Wednesday, 18 September 2024

When a US State Outsources Mental Health to China


Many are voicing concerns about the State of Montana outsourcing its behavioral health to a private consulting firm, Alvarez & Marsal (A&M), which also happens to do business with China.  Montana’s decision to hire A&M to revamp the state’s behavioral health system has sparked concerns mostly relating to the $300-million price tag associated with the account, but oddly has avoided mention of the firm’s ties to China.  Why?

The Montana move to outsource these important high-dollar accounts highlights the Behavioral Health Commission’s unchecked power and lack of public oversight.  A&M, a global professional services firm, has a strategic partnership with the Chinese state-owned Zhongze Group, raising questions about potential conflicts of interest and national security risks.  Entrusting a company with Chinese connections to overhaul Montana’s sensitive behavioral health infrastructure is for many a cause for alarm.

According to the official Montana website, Governor Greg Gianforte signed House Bill 872 into law on May 22, 2023, providing a generational investment to reform and improve Montana’s behavioral health and developmental disabilities service systems.  A central component of the governor’s Budget for Montana Families, the $300-million investment will expand intensive and community-based behavioral health care and developmental disabilities services across Montana.  This new oversight commission, the Behavioral Health System for Future Generations Commission (BHSFGC), is formed around the A&M relationship and recommendations at an estimated cost of five to ten million dollars for A&M.  Do the taxpayers of Montana really think that’s the final price tag for A&M’s assistance?

These behavioral health oversight committees, like in Montana, are nothing new.  The United States has a long, dark history of using unelected behavioral health committees to set mental health policies, endorse risky mental health treatment protocols, and write legislation.  These “experts” have been the architects of some of the most inhumane “treatments,” such as lobotomies, electric shock treatment, and the massive drugging of children with dangerous psychotropic mind-altering drugs.  The committee reports to the governors in each state, while the taxpayers get the benefit of funding the programs and the treatments but then are provided little to no information about whether the programs are effective and, more importantly, whether anyone is getting better.

Governors appoint many of the members, often with heavy ties to the behavioral health industry, who benefit financially from connections to the psychiatric and pharmaceutical industries.  Yet these oversight committees operate outside the view of the public and burn through billions of dollars on failed psychiatric approaches without any accountability.

In fact, when these behavioral health programs fail, to avoid public criticism — such as “why isn’t anyone getting better” and “how is that significant tax money being spent” — the committee often changes its name.  For example, the Riverview Hospital for Children in Middletown, Conn. was a state-run psychiatric facility and, despite the desire to have to shut down, it was rehabilitated into the Albert J. Solnit Psychiatric Center — South Campus, the only state-run psychiatric facility in New England.  Riverview had its problems, including restraints, and a federal inspection cited the hospital for poor performance in areas such as medication, mental health assessments, treatment plans, and staff training.  Then, when the abuse is made public, new calls come for more spending to solve the problems created at the last facility.  It appears that nothing gets better — especially not the patients.

So you wonder where this behavior health push began.  Ironically, President John F. Kennedy created the very first structure, a President’s Panel on Mental Retardation.  Over time, this name has frequently changed.  The original purpose was to cure mental retardation, and the panel was established within the Executive Branch but operated outside the legislative process.  Of course, none of the panel members was ever elected by the people, many of them psychiatrists directing human research and writing legislation recommendations for the president with big price tags attached.

President Nixon expanded this quasi-governmental panel and moved it to the states, under the Executive Branch, reporting to the governors.  Over the years, the name of the committees has changed.  But today, these committees are usually called behavioral health oversight committees, varying slightly depending on the state.

The public understands it as the “mental health system,” and the average person wouldn’t know what behavioral health entails.  However, it is a powerful structure buried within the government bureaucracy that makes recommendations to the state government on how the public should behave, what is acceptable, and to what lengths the state will go to enforce psychiatric treatments on the poor and uniformed.

The public has no idea that those who sit on these committees are very friendly to the behavioral health vendors who make up the psychiatric and pharmaceutical industries and are themselves considered the most important “stakeholders” because they provide the services.  These committees and commissions set policies within public schools, prisons, foster care, and the community that benefit the vendors.

Given the amount of money on the table in Montana, it is shocking to see these new developments with A&M and its connections to China.  Is there no company in the state of Montana that can handle this state contract?  Really?  One must wonder what the contract with A&M ultimately will cost the taxpayers of Montana and who is to advise the public on whether A&M’s work was worthy of the enormous pay.

Allowing a firm with ties to the Chinese government to have access to sensitive health data and shape state policies seems like a costly mistake.  One must consider if there may be serious national security concerns attached to this relationship. 

The first public meeting of the BHSFGC is set for the end of June.  Will the new commission be public-friendly, or will it be a continuation of the behavioral health industry vendors setting policy without checks and balances?  More importantly, with $300 million on the table, when will the public get a report that will let them know whether anyone is getting better?  That’s the point, right?

<p><em>Image: ElisaRiva via <a href=

Image: ElisaRiva via Pixabay, Pixabay License.


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