Higher education and community mental health have commonalities in student and client admissions. Many colleges and universities tout need-blind admissions policies. That means they admit students without looking at their financial circumstances. Then, they decide whether to offer students financial aid. They also remain free to maintain or reject their need-blind policies.
Schools with the deepest pockets, those with endowments running into the hundreds of millions or billions, are the best-positioned to offer need-blind admissions because money for financial aid is not in short supply.
Let’s compare this to community mental health centers such as West Central Behavioral Health. It, like Yale, Harvard, Dartmouth (its neighbor), and other elite schools, has a need-blind admissions policy integral to its mission. It accepts clients regardless of their ability to pay. There may be bandwidth issues preventing it from taking everyone seeking help for mental health or substance use disorders, but that’s usually because the demand outstrips West Central’s capacity to provide clinical services. In these cases, people must be referred to another provider. Often, other providers won’t accept clients whose only insurance is Medicaid, or who have no insurance at all.
This puts West Central in tenuous straits. How do you turn people away who need help knowing they won’t find it elsewhere? Yet, how do you keep the lights on and salaries paid if the money doesn’t flow?
This is a dilemma most Ivy League schools will never face. But community mental health centers face it every day. Of particular note is when a mental health crisis occurs. Then, a crisis clinician is ready to help without inquiring about insurance or the caller’s financial circumstances. In times of crisis, we respond.
Need-blind admissions may be a common denominator for community mental health centers and elite colleges and universities, but the commonality ends there. On one hand, elite schools are free to drop their need-blind policies if they choose. And students seeking admission generally have other options.
On the other hand, community mental health centers are open to all comers unless clinical resources aren’t available. And, community mental health clients usually don’t have any other options.
The clientele of the two types of organizations are distinct. Deep-pocketed alumni can fund colleges and universities far more readily than the clients of vulnerable community mental health centers. Alumni give back to their schools at notably high rates, getting recognition that can be deeply gratifying. Community mental health center clients have limited (if any) disposable financial resources. Even if they could afford to give, they often give anonymously.
Wealthy schools let their graduates know that tuition doesn’t cover the actual cost of educating students. Similarly, community mental health centers don’t generate enough revenue to cover the actual cost of care. In my analysis, Medicaid only covers, on average, 73% of the cost of care for West Central’s clients. That leaves a huge financial gap in the effort to keep the doors open for people in dire need.
Without a multibillion-dollar endowment, West Central must rely on appropriations from towns and counties, along with donations from private individuals, corporations and foundations. Without this support, it couldn’t serve the neediest. In contrast, Dartmouth’s $6 billion endowment, with an average annualized return of 10%, could generate $600 million this year. That could fund West Central’s budget gap for 222 years!
Community mental health centers exist for many reasons, not the least of which is basic but powerful: to help local people get well and be more productive members of our society.
The COVID-19 pandemic highlights our tenuous grip on happiness and stable mental health when isolation, physical health issues, and financial and family stressors arrive. Thankfully, for those who need clinical support from trained therapists, doctors, nurses, social workers, case managers and crisis clinicians, community mental health centers like West Central exist.
But a need-blind admissions policy works only so long as donors support the mission.
Donations help pay for therapy when there is limited or no insurance coverage, or fund crisis support services when a person has no place else to turn. All ages, genders, races, abilities and ideologies are welcome. It’s not limited to the best and the brightest, to those who score well on a test, or to star athletes on a playing field. By their very nature, community mental health centers serve the underserved in the greatest of financial and psychological need, helping them to survive and thrive.
I encourage giving to a broad array of organizations, alma maters included. Yet, when a pandemic like COVID-19 hits, forcing those already barely hanging on into ever-deepening despair, it’s time to adjust our giving to support true need. I encourage people who can be philanthropic to turn their attention to local nonprofits, and particularly to community mental health centers like West Central Behavioral Health, to support the need-blind admissions that will serve well our most at-risk family, friends, and neighbors.
Dave Celone, of Sharon, is director of development and community relations at West Central Behavioral Health, with offices in Claremont, Lebanon and Newport, N.H. Email dcelone@wcbh.org. West Central’s 24/7 emergency services number is 1-800-564-2578. The website is www.wcbh.org.