Federal sequester, state cuts threaten mental health research at MUSC
Years before Alice Boland pulled a loaded handgun on an Ashley Hall administrator outside the school in February, she was treated for her mental illness by medical professionals.
By the numbers
100,000Patients suffering from mental illness that the S.C. Department of Mental Health treats every year. $90 millionAmount cut from the Department of Mental Health’s budget from 2008 to 2012. 1,784Inpatient hospital beds in South Carolina designated to treat psychiatric patients.$30 millionAverage funding MUSC’s Department of Psychiatry receives from the federal government each year for research.2,938Inmates designated mentally ill by the S.C. Department of Corrections, out of an approximate 22,000-inmate population.Source: State agencies
So was Newtown, Conn., shooter Adam Lanza.
People suffering from mental illness are capable of committing atrocious crimes — Adam Lanza in Newtown, Conn.; James Holmes in Aurora, Colo.; Seung-Hui Cho in Blacksburg, Va.But the mentally ill are not necessarily predisposed to violence, and, in fact, are much more likely to be victims of crime than perpetrators of it, said Dr. Thomas Uhde, chairman of MUSC’s Department of Psychiatry.“We do need increased funding to provide comprehensive treatment and conduct research in these areas, but that should not be understood that people that suffer from brain disorders are much more likely to be out there committing these acts,” Uhde said. “That is not the same statement and they often get confused.”A 2006 study by researchers at Northwestern University determined that people suffering from severe mental illness are 11 times more likely to be victims of a violent crime than the general population.“We have people with mental illness who come in here and we have to treat because they themselves have been the victims of hostility,” Uhde said. “Part of that is the stigmatization of the illness itself.”
In each case, there were tests, diagnoses, intervention. Yet the mental health care system still failed them both. Even worse, the system failed the public.
Lawmakers in Columbia and Washington realize something’s not working. They are considering new gun-reform laws and registries to track the mentally ill in light of these recent cases. Dr. Thomas Uhde, chairman of the Medical University of South Carolina’s Institute of Psychiatry, concedes a solution is complex, but the crux of the crisis is money — there’s not enough of it.
“We have a national problem in terms of our ability to provide mental health care to those that are in need,” Uhde said. “We’ve decreased the number of beds throughout the country. We’re treating more people for mental illness in the prison system and in shelters than we are in the hospital system. ... It’s an outrage.”
Looming federal sequestration cuts piled on top of dramatic reductions at the state level threaten to make a bad situation even worse, he said.
“We’ve been able to continue to conduct pioneering research during very, very difficult times, but there are real challenges to our being able to continue that path,” he said. “The sequestration — or castration, depending on your perspective — is an example of that.”
MUSC’s Institute of Psychiatry — “the other IOP” as university insiders call it — is more than just group therapy and Prozac prescriptions. It accommodates 83 psychiatric patients at its hospital, which is only 4 percent of state hospitals’ total capacity for psychiatric patients, but is considered one of the leading psychiatry departments in the country for research.
Doctors and scientists there are studying a range of psychiatric illnesses, including post-traumatic stress disorder. They also are testing cutting-edge new therapies, such as magnetic brain stimulation and how it affects someone’s compulsion to commit suicide.
The psychiatry department uses a little more than half of its annual $70 million operating budget for this research. Some of this money trickles down from the S.C. Department of Mental Health, but less and less in recent years.
Bill Lindsey, executive director of the South Carolina chapter of the National Alliance on Mental Illness, said $90 million was cut from the mental health department’s budget between 2008 and 2012.
“That was just a huge chunk of money that went away,” Lindsey said.
Gov. Nikki Haley restored about $17 million to the Mental Health Department’s budget during the current fiscal year and has proposed to return another $11 million to its operating budget next year. Even so, Lindsey said the department is still cash-strapped, and South Carolina’s 100,000 mentally ill who seek treatment at the state’s mental health clinics each year are suffering because of it.
“The Department of Mental Health has only been able to treat the sickest of the sick,” Lindsey said. “We’re happy to see some money coming back in, but it doesn’t add to all that money that’s been lost. That’s the hard part.”
Although MUSC’s psychiatry research efforts are mainly sustained by federal, not state, money, that may be in jeopardy now, too.
MUSC’s Institute of Psychiatry ranks eighth among all psychiatry departments in the U.S. for the amount of funding it received from the National Institutes of Health in 2012. It also receives millions from other federal agencies, including the Department of Defense.
Each of these agencies will be forced to make significant spending cuts if Congress and President Barack Obama cannot agree on a plan to avert sequestration. Although the deadline to make a deal technically passed on March 1, a compromise still could be reached.
“If you have Department of Defense reductions, the question becomes where are they going to target their reductions?” Uhde asked. “Don’t know, but could be in the area of research.”
The bottom line is that MUSC’s psychiatry department and other academic research centers like it could suffer, he said.
“Our overall research portfolio approaches $40 million a year and $27 to $30 million of that is from the federal government,” he said. “The problem in the mental health field and in research is that we’ve already sustained cuts after cuts after cuts.”Reach Lauren Sausser at 937-5598.