Creating Dynamic
Policy Change in
Mental Health
Thomas Bornemann, Ed.D.
Director, Carter Center Mental Health Program
Outline
 Carter Center Mental Health
 Affordable
Program
Care Act: Mental Health and Addiction
 Current Issues
in Mental Health
 Case Study: Georgia’s
 Conclusions
Mental Health System
Carter Center Mental Health Program
 Founded
in 1982; led by Rosalynn Carter
 Active internationally, nationally, and
 The
within Georgia
Rosalynn Carter Fellowships for Mental Health
Journalism
 Liberia
 Public Policy
 Georgia
Affordable Care Act (ACA) :
Behavioral Health
 Dynamic policy environment
 Milestone in
health care policy
 Expands preventive
services and integration with primary
care
 Hurdles
will arise in implementation but will ultimately
greatly expand access to mental health and addiction
services
 Parity issues
Current Issues in Mental Health
Current Issues in Mental Health
Children and Adolescents
 Foster care
and adoption services
 Comprehensive screenings and routine checkups
 Collaborative partnerships with therapists and other
invested parties
 Support for families who adopt children in the child
abuse and foster care system
 School-based
health centers can provide behavioral
health services and early screenings for low-income
children
 Juvenile
Justice reform
Current Issues in Mental Health
Special Populations
 Transitional
age children
 Many mental health disorders begin in adolescence
 Providing solid transitional services will prevent young
people from exiting the mental health system
prematurely
 Community services should
include efforts to address
disparities in racial minorities, LGBT individuals,
developmental disabilities and other populations with
unique needs
 Veterans
 Older
and their families
adults
Current Issues in Mental Health
Policy Issues
 Department of
Justice settlements in New Jersey and
North Carolina and ongoing lawsuit in New Hampshire
and other states under scrutiny
 From 2009
to 2011, states collectively cut $1.8 billion for
children and adults with mental illness (NAMI)
 Cuts have
reduced mental health services and shifted
the burden of first response for people in crisis to law
enforcement officers and emergency room physicians
 Workforce
development
Policy Investment in Mental Health
 Policy can lead
to concrete, measurable results
 Nonprofits have
flexibility to accomplish policy changes
that government agencies and clinicians do not have
 Investments in
policy can affect large numbers of people,
and are potentially sustainable, long lasting, and cost
effective
Case Study: Georgia’s Mental
Health System
Case Study: Georgia’s Mental Health System
A Hidden Shame: Death in Georgia’s
Mental Hospitals
Sarah Crider, died at fourteen
-Atlanta Journal-Constitution
Case Study: Georgia’s Mental Health System
GA Mental Health System Under Scrutiny

August 2008—Carter Center Mental Health Program (MHP) gets involved in
case against the state of Georgia

January 2009—Conditional settlement reached between Department of
Justice and Georgia re: CRIPA

February 2009—MHP and other state and national stakeholders entered as
amicus curiae

July 2009—Department of Behavioral Health and Developmental Disabilities
created (DBHDD)

January 2010—Second suit filed addressing community services/Olmstead

October 2010—Final settlement addressing both suits finalized

May 2011—Carter Center releases draft of Vision Report

May 2013—Governor signs Juvenile Justice Reform Bill (HB 242)
Case Study: Georgia’s Mental Health System
Creation of Community Services
Case Study: Georgia’s Mental Health System
Progress and Results
 Complete reform
of Georgia’s mental health system in
five years despite recession
 Georgia mental health services
are a model for the rest of
the country
 Narrow policy intervention
led to significant change
 Leveraged a community-based crisis system into a
community-based treatment system
 Learning
Collaborative for Integrated Care
Case Study: Georgia’s Mental Health System
Keys to Success
 Investments from
local foundations allowed The Carter
Center to take a leadership role in the settlement
 Strong leadership by
the state government
 Trust
 Engaged
all parties - not weighted in any one direction
 Transparency
Funders for our Georgia Activities
 The
J. B. Fuqua Foundation (GA Urgent Model Project;
C&A due diligence grant)
 The
Tull Charitable Foundation (GA Urgent Model Project)
 The
Betty and Davis Fitzgerald Foundation (GA Mental
Health Activities – Vision Document regional meetings)
 Healthcare Georgia
Foundation (Integrated Care, Health
Policy)
 The
John and Polly Sparks Foundation (GA Mental Health
Activities)
Conclusions
 Mental health is
a national concern with heavy emotional
and financial costs
 There
are opportunities for investment in multiple areas:
children, older adults, trauma survivors, etc.
 Investment in
policy creates long-lasting, wide spread
changes with a high economic and social return on
investment
Thank you
Thomas Bornemann, Ed.D.
Director, Carter Center Mental Health Program
ccmhp@emory.edu
(404) 420-5165