Perdue: Innovation could save money

Perdue: Innovation could save money

Alabama Mental Health Commissioner Jim Perdue has some innovative ideas about improving the delivery of mental health in Alabama. Monday, he tested a few of them on the more than 50 people who attended a town hall meeting in Andalusia.

Perdue, the former probate judge of Crenshaw County, previously chaired the South Central Alabama Mental Health board. He is conducting town hall meetings all across the state.

"Our purpose today is for information," he said. "People don't know much about mental health. They know everything they want to know, which is nothing.

"The attitude is 'you handle it, keep it quiet, and don't bother me,' " he said. "But we can't ignore what we need to do in mental health."

He wants to start with the mental health services provided to those who are incarcerated by the Alabama Department of Corrections. The Alabama DOC currently has 25,000 prisoners.

Because Alabama has closed most of its mental hospitals, its de facto delivery system for mental health is prisons, he said.

"Forty percent of people in Alabama in prison, allegedly, are mentally ill," he said. "They either have a serious mental illness or a substance abuse issue, and that's why they're there."

Currently, he said, the state has a $12 million annual contract with an out-of-state company that hires people to assess and treat those prisoners. He is advocating putting those financial resources into the state's community mental health facilities.

When prisoners leave the system, he said, the company with whom the state currently contracts, is through with them.

"If we did the assessments and services through community mental health centers, the same people assessing and treating in them prison could offer the warm hand that walks them out of prison.

If treatment helps, and they're in there because of mental illness, then what if half of those people could leave early?"

The mental health centers could require those who left incarceration early to make appointments, take the psychotropic drugs that stabilize them, pass drug tests that screen for illegal substances, and to behave.

"Then they could get out, get a job, pay restitution, pay child support, all those things you need to do," he said.

Perdue also is advocating repurposing a former mental health hospital

Searcy Hospital in Mobile County was built originally as a fort and was used in the French and Indian war, he said. Later, it was converted to a hospital for tuberculosis and mental illness. Four years ago, the state walked out.

"Fourteen years ago (as a probate judge), I went there to visit Searcy Hospital, because I wanted to see where I was sending people on mental commitments.

"It looked like Blue Lake Church camp with a wall around it," he said. "Sort of like Montgomery Country Club. The trees were painted wainscote high with white.

"Today, it looks like a movie set on a horror film," he said. "The buildings are collapsed. The State Archives and History tells me it is the most historical untouched piece of property in the state, and we are letting it waste."

Elsewhere, those who are incarcerated and are terminally ill, are housed together.

"If we were to lease Searcy to an organization, these people would be no escape risk," Perdue said. Those who are incarcerated are not eligible for Medicare of Medicaid benefits, so the state DOC pays for all of their health care. If the Department of Mental Health leased Searcy to a hospice organization, and terminally ill prisoners were sent there, they would qualify for health benefits, potentially saving the state thousands each year.

Perdue also is interested in partnering with the University of Alabama. At present, the state Department of Mental Health is housed in Montgomery, and leases two floors in an RSA tower for $1.3 million per year.

But most of the department's employees ? more than 900 ? are in Tuscaloosa, where it operates Bryce Hospital and Taylor Hardin, the facility for those found not guilty of criminal charges by reason of insanity. Taylor Hardin has 115 beds and a long waiting list.

The Department owns a golf course in Tuscaloosa and University Mall. Perdue is considering negotiating for UA to build mental health a larger facility for Taylor Hardin, in exchange for its other properties.

Perdue also wants to start an early intervention program for autism. The program he describes could cost $50,000 per year per child, he said. But studies indicate that half of the children could be mainstreamed by third grade, he said, and almost all could be mainstreamed before graduation.

"If, after the age of majority, they still have a disability, then they're (the Department of Mental Health's)," he said. "We spend $2 million to $2.5 million on someone between the age of majority and when they die. This is something we have to address."