Neglect of the mentally ill imposes a high cost
BY HANK ASHBY
The tragic loss of precious lives in Connecticut points a spotlight on our nation’s stunningly deficient mental health system. Thousands of seriously ill people in our country are living in our communities without ongoing treatment and support. Many are homeless or are warehoused in jail cells.
Congress passed legislation back in the 1960s that effectively closed the “inhumane” mental hospitals which had been providing long-term care and treatment.
President Kennedy supported closing these hospitals but simultaneously called for building and staffing of proper care facilities in local community settings.
That has not happened. A recent study cited on the Treatment Advocacy Center’s website reported that “Nationally, the number of beds available in the U.S. is 28 percent of the number considered necessary for minimally adequate inpatient psychiatric services.”
Mental illness can take many forms, including bipolar disorder, schizoaffective disorder and schizophrenia. These lifelong illnesses are not contracted by choice and are organic brain diseases similar to Alzheimer’s, Parkinson’s disease or multiple sclerosis.
Severe mental illness affects, chemically alters and impairs that part of the brain that gives insight and judgment. Many victims of serious mental illnesses simply do not have the capacity to understand and make decisions regarding treatment of their own illnesses.
Our own son ended his struggle with mental illness at the age of 25, while on a waiting list for comprehensive outpatient treatment.
Although as loving parents we did everything possible to get him desperately needed treatment, everywhere we turned the system let us down. By law, even severely impaired victims are not required to receive treatment (even though like Alzheimer’s patients, they lose the mental capacity to make their own decisions).
Having firsthand experience dealing with all the problems of our nation’s mental health care system, here are some “musts” to provide appropriate care and to possibly avoid preventable tragedies:
1) Make mental health care a core function of government, since the cost (legal, court, probation, hospital, substance abuse, incarceration, criminal and violent acts) of not treating those with severe mental illness is considerably higher for government and society in the long run. It is a function of government to protect constituents from harm and to be good stewards of public funds.
2) Medication and medication oversight must be mandatory for those diagnosed with schizophrenia, schizoaffective or bipolar disorder. Set up mental illness support groups to help support victims (also called “consumers”) and their family members.
3) Many in our jails are mentally ill and have little chance for improvement in violent and stressful environments. Reapportion funding away from jails to mental health facilities where consumers can receive appropriate care.
4) When police are informed that someone has threatened to harm himself (or others), officers must be required to transport that individual to a hospital for a mandatory evaluation.
5) Revise HIPAA laws to make mental health records accessible to concerned family members so they understand the diagnosis and treatment options. Recognize the stress they endure and assign a social worker to help manage their loved one’s ongoing care. Minimal investment in family support may keep the mentally ill out of expensive public-financed facilities.
6) Before releasing a diagnosed mentally ill patient from any hospital or jail, require that a social worker place the individual in a proper long-term care facility or provide reliable community-based comprehensive care and housing to ensure compliance.
7) Require parity of medical and mental health insurance benefits for treatment of the severely mentally ill to ensure adequate coverage for medication, long-term care and ongoing treatment.
While appropriate care seems costly, inadequate care and inaction are far more costly.
Helpful resources are: the National Alliance on Mental Illness site at www.nami.org/ and the Treatment Advocacy Center at http://www.treatmentadvocacycenter.org/ .
Hank Ashby, a Mount Pleasant resident, has been active with the National Alliance on Mental Illness.