While state Sen. Randy McNally, R-Oak Ridge, recently won an award for his support in funding mental health services for adults and children in Tennessee, mental health officials indicate the state still has hurdles to cross in increasing awareness and access to care.

McNally, along with Rep. Michael Harrison, R-Rogersville, earlier this month received a Legislative Victory Award from the Tennessee Association of Mental Health Organizations for leadership in Nashville and for their support of "critical State funding to preserve essential behavioral health services" in Tennessee, according to a press release from the association.

Ellyn Wilbur, executive director with the Association of Mental Health Organizations, said McNally and Harrison won the award for their sponsorship of a budget amendment to restore funding for mental health peer support centers and Behavioral Health Safety Net services.

Wilbur said the state currently has 40 peer support centers that connect patients with people who have firsthand experience with mental illness.

"That funding was in jeopardy, and it could very well be in jeopardy this year, hopefully not," Wilbur said.

She said the Behavioral Health Safety Net assists about 30,000 people in the state without insurance or TennCare in getting access to care.

Wilbur said those two funds were nonrecurring and have to be approved each year.

"A lot of the funding for services that go through the Department of Mental Health are considered recurrent funding, and so that's determined by the budget that's passed by the state," she said, "but nonrecurrent funding you have to look at it every single year as to whether or not it will be included at all, so that was especially important."

In addition to the Legislative Victory Award, McNally in 2012 was named the Legislator of the Year by the Tennessee District Attorneys General Conference. He was also named a Guardian of Small Business.

"I am honored to receive this distinguished award from TAMHO," McNally said in the release about the mental health award. "I will continue to promote and advance legislation to protect behavioral health."   

Despite the efforts of McNally and Harrison, the state is still facing an uphill battle regarding mental health.

The National Alliance on Mental Illness reported in its most recent survey that Tennessee's mental health system had fallen from a grade of "C" in 2006 to a "D" in 2009. Indicators included health and promotion, recovery services, consumer and family access to essential information and community and social collaboration with mental health agencies in the state.

Connie Whaley, East Tennessee regional coordinator with the alliance, said the state "deserved" the grade it received because access to care did not meet demand.

"It's hard for me to comment very negatively because we are dependent on the legislators for our financing - a lot of it - and we also are dependent on the goodwill of the Department of Mental Health, but the services available, they're inadequate," Whaley said.

NAMI is an organization that advocates for improved access to services and treatment, supports research and works to raise awareness about mental health concerns in the communities it serves.

Whaley said because of funding shortfalls, her territory in Tennessee has doubled in the last two years. She is now the coordinator for the eastern half of the state, noting that in the wake of the Newtown, Conn., shooting and other tragedies, the conversation among officials about mental health often takes a wrong turn.

"Unfortunately, it take things like the incident in Sandy Hook to get people's attention and get them to talk about it, and unfortunately, frequently, what they talk about when you get their attention is wrong," Whaley said. "Rather than (addressing the issue) with education and support and being proactive and avoiding problems, they just want to lock everybody up is what it comes down to (in) a lot of the conversation."

She said the state is working to expand its Crisis Intervention Team training for police officers to recognize when a person is suffering from mental illness. She also pointed to the expansion of crisis services and crisis stabilization units as positives in the state mental health system. Units are located in Knoxville, Morristown, Johnson City and elsewhere in Tennessee.

"These are all wonderful programs, but they are underfunded," Whaley said. "They�re too small, but we're making progress with them."

Wilbur said the mental health system sees about 90,000 patients per month, noting that while physicians and therapists are offering quality care, funding shortfalls are a recurring theme.

"They're serving a lot of people and doing a very good job at it," Wilbur said. "At the same time, the funding that's been available through the Department of Mental Health has really decreased over time, and the number of people who don't have insurance has increased over time, especially in the last three years associated with the economic downturn, so that really is a huge challenge for the system as a whole."

Harrison's district in Rogersville recently made news when Hawkins County Commission and the local board of education outlined plans to provide $725,000 to position a school resource officer in each of the county's 19 schools, a measure Whaley said was ill-conceived.

That sum "will buy a lot of mental health care," Whaley said. "And I won't even get into the politics of the probability that there would be an incident in one of their schools or the probability that an officer would help, but that money would buy a lot of health care."

Another problem specific to East Tennessee was the closure last year of Lakeshore Mental Health Institute in Knoxville.

Whaley said as a result police agencies were either having to keep people with mental illness in jail or transport them to other mental health facilities in the state.

"The big problem with that is if someone is in psychosis, if they're actively hearing voices and having hallucinations, the longer they're allowed to stay in that state, the more likely it is that it'll become permanent," Whaley said. "And right now, it's a real burden on all of the sheriff's departments to transport so far, and apparently the forensic units in those hospitals are full."

Noting cases in which some parents wait up to 10 years before getting their children the mental health care needed, increased awareness and erasing the stigma associated with mental illness was the key in addressing the underlying problems.

"It's not these mass shootings, and I don't really want to make mental health about that, but that is a component of it, that people did not get help in time, and they didn't because they were ashamed, and they were ashamed because they didn't understand," she said.