Mental Health cut to the bone
State agency closing treatment centers, programs
By Jill Coley
Sandi DeVore suffers from bipolar disorder, marked by dramatic mood swings between mania and depression. The 61-year-old Hanahan resident lives on a fixed income and relies on the state Department of Mental Health to control her symptoms.
The Post and Courier
Sandi DeVore and other patients of the now closed Goose Creek Mental Health Clinic carpool to a facility in Moncks Corner.
But getting help is harder. After the Goose Creek Mental Health Clinic quietly closed in May, DeVore joined the clinic's 60 outpatients who had to make other arrangements. Now, DeVore travels half an hour to the Berkeley Community Mental Health Center in Moncks Corner.
"It's a hardship for us to get there," she said. DeVore and about four other nearby Mental Health patients try to make their appointments on the same day and carpool.
The Department of Mental Health, already besieged by a decade of cuts, was brought to its knees by the Legislature's slashing of $26 million for this fiscal year, a 12 percent cut in the agency's budget.
Lawmakers acted this fall in response to a $500 million shortfall blamed on the slumping economy.
Mental Health officials announced Tuesday how they are absorbing those cuts: Four regional centers, a prevention program and a crisis stabilization program are closing, and 75 beds from psychiatric hospitals, nursing homes and alcohol and drug treatment centers are disappearing across the state.
Previous story
Mental health patients strain hospital ERs, published 11/23/08
Fifty Mental Health positions are being eliminated, including 29 contract and temporary employees, and 111 positions will stand unfilled. Remaining employees must take five days off without pay.
These hits come on the heels of slow, steady cuts. Since 2000, the Department of Mental Health has lost more than 500 beds. Staff at the Charleston/Dorchester Mental Health Center has shrunk to 244, from 450 four years ago.
The Department of Mental Health also is facing funding losses from Medicaid, especially revenue from community mental health services, officials said.
Jeff Stensland, director of public information for the state agency responsible for Medicaid, said the changes in funding to community centers are not the result of changes in Medicaid standards, but rather an increased enforcement of established billing guidelines.
"It's absolutely devastating that this much of the budget cuts is coming on the backs of mental health patients," said Bill Lindsey, executive director of the S.C. National Alliance on Mental Illness.
The Charleston/Dorchester Mental Health Center lost about $1 million in state funds, eight temporary employees, all of whom were counselors, and 30 positions are unfilled, Executive Director Debbie Blalock said .
As a result, adult caseloads could double to 140 from 70, Blalock said. Counselors who serve children also could see a doubling in caseloads, resulting in one counselor helping up to 40 children.
Clients with complex needs will continue to be managed by teams with much lower ratios, she said. Last year, the center served about 7,000 individuals.
"It's scary. What we're talking about isn't a peripheral service. It's health care," Blalock said.
State budget cuts also are quieting voices who speak out on behalf of society's vulnerable. The Protection and Advocacy for People with Disabilities Inc. was established 30 years ago by federal mandate in each state to advocate on behalf of people with all types of disabilities.
In October, for the first time, the Legislature erased the state's contribution to the group, totalling nearly $300,000, or 15 percent of its budget, Executive Director Gloria Prevost said. "This is a time for great concern," she said. "We are getting calls from people in hospitals waiting for psychiatric beds."
Lindsey of the S.C. National Alliance on Mental Illness said, "If folks don't get the treatment they need, the state ends up paying for it." People with untreated mental illness can end up in jail, emergency rooms or homeless, he said.
In the last year, Berkeley Community Mental Health Center lost five employees when the Goose Creek clinic closed, and has since lost another five through attrition, Executive Director Debbie Calcote said .
"We've experienced fiscal cuts in the past, but not as severe as this," Calcote said.
Mental Health patient DeVore has signed up for a peer counseling class at the Moncks Corner clinic, a 30-mile drive from her home, to help others, she said. "The cutbacks are getting so we're going to have to take care of each other," she said.
CUTS DETAILED
The S.C. Department of Mental Health is required to cut $26 million from its budget for this current fiscal year.
ADMINISTRATIVE CUTS INCLUDE:
— Mandatory five-day furlough for almost all agency employees.
