Cuts to Medicaid spending likely to hurt NC in the long run

As mental health funding continues to shrink, some worry North Carolina might see broad and negative consequences. 

N.C. Rep. Verla Insko, D-Orange, said the overall lack of spending on Medicaid expansion hurts North Carolina in the long term. Without accessible health services — both mental and physical — the state will ultimately spend more on emergency healthcare and other reactionary measures. 

“If we had expanded Medicaid in 2014, the federal government would be paying 100 percent of the cost," Insko said. "North Carolinians would pay nothing, so we would bring millions to the state; it would cover everybody.”

In reality, Insko said current cuts to mental health services and to Medicaid will continue to cost North Carolina taxpayers in the future. 

“It’s not smart," she said. "It’s the short-term decisions that are impacting our long-term viability.”

Ernestine Briggs-King, a psychiatry and behavioral sciences professor at Duke University, said she is disappointed with a trend of decreased funding for mental health services in the state — particularly for children.

"It's kind of shortsighted to deny (children) the care that they need now," she said. "I think the costs are probably even greater in the long run, but it's kind of like you pay now or you pay later."

Darcy Gruttadaro, director of the Child and Adolescent Action Center at the National Alliance on Mental Illness, said the stakes are extremely high for the state and children who do not receive adequate health services.

Children with mental health conditions are among the likeliest to drop out of schools, as well as become incarcerated, she said.

"Research shows that 70 percent of youth involved in the juvenile justice system have one or more psychiatric issues and (30) percent have serious mental illness, so they become entangled in the juvenile justice system," she said. "That’s very traumatic for them, and ultimately, they’re at great risk of graduating into the adult jail and prison system."

But with appropriate and early mental health treatment, these children can lead autonomous and successful lives, Gruttadaro said.

"It has a ripple effect, so if (children) can lead independent, productive lives, they'll have jobs, they'll be part of the tax base," she said.

She said positive effects of early treatment might be seen statewide as well.

“It doesn’t just impact the individual; it impacts their family and community, too," Gruttadaro said. 

Briggs-King said the state has already identified a lot of ways to improve the mental health system, and now is the opportunity to implement them. 

"We really need to invest in our kids, invest in mental health services, provide them with all the things that we know will help them thrive and take us into the new century as leaders and not as folks that will be a burden to the state."