The State of New Mexico legislature is considering a bill that would expand funding for mental health services. Reportedly, it has strong bipartisan support. Although this sounds like a positive development, I personally have doubt that it will do much.
New Mexico looks to change investment in behavioral health
In a state with some of the highest rates of suicide, mental illness and substance abuse-related deaths, legislation targeting high-risk areas with more money and treatment programs proven to work is winning bipartisan support…A bill that would establish behavioral health investment zones across New Mexico passed the House on a 62-1 vote earlier this week and is now pending in the Senate…Democratic Rep. Patricia Lundstrom of Gallup, the bill’s sponsor, says New Mexico can no longer afford to throw money at the problem. The bill, she says, would provide a road map for the state and communities like her own to determine if they’re investing wisely…A recent legislative analysis found that of the half-billion dollars spent on services in New Mexico last year, only 11 percent went to proven programs…
They seem to have figured out that they cannot merely throw money at the problem. They need to focus of interventions that are effective. They are picking up on the recent trend to support interventions that are evidence-based. So far, so good.
There is a catch, however. It is one thing to say that you will only spend money on evidence-based programs. It is, however, an enormous challenge to figure out what constitutes sufficient evidence. Naturally, a person can find some evidence to support a lot of interventions. But how good is the evidence? How good does the evidence have to be? And, the biggest challenge: how good are politicians, when they attempt to critically evaluate scientific evidence?
If they say they are handing out money, but need to see evidence before they spend the money, you can bet that people will line up halfway across Santa Fe with binders full of evidence. But will it really mean anything?
It is, in fact, quite difficult to make sense of most scientific research. Some of it is not very good. Most of it is valid, but only in a limited set of circumstances. There are vexing problems in trying to figure out how applicable a given finding is, with respect to a particular problem, in a particular population.
There is another catch, too. In order for any treatment to work, it has to be administered by well-trained providers, working in a suitable environment. New Mexico has a chronic problem finding well-trained providers. It also has been challenging to set those providers up with good management, and with adequate resources.
It worries me to see so much focus on finding evidence-based programs, without attending to these other factors.
