By  JON BAKER

LINCOLN — As president and chief executive officer at Northern Rhode Island Community Services Inc., located in Woonsocket, Chris Stephens would like  to help all those who come to him in need of mental health or addiction care.

ByNowadays, given the economic woes in Rhode Island and across the United States, he’s finding it more difficult to provide such services, at least to meet demand.
“Picture this: You’re the mother or father of a working class family in Woonsocket or Lincoln, and you read in the paper that in Rhode Island all but 10 percent (statewide) have health insurance for counseling for stress due to the economic environment,” Stephens said. “There have been cuts in services and loss of jobs. Instead of that number being at 10 percent, it’s more like 20-30 percent.
“We have a number of people who are walking through our doors without insurance, and it’s getting harder to deliver the type of services we’d like,” he added.
“Take the milkman, the guy who knocks on our door and states he likes our mental health services, but says he can’t afford it because his company cut back or because he just got laid off. He tells us he’s really nervous, he can’t sleep or eat, or he has a kid with emotional problems.
“The problem is that the agency’s door he knocked on has had several hundreds of thousands of dollars in cuts, and can’t provide the care he needs. At my place, there have been $700,000 in state cuts in the last six months. Pure and simple, because of the economy, the ability to provide counselors is dropping, while demand, understandably, is going up.”
Stephens isn’t alone in his anguish. On Thursday afternoon, he sat at a conference table with Joseph Dziobek, president/CEO of Fellowship Health Resources, Inc. of Lincoln, and Elizabeth Earls, who holds the same positions with the Rhode Island Council of Community Mental Health Organizations, Inc. in Cranston.
All say they’d love to be able to offer the same services they did years ago, but like everyone else, they are feeling the effects of the declining economy.
“I think it’s important for folks to recognize the symptoms they’re feeling aren’t unusual, and that it’s still important to seek treatment,” Earls said. “They also need to know that there is a system in Rhode Island, but it’s struggling. I’d like to tell those people the system will make every attempt to help them, but we’re feeling it, too.
“I represent 11 organizations in Rhode Island,” all of which deal with treatment services, she added. “What I’ve seen are huge (state) cutbacks, $11 million in total children’s services. Rhode Island had offered pretty intensive services (years ago), so we had the ability to put counselors in the homes or schools. Children had a chance to stay at home and receive counseling there, but that program was eliminated as of Aug. 1.”
She noted the state put a different program in place, with the acronym “CAITS” (Child and Adolescent Intensive Treatment Services).
“It has half the funding and offers less than half of the services,” she said. “There have been lots of layoffs, not only in my organizations but others as well …
“The hard thing for me? I was speaking with a woman from South County just the other day, and she had two children. She asked me, ‘What can we do? Can I talk to town leaders, or state leaders? How can I help my kid?’ She actually asked me if she could conduct a bake sale to try to keep the program open.
“She didn’t have the money or the resources to help her child get the counseling to become more mentally healthy. It’s heartbreaking. It’s unprecedented.”
Stephens admitted that all 200 of his company’s employees were forced to accept a reduced work week, with a resulting pay cut, since April.
“We didn’t fill eight positions as they became empty due to attrition,” he claimed. “At the same time, we saw a 15 percent increase in uninsured clients. The staff is getting paid less, and working less hours, though a higher percentage of people are asking for resources, and they have no way to pay for them … When someone does come to us with insurance, I desperately have to serve that person just to be able to balance our own budget.
“The loser in all this is the person who is temporarily uninsured or unemployed, and those are the ones who are most in need,” he added. “Fact is, you try to figure out what can you do without becoming insolvent, but the whole community loses. It’s a Catch-22.”

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This is how Dziobek views his situation at Fellowship Health Services, which has suffered two layoffs within the last six months, without replacements:
“I was talking with a young man the other day, and his son has a form of mental illness,” he explained. “He was telling me he needs services for his son, and he was finding it difficult to access those services, especially the way the economy is now.
“We’re experiencing rate reductions for (counseling). If an insurance company says, ‘We’re reducing the rate of reimbursement for a clinical social worker,’ then the organization that employs that social worker may have to let him or her go because (the individual company) can’t afford that person because between salary and benefits, it just doesn’t add up.”
He also offered another viewpoint.
“If I have a child with a mental illness, and the economy is pretty solid, the chances of finding a service to benefit my child are pretty good,” he noted. “Now, when you see all these budget cuts, services are reduced. What does that mean? If you may have been seen in a week (during good times), now it may take three months; that is, until a clinician becomes available.
“We’ve been staffed rather minimally for a couple of years now … and we’ve had fewer staff members available,” he added. “I would say our ability to serve clients has dropped.”
Stephens chose to deliver a child’s side of the story.
“Say there is a child with autism in Lincoln, and parents have a choice of getting services in the community or a hospital, and the decision is to go with the community,” he mentioned. “The frustration comes from the community-based services being sliced. You may save the taxpayers money, and it’s being done because the state needs to save.
“The problem is that when you do this, there’s a greater likelihood the parent may not be able to handle the child anymore,” he continued. “With services less available, the state may end up paying more as a result because the child must move to another level of care.
“This is the worst it’s been in 27 years; in 1981, there was a major shift in federal funds for such mental-health services.”
Earls said she has heard leaders in the domestic violence field who have said that as people lose jobs, stress escalates.
“They may drink more, which could create alcoholism, or get angry, which would create more family tension,” she said. “With that, a young child may act up in school, and the whole thing just spreads like a cancer. There aren’t enough people out here to help with such services.”
Noted Dziobek: “If one is drinking more or one becomes depressed, that automatically affects physical health, things like hypertension or obesity could happen. The bottom line is mental stress does affect the quality of physical health.”
Is there a quick fix?
“No, there isn’t,” he added. “I think the resources need to be available, and there’s got to be another way to fund services. Until then, and as cuts continue, you’ll see more people will go without those services, and that means more will suffer from depression, other mental-health care issues. More people will end up in a hospital-type setting, and in worse shape.”