Gov. Rick Snyder's surprise appointment of James Haveman to head the Department of Community Health raises troubling questions about the direction of mental health care in Michigan. During the administration of Gov. John Engler, Haveman was the department head largely responsible for sweeping changes that undermined community mental health care and, in effect, pushed tens of thousands of mentally ill people into jails, homeless shelters, prisons and hospital emergency rooms, as reported in this year's Free Press editorial page series, "Criminal Negligence."

Engler and Haveman closed 10 of the state's 16 psychiatric hospitals. And in the most egregious example, they waged a contentious battle over Lafayette Clinic in Detroit, cheap Air Max 95 during which Haveman was held in contempt by Wayne County Circuit Judge Richard Hathaway.

Few people dispute that shifting more mental health care from institutions into the community was, in general, humane and cost-effective. Still, the pace of the hospital closings left community mental health agencies unequipped to handle the changes.

In April 1992, the Free Press editorial page called on Engler to replace Haveman.

Mental health -- and other health care -- professionals and advocates also say Haveman, who takes office Sept. 1, was often imperial and arrogant. He angered some providers -- as well as some consumers and family members -- by moving the state from a fee-for-service system to a managed-care model of Medicaid.

Snyder's press secretary, Sara Wurfel, on Monday cited Haveman's expertise in integrating physical and mental health care, as well as his demonstrated ability to lead a large agency. He will not, she said, change Snyder's mental health policies or priorities.

Haveman's appointment follows the unexpected resignation of Community Health Director Olga Dazzo. Haveman served first as Engler's director of the Department of Mental Health, and then as DCH director after the two departments merged. Later, Haveman helped set up the national health care system in Iraq after the U.S.-led invasion toppled the regime of Saddam Hussein.

Haveman's new tenure ought to be watched closely by the public, legislators, the mental health community and the governor himself. The state Senate, in its advise-and-consent role, should grill Haveman about where he plans to take health care in Michigan, including whether he would require mentally ill Medicaid patients to take low-cost generic drugs, even when no generic equivalent exists.

Haveman should reach out to the mental health and health care communities, including advocates, providers, consumers and families, to ensure lines of communication remain open. "The last thing anyone would want is a return to the '90s," said Mark Reinstein, president of the Mental Health Association in Michigan. "We need to wipe the slate clean and figure out a way to do better."

Michigan's 46 local community mental health agencies reach less than half of the people who may need their services. Meantime, the state provides the fourth-lowest number of public psychiatric hospital beds, per capita, in the nation. Michigan needs an adequately funded and more efficient community mental health system -- and a sufficient number of public psychiatric hospital beds to serve the state's most severely mentally ill patients.

To move the state forward, Haveman must learn from past mistakes.

 


Comments




Leave a Reply