A number of agencies and organizations outside the community mental health grantee system supply services to Alaskans with mental or emotional disorders. Data provided by some of these agencies and from other sources are reviewed in this section. This information is valuable, but must be viewed with previously noted cautions concerning comparability and duplication in mind.
The Department of Health and Social Services identified and matched FY 96 Medicaid recipients with several other Department of Health and Social Services programs. Nearly 11,000 Medicaid recipients were identified as recipients of other Department of Health and Social Services programs, except for state mental health programs.. Despite this, the Department of Health and Social Services report enlightens in several ways:
· 1,900 mental health consumers (17.4%) appear in DFYS records.
· 501 mental health consumers, or 4.6% of the Medicaid total, also appear in the Alcohol and Drug Abuse management information system and thus are dually diagnosed or dually served.
· 125 mental health consumers are also served by the Infant Learning Program, thus indicating not only mental health services, but developmental disability services.
These numbers are reliable, but incomplete. We can only speculate how many non-Medicaid beneficiaries were served in Department of Health and Social Services programs and about what portion of the nearly 11,000 Medicaid beneficiaries also received grant funded mental health services. We find clues to the second item in two sources. The Bristol Observatory report identifies about 38% of those admitted to community mental health centers during FY 94-96 as Medicaid eligible at some time during the period. FY 98 data gathered by the Division of Mental Health and Developmental Disabilities indicates that 31% of community mental health center clients were Medicaid recipients.
The AMHB annually obtains data from some other agencies serving people with psychiatric disorders. Again we caution that this data originates with independent sources. As a consequence, we hesitate to make any effort to aggregate the data into an overarching count of the clients served. The data does indicate the status of services in these life domain areas.
· Rural Human Services projects currently number seven statewide. FY 97 case data are available from two regions, which reported 480 individual cases, including crisis encounters. Village counselors from three reporting regions recorded nearly 1,700 outreach and crisis intervention encounters (with individuals not counted as cases). These three regions staged some 1,400 public information, education, and skill building presentations and community building activities. A total of 11,880 people attended these events.
· The Office of Public Advocacy (OPA) caseload included 255 individuals with mental illness in FY 97. Most are ages 22 to 59, although 14% are 60 or over.
· Jobs top of the list of needs expressed by individuals with chronic mental illnesses. A resource at hand for them is the Division of Vocational Rehabilitation, which carries about 500 open cases for individuals with psychosis, neurosis, and other mental and emotional disorders. These people received services including:
17. Counseling and guidance
22. Job referral
23. Vocational training
24. On the job training
· The Department of Corrections (DOC) housed 1,741 mentally ill offenders in correctional facilities, including about 30 Institutional Discharge Project Plus (IDP+) participants, during FY 97. A single day snapshot counted 1,493 mentally ill offenders, including those in community residential centers and on probation. The DOC mental health unit offers a range of services for inmates with "chronic or acute mental illness or severe personality disorders who present significant behavior and management problems."
· Local school districts provide special education programs for students with a variety of disabilities including serious emotional disturbance (SED). Including preschool ages 3 to 5, local schools provided special education services to about 850 SED children and adolescents as of December 1997. Even combining this number with the 3,300 SED clients served by community mental health centers and the 1,900 children in Division of Family and Youth Services custody receiving Medicaid services (and assume no duplication across data sources) yields a low number of children served (6,000) compared to our estimate of 14,900 SED youth.
· Three private hospitals (Providence, Charter North, and Fairbanks Memorial) providing psychiatric inpatient services reported some 2,850 psychiatric admissions during FY 96.. Please note this data was preliminary and should be replaced by better numbers soon.
· The Healthy Families Alaska program serves 303 families with children from birth to age 5 at risk of neglect and abuse. Services include prevention and early intervention for both mental health problems and substance abuse. The Division of Public Health estimates that 5,100 families are eligible for the program annually.
· Housing is a critical necessity for chronically mentally ill Alaskans. DMHDD supported residential settings represent a diversity of choices for Alaskans with psychiatric disorders thanks to efforts to bring together resources from the Alaska Housing Finance Corporation, non-profit agencies, federal and state agencies and advocacy organizations. As of July 1996, over 1,000 consumers occupied supported housing in 17 communities. The options ranged from owned homes to supported apartments to board and care facilities.
These data fragments reinforce two traits of the "system". First, it encompasses varied and valuable resources, many of which are outside what most consider the traditional mental health system. Second, as a consequence, the overall system may not be ideally cohesive or coherent.