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Ward 7 Councilmember Vince Gray is back at the helm of the Committee on Health after suffering a stroke. At the committee’s first oversight hearings, Gray showered praise and lobbed largely softball questions during the Council’s annual opportunity to probe executive agencies. This week, Gray’s questions were aimed at the D.C. Health Benefit Exchange Authority and Department of Behavioral Health. What difficult questions Gray didn’t ask, certain public witnesses and colleagues At-Large Councilmember Christina Henderson, Ward 4 Councilmember Janeese Lewis George, and Ward 2 Councilmember Brooke Pinto did.
Here were a few of the top takeaways, questions, and concerns around the two agencies’ public health interventions this past year and going forward:
• Mental Health Patient Treatment Complaints
Patient advocates at mental health and psychiatric facilities in the District denounced DBH for reported involuntary discharges, unsatisfactory supervision, and access issues. Overcrowding, reports of staff yelling at each other and at patients, overmedication of patients to compensate for incompetency, and overall “chaos” were common claims involving the Psychiatric Institute of Washington, said Katerina Semyonova of the Public Defender Service.
The most frequent complaint the Legal Counsel for the Elderly receives is patients getting discharged without their consent, said Mark Miller, long-term care ombudsman for the pro bono legal organization. Miller said discharge without consent is unsafe and illegal. The issue is largely tied to a lack of de-escalation skills among staff and minimal supervision, he explained, calling for DBH to invest in better training and a more effective discharge model.
It’s also difficult to access treatment in the first place, said Jaclyn Verner, staff attorney at Disability Rights DC. Assertive Community Treatment teams designed to reach people with severe mental illness who haven’t been getting treatment are failing to follow up with patients after psych center discharges and to respond during crises, according to Verner. In those cases, law enforcement officers become the default first responders.
Access to substance use treatment programs reflect another gap in DBH services. Gray brought up the surge of opioid-related deaths in the District last year; Henderson stressed the disproportionate impact of these overdoses and deaths on communities of color. A key obstacle for substance use and mental health treatment programs is understaffing, said DBH director Barbara J. Bazron when councilmembers pressed her on reported failures. The District’s trouble getting enough qualified professionals in the hiring pool and maintaining them in a period of high turnover are nationwide issues during the pandemic, she said. Lewis George asked DBH to reimagine what partnerships could look like to help with these gaps.
A 911 diversion pilot that started in D.C. in June also came under fire for not helping de-escalate some high-stakes situations. Bazron noted that responding to violent scenarios, even if they involve people with mental health issues, is not DBH contractors’ role. “We don’t do violence interruption,” she said. She reiterated the agency’s goal, under Mayor Muriel Bowser’s request, to train every MPD officer in behavioral health and de-escalation by the end of 2022.
• Youth Mental Health Access Issues
Pandemic-era mental health challenges have hit youth hard, particularly Black and Brown girls in the District. Multiple witnesses said during the hearing that DBH needs to do more to target D.C. youth with school-based programs.
“The inability to access behavioral health services is a serious obstacle to these children overcoming the traumas they’ve already experienced in their young lives,” said Tami Weerasingha-Cote of D.C.’s Children’s Law Center. She cited long wait lists for counseling and connection issues with the DBH’s access helpline and referral agencies. “The District’s failure to provide them with these needed services is yet another injustice they are suffering.”
Weerasingha-Cote and others demanded DBH ensure each D.C. public school have a mental health clinician. She said only 80 percent of DCPS schools currently have a clinician in place or onboarding, despite receiving funds in the 2022 budget.
“The traumatic experiences my son Nicholas went through as a DCPS student sadly reflected some of the weight of the very same traumatic experiences of my own childhood,” said Russchelle Moore, a Ward 6 parent leader with PAVE, recounting her and her son’s struggles as youth dealing with bullying. “As a single mom of a child with autism, it hurts my heart to see history repeat itself in some ways.”
• Greater Access to Health Insurance
In lieu of tough questions for the D.C. Health Benefit Exchange Authority, Gray asked the agency for their top recommendations for uninsured or underinsured D.C. residents. Agency officials said residents should take advantage of the lower health insurance premiums through 2022 via the American Rescue Plan. They urged individuals to enroll in the District’s health insurance marketplace at DC Health Link by the end of the enrollment period on Jan. 31, especially because it’s unclear whether Congress will extend the law. They also suggested that residents insured through DC Health Link reach out to their insurance provider to check what type of coverage they have for COVID-19 treatments. Unlike earlier in the pandemic, treatment for COVID-related conditions is no longer automatically provided free of charge, they said.
—Ambar Castillo (tips? firstname.lastname@example.org)
Note: A previous post misspelled Russchelle Moore.
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