On June 15, the online news agency New Mexico Sun published the below 750-word Dinelli opinion guest column on the state’s 48% increase in homeless and the need for a Behavioral Health Treatment Court.
Headline: Reversing the Homelessness Crisis: Is New Mexico Ready for a Behavioral Health Treatment Court?
By Pete Dinelli
On May 22, the NM Legislative Finance Committee (LFC) released a report on the state’s homeless and the affordable housing shortage which included the preliminary estimates of the 2023 Point In Time (PIT) annual homeless count. The “Point in Time” (PIT) survey is conducted once a year to determine how many people experience homelessness on a given night in communities across New Mexico. The PIT count is the official number of homeless reported by communities to the federal Department of Housing and Urban Development (HUD).
According to the LFC Report on Homelessness and Affordable Housing, New Mexico’s homeless numbers increased 48% in 2023 going from upwards of 2,600 people to 3,842. The increase was driven by an increase in the unsheltered count with 780 more people in Albuquerque and 232 more in the rest of the state. About half the emergency shelter beds available were used indicating overall adequate bed numbers statewide. However, shelter accessibility was reported as significantly lowering utilization rates because some individual emergency shelters are full while others are extremely hard to reach.
LFC points to 7 risk factors for homelessness and housing insecurity as being poverty, unemployment, involvement criminal justice system, substance abuse, mental illness, lower physical health and educational achievement. People experiencing unsheltered homelessness are more likely to exhibit multiple risk factors. These individuals tend to have higher service needs, tend to be more frequent users of community services, such as emergency room visits and inpatient and outpatient treatments, and require more acute care.
The LFC report found the state lacks enough transitional and permanent housing to help people exit homelessness and found the need for an estimated 859 additional housing units for the state’s homeless population. The estimated cost would be $11.4 million annually. According to the LFC report, the state stands to lose an estimated 5% of its roughly 29,000 publicly assisted rental units over the next five years due to expiring affordability commitments or deterioration.
In 2023, the cost to New Mexico taxpayers, based on an estimated population of 3,842 individuals experiencing homelessness is $98.5 million to $192 million. A 2022 NM Housing Strategy report found a need for 6,500 to 8,400 housing units for populations, including the chronically homeless, people on the state’s developmental disabilities list and people exiting prison or mental health institutions.
PIT data breakdown for the unsheltered for the years 2009 to 2022 reports 46% of the unsheltered suffer from serious mental illness and that 44% of the unsheltered suffer from substance abuse for a staggering 89% combined total. In Albuquerque, 30.19% of the homeless self-report as having a serious mental illness and 25.5% self-report as substance abusers for a 55.69% combined total.
Getting mental health treatment and drug counseling to the homeless is just as critical as temporary shelter, transitional housing and permanent and affordable housing. Much more can and must be done with the initiation of civil commitment hearings to deal with the homeless who are mentally ill or who suffer from drug addictions who are a serious danger to themselves and to others to ensure that they get the medical and mental health treatment services they desperately need.
There is a critical need for a civil mental health and drug commitment court for the homeless suffering from mental illness and/or drug addiction and who pose a threat to themselves, their family or to the general public. Such courts do in fact exist in the other parts of the country and have proven to be highly successful. Governor Michelle Lujan Grisham and the legislature should seek to create a specialty “Behavioral Health Treatment Court” functioning as outreach and treatment court for the drug addicted and the mentally ill in a hospital or counseling setting and not involving jail incarceration.
There is an even bigger need for the construction and staffing of a mental health facility or hospital to provide the services. As it stands now, there exists less than adequate facilities where patients can be referred to for civil mental health commitments and treatment. There is glaring and absolute need for a behavioral health hospital and drug rehabilitation treatment facility.
New Mexico is currently experiencing historical surplus revenues and this past legislative session the legislature had an astonishing $3.6 Billion in surplus revenue. It likely the state will continue to see historic surpluses. Now is the time to create a “Behavioral Health Treatment Court” and dedicate funding for the construction of behavioral health hospital and drug rehabilitation treatment facility the courts can rely upon for referrals.
BERNALILLO COUNTY BEVHAVIORAL HEALTH TAX FOR SERVICES
In 2021, studies suggested that nearly 50% of Bernalillo County residents needing mental health or addiction treatment services were not getting the help they need because of gaps in New Mexico’s behavioral health care. Untreated behavioral health conditions have led to increased and sometimes tragic interactions with law enforcement, over incarceration, overuse of hospital emergency and inpatient services, and unnecessary suffering on the part of patients and their families.
It was on February 26, 2015, the Bernalillo County Commission approved a 1/8% gross receipts tax increase on a 3-2 vote to fund new behavioral and mental health services to improve access to mental and behavioral health care services in the county. When enacted, the county commission announced the intent for the tax was to invest the funding “in proven ways to better manage the high cost of addiction, homelessness and mental health problems”. According to a county commission announcement, “these issues impact families throughout the community and drive up the cost of public services, especially at the Metropolitan Detention Center.” The gross receipts tax costs shoppers one cent on a $10 purchase of goods and services.
