A dozen leaders of the OTOC Mental Health Action Team met on Tuesday, September 8 with Senator Bob Krist (Dt. 10—North Central Omaha) to discuss their concerns about the mental health systems in Nebraska and especially about the behavioral health care available to persons who are incarcerated in our jails or prisons.

Sen. Krist has been a key voice in the Unicameral for prison reform and has sponsored or supported several bills in the last Session which mandated improved treatment of prisoners in jails. OTOC leaders traveled to Lincoln on several occasions to testify in support of several of those bills including LB 10 (suspended rather than terminated the Medicaid eligibility of person in prison), LB 598 (mandates better assessment and support for incarcerated persons while in prison and support upon release) and for restoration of funds to Region 6 Behavior Health Center that were cut in anticipation of Nebraska expanding Medicaid under the Affordable Care Act.

Senator Krist is very knowledgeable and passionate about prison reform and reforming mental health care so that Nebraska stops criminalizing cases of mental illness and addiction. About 40% of those now in State prison have mental illness or substance abuse issues that would often be better treated in the community.  Senator Krist discussed the decline of behavioral health care in the state and some of the funding and policy decisions over the last 30 years which have led the current situation in our state.

He stressed that when a child comes into the juvenile system it is imperative to serve the child and his family.  Senator Krist insisted that our state must address the family structure and family unification.  He asserted that when a troubled child is assessed, they should be assessed for mental illness and related issues and that report be sent back to the judge who ordered the assessment in order to better inform how to refer the child.  Too many children are failed by the system.  Too many children become our mentally ill adults in our penal system.

Senator Krist explained to the group the best method of following the enactment of a bill is through a new website that will soon be offered through the state legislature.  Senator Krist went over the prison bills that OTOC has been following and testifying in favor of including LB 605, LB 598, LB 10 and others. Dr. Fred Echternacht, Don Zabolsky and Mike McClellan discussed OTOC’s interests in the reforms that have been adopted and in assuring that they be implemented as soon as possible. OTOC leaders agreed that these bills were some good first steps in improving the mental health care for the incarcerated individuals but that the entire mental health system has so many gaps and currently lacks the capacity to help people adequately recover from mental illness.

On the subject of juvenile delinquents El Siebert and Jonah Deppe offered recommendations.  El Siebert believed that some of those case workers who visit the homes are not trained well enough to see signs of dysfunction and abuse  Jonah Deppe shared that Omaha’s care for juvenile offenders has changed for the worse over the years.

Mike McClellan spoke of the need for Medicaid Redesign for the mentally ill after Senator Krist spoke of the past difficulty to seeing Medicaid approved in the state of Nebraska.  Senator Krist recommended that we talk to several other Omaha Senator who are thinking about Medicaid reform  and insurance coverage. Mike also brought up the Tri-West Report, and Senator Krist briefly spoke to the fact that some legislators are  involved in following up on the Tri-West Report findings.

Senator Krist agreed with our researchers and offered his additional knowledge that the Magellan Insurance Company does not deny anything that had not been already set in place by Health and Human Services.

One member raised the problem that there are not sufficient mental health beds or housing for people who have chronic mental illness and some who are released from prison have no place to go and will inevitably re-offend for lack of support.  Sen. Krist acknowledged there is likely a need for additional facilities to address the problem of lack of beds.  He said that the mental health system in Omaha is being kept afloat by the generosity of private donors.

Sarita Penka asked the senator not to forget that there are families dealing with mentally ill loved ones that have not offended enough to be incarcerated, and these individuals are often under served and families live with little hope.

Senator Krist asked OTOC leaders to send him our stories about problems our families have experienced in obtaining mental health care. He indicated he would take those stories to the Ombudsmen and to appropriate parties for an explanation.

by Sarita Penka, OTOC Mental Health Action Team Chair