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By Lacey Berumen, executive director of the Colorado chapter of the National Alliance for the Mentally Ill.

May is Mental Health Month and while there is much for mental- health advocates in Colorado to celebrate, there is a dark cloud on the horizon.

First, the good news: Gov. Bill Ritter has taken important steps toward lifting Colorado from the bottom of the heap when it comes to funding for mental- health services. He has proposed meaningful increases in mental-health funding and important initiatives to improving mental-health services as part of his efforts to reduce recidivism in the criminal justice system.

The dark cloud on the horizon, though, is the Medicaid preferred drug list Ritter ordered the Department of Health Care Policy and Financing to implement.

The theory behind this preferred drug list is simple: reduce Medicaid prescription drug costs by limiting access to only those drugs that a committee of “experts” has determined are effective and for which manufacturers are willing to provide deep discounts, or supplemental rebates. If the committee says a medication is effective and its manufacturer will pay a supplemental rebate, it’s on the list. Doctors are discouraged from prescribing drugs that are not on the list by forcing them to go through a cumbersome prior authorization process for medicines that are not preferred.

The drug-list theory might make sense for many medical conditions, but its one-size-fits-all premise is a disaster for those with mental illness.

Scientists know that there is a genetic basis for severe mental illness and that these genes are found in different combinations in different patients. It follows that an antidepressant that helps one patient might cause unacceptable side effects in another patient.

When Coloradans with chronic mental illness are denied access to effective medications and treatment, all of us pay, both in terms of the loss of valuable members of society and in the cost of emergency room treatment and criminal justice system involvement.

The number of inmates with mental illness diagnoses in Department of Corrections facilities has grown from 2,348 to 3,588 in the last five years. According to the National Center for Mental Health and Juvenile Justice, the vast majority of youth involved with the juvenile justice system have at least one diagnosable mental- health disorder.

Other states have learned the hard way that a Medicaid preferred-drug list that is implemented as a cost-savings measure can actually drive costs up, if it is applied to psychiatric medicines. That’s why 26 states with Medicaid preferred-drug lists exempt drugs for mental-illness diagnoses.

While most states established preferred-drug lists through the legislative process and have statutory protections for psychiatric medications, Ritter bypassed the legislature and instructed the Department of Health Care Policy and Financing to create a preferred-drug list via executive order.

In his executive order, the governor promised to “protect vulnerable populations.” To keep that promise, mental- health medicines must be exempted from any preferred-drug list and prior authorization restrictions. To do otherwise would negate the positive effects of Ritter’s other mental-health initiatives.

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great job! it is about time our mentally ill are given a voice. When we are doing 20k runs for the mental illness cause we'll have arrived to actual public consiousness...thanks for printing such a well wrtten letter. Susan Engler

great job it is about time our mentally ill are given a voice. When we are doing 20k runs for the mental illness cause we'll have arrived to actual public consiousness...thanks for printing such a well wrtten letter. Susan Engler

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