The tax generates approximately $20 million annually. The goal of the one-eighth of 1 percent gross receipts tax hike, according to the county website, was to “develop a comprehensive, well-networked and accessible continuum of care for children, youth, and adults in need of behavioral health services” in partnership with federal, state and local government partners, plus the nonprofit and private sector. It has yielded nearly $161 million in its first seven years. It moved $80 million out the door in that time, and has some of the balance committed to major projects. The 1/8th% gross receipts tax was enacted to be used for the purpose of providing more mental and behavioral health services for adults and children in the Albuquerque and Bernalillo County area. The intent is to provide a safety net system for those in need of mental health not otherwise funded in New Mexico.
https://www.bernco.gov/uploads/files/BH%20news%20release%20PDF.pdf
Eventually, the county commission earmarked the bulk of what it had been amassed over 5 years for one-time expenditures. Those expenditures included $30 million for a new crisis triage center, $12 million for supportive housing and $4 million for the Bernalillo County CARE campus, formerly known as the Metropolitan Assessment and Treatment Services center, or MATS. The renovations to the CARE campus created an outpatient behavioral health clinic and living room space for peer-to-peer counseling sessions.
NEW SYTEM TO AWARD FUNDING
It was in 2019 that the Bernalillo County Commission established the Behavioral Health Initiative (BHI) representing a significant step forward in local efforts toward addressing and preventing the mental health, substance abuse, addiction, and homelessness crisis in Albuquerque/Bernalillo County and the middle Rio Grande region of New Mexico.
In November, 2019, County Manager Julie Morgas Baca asked the Bernalillo County Commission to approve a resolution that permits “stakeholders, providers, community members, staff, commissioners, or other interested parties” to propose behavioral health service ideas through a website. Up until then, only county staff had been authorized to propose behavioral health service ideas. All program appropriations require final approval of the County Commission.
According to Bernalillo County Manager Morgas Baca:
“I just really think it needs to be opened up, and we need to realize there’s a lot of people out there who have real life experience. … I want to solicit their input to see how much of a difference we can make in addition to what we’re already doing.”
On November 12, 2019 the resolution creating the BHI passed by a 5-0 vote unanimous vote.
https://www.abqjournal.com/1391385/c
Under the new ordinance passed, each idea from stakeholders, providers, community members, staff and commissioners goes through a vetting process. A county commission appointed committee ensures each proposal meets the criteria for an expenditure based on the behavioral health tax language approved by voters. A separate subcommittee of stakeholders and subject matter experts also reviews the ideas and recommends the next steps.
The BHI currently funds 40 contracts throughout the community. The four primary focus areas are:
- Crisis services, including the law enforcement and clinical support teams that respond to 911 calls for nonviolent incidents involving someone with a behavioral health issue.
- Community supports, such as peer-to-peer services for those with behavioral health concerns.
- Housing assistance with a voucher system.
- Prevention, Intervention and Harm Reduction, such as suicide prevention programs and initiatives aimed at reducing “adverse childhood experiences.”
According to a 2022 Albuquerque Journal news report “suicide rates in Bernalillo County are higher than they were before the tax … and drug overdose deaths have soared. The number of people who are homeless in Albuquerque – which represents the vast majority of Bernalillo County – is higher today than in 2015 [when the tax was enacted], according to official counts. And while the tax has been described as a mechanism for working alongside others to develop a “continuum of care” in the community, the county and its most logical partner – the city of Albuquerque – showed “no effective collaboration at all levels to improve the lives of citizens,” according to a 2021 analysis the city and county ordered to identify local needs.
“Bernalillo County Manager Julie Morgas Baca acknowledged the need for improvement. She said the county is now partnering with the city on multiple projects – including the city’s Gateway Center homeless shelter and services hub – reengaging community members in its BHI decision-making and developing a plan to better inform the public about available resources.”
The county says the BHI programs have served at least 131,732 individuals in just over seven years. County officials say they are confident the programs are making a difference in people’s lives.
Links to news sources are here:
The Bernallilo County Commission through its Behavioral Health Initiative (BHI) should partner with the state of build a Behavioral Health Treatment Hospital to assist with civil commitments.
__________________________
POSTSCRIPT
ABOUT THE NEW MEXICO SUN
The New Mexico Sun is part of the Sun Publishing group which is a nonprofit. The New Mexico Sun “mission statement” states in part:
“The New Mexico Sun was established to bring fresh light to issues that matter most to New Mexicans. It will cover the people, events, and wonders of our state. … The New Mexico Sun is non-partisan and fact-based, and we don’t maintain paywalls that lead to uneven information sharing. We don’t publish quotes from anonymous sources that lead to skepticism about our intentions, and we don’t bother our readers with annoying ads about products and services from non-locals that they will never buy. … Many New Mexico media outlets minimize or justify problematic issues based on the individuals involved or the power of their positions. Often reporters fail to ask hard questions, avoid making public officials uncomfortable, and then include only one side of a story. This approach doesn’t provide everything readers need to fully understand what is happening, why it matters, and how it will impact them or their families.”
The home page link to the New Mexico Sun is here: