managed care could benefit mental health in Missouri.

In the past, private insurance companies typically haven't included mental health services in their coverage.

As a result, it has been left to the state to provide such services.

Wilson said state and community agencies should work together to provide a "seamless" system of mental health services.

Wilson, who previously was medical director of Malcolm Bliss Mental Hospital at St. Louis, said there has long been a stigma associated with mental health services.

At one time, mental health patients were segregated from the rest of society. "The state has always had state hospitals," he said.

But times have changed. Society has moved away from "warehousing people because they are ill," he said.