Mental health liaisons laid off

Agency loses 100 case managers; more cuts feared

The state Department of Mental Health, facing a more than $9 million cut in its budget, yesterday laid off nearly one quarter of the case managers who supervise people with severe mental illness and make sure they get the services they need.

About 100 case managers received their pink slips or will get them today, said John Labaki, president of the Department of Mental Health chapter of local 509 of the Service Employees International Union, which represents state case managers, clinical social workers, and others.

State officials said about 3,000 clients would lose their current case managers.

Those clients will be shifted to other case managers among the remaining 350, said Kristina Barry, spokeswoman for the Department of Mental Health.

"Case management is still very vital and highly valued at the Department of Mental Health," she said.

"These are challenging times for the Department of Mental Health and all the agencies in state government, so unfortunately a difficult decision had to be made," she said.

The mental health cuts and layoffs are part of the $1 billion in budget cuts that Governor Deval Patrick is making in response to revenues lost in the economic crisis. Further cuts are expected, and advocates say people with mental illness have been hit so hard by the cuts that they should be excluded next time.

"We feel that the first round of cuts is disproportionate for mental health and are adamant that the next round of cuts should spare mental health consumers," said Toby Fisher, policy director of the National Alliance on Mental Illness of Massachusetts.

The state is laying off mainly newer case managers with fewer than seven years of seniority, union officials said. The cuts also include 20 administrative staff members, Barry said.

Pamela Colton, a case manager with a master's degree, has worked for state agencies for nine years but moved to the Department of Mental Health's Hyannis office six months ago. She was laid off yesterday, eight months shy of the 10 years she would have needed to be vested in the state retirement system.

But it is not herself she is worried about, she said. It is the mentally ill children.

"I understand that the state has to balance budgets and do what they need to do," she said. "I just don't like it hurting children and their families. Some of these families are not going to have access to a lot of the resources that workers are extremely aware of."

Programs that provide mental health services sometimes complain that case managers act as an extra layer of personnel between them and clients. But case managers, as system "insiders," are also seen as greatly improving a patient's chances of receiving needed services. And for many people with chronic mental illness whose family and friends have fallen away, longtime case managers provide a much-needed sense of continuity.

"Case management is a really key element of recovery and getting proper treatment," said Karl Ackerman, president of the Transformation Center, a Roxbury-based nonprofit run by people in recovery from mental illness. "When you're overwhelmed with a psychiatric disability, it's very hard just to show up at an appointment, if you have an appointment, let alone try to juggle various appointments with clinicians, with services, housing issues - all those kind of necessary elements that are just the basic needs of anybody."

Even before these latest cuts, he said, "There weren't enough case managers. People going in to receive Department of Mental Health case management services were waiting months."

Labaki, of the SEIU, said vulnerable clients are facing a big loss. "We don't know for sure how it will end up for them. They may end up back in the street, back in the hospital, or, unfortunately, back in prison."

Carey Goldberg can be reached at goldberg@globe.com