— Freeze on non-essential travel.
— Moratorium on the purchase of vehicles and equipment.
— All contracts are under review, and a number of contracts have been canceled.
OUTPATIENT SERVICES:
— 21 positions will be eliminated.
— 111 existing positions will be left unfilled.
— 29 contract and temporary employees let go.
— Closure of a six-bed crisis stabilization unit at the Anderson-Oconee-Pickens Mental Health Center.
— Closure of the Goose Creek Mental Health Clinic.
— Elimination of an intensive prevention program for at-risk children at Columbia Area Mental Health Center.
— Closure of a 10-bed community residential care home in Manning.
— Closure of two satellite facilities in Horry and Williamsburg counties.
INPATIENT SERVICES:
— Bed capacity at the Patrick B. Harris Psychiatric Hospital in Anderson reduced by 11, leaving a bed capacity of 133.
— Two units consolidated at the William S. Hall Psychiatric Institute, the department's child and adolescent inpatient hospital in Columbia, resulting in the loss of six beds.
— The number of nursing home beds at C.M. Tucker Jr. Nursing Care Center in Columbia reduced by 38, or approximately 10 percent of current capacity.
— Bed capacity at the Morris Village Alcohol and Drug Treatment Center in Columbia reduced by 20, to an available capacity of 124.
Reach Jill Coley at 937-5719 or jcoley@postandcourier.com.
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karmann (anonymous) says...
Thanks to the legislatures who did not see this coming and prepare for it.
December 3, 2008 at 6:19 a.m. ( permalink | suggest removal )
ironhorse (anonymous) says...
Will this cut affect Newt or will her insurance pay up?
December 3, 2008 at 6:38 a.m. ( permalink | suggest removal )
HomeGirlie (anonymous) says...
Just in time for the Christmas depression season...fantastic!
December 3, 2008 at 7:17 a.m. ( permalink | suggest removal )
UrGatorbait (anonymous) says...
More wonderful preparation from the elected twits of this state. We can have a by golly tax free gun weekend for the paranoid few that substitute a gun for a partner but mental health? Nah just cut services for those with diseases and help add to the stigma of mental health. Maybe that's why gun sales went up.
What a janked up state.
December 3, 2008 at 8:05 a.m. ( permalink | suggest removal )
Jimlslander (anonymous) says...
I'm not sure where I will get my meds now.
December 3, 2008 at 8:23 a.m. ( permalink | suggest removal )
Southern_Cousin (anonymous) says...
This is absolutely irresponsible.
The DMH is resposible for casemanagement of many, many people who, when not properly medicated, tend to act out criminal tendecies. Whether this becomes child molestation, violent behavior or other dangerous behavior people who are out-of-touch with reality do, this is a very serious public health problem.
And the state just authorized a salary of $1 million for the new Clemson football coach?
Something has got to be done - the priorities of our state government are NOT IN OUR BEST INTEREST, and not by a long shot.
I hope no one in YOUR family is harmed by a mental health patient who should be under care with DMH, but has slipped through the ever-widening cracks in this system.
December 3, 2008 at 8:27 a.m. ( permalink | suggest removal )
SimplyMad (anonymous) says...
Holy Cow! I wasnt going to comment on this one, BUT, JimIsl. made a funny! LOL!
This is one (of a few other) programs that I believe should not be cut. There is so much waste in state and federal government, there has to be other programs that can be cut or eliminated.
Like in NO bailout for the auto industry, and how about a few million for this Mental Health program.
Like jimbo, I am worried about his medication being cut, not that he has been taking it anyway.
December 3, 2008 at 8:51 a.m. ( permalink | suggest removal )
Jimlslander (anonymous) says...
That wasn't a "funny" SimplyMad, it was the truth. I rely on medication to keep my manic-depressive personality in check. You may not realize this, but there are times when I get out of control. I say things that make no sense. Usually, when this happens, it's because I haven't taken my meds. My "life-partner" helps me remember to take them, but even his help is no good if I can't get the meds in the first place. I am really concerned.
December 3, 2008 at 9:02 a.m. ( permalink | suggest removal )
SimplyMad (anonymous) says...
Ok, Jimbo. I apoligize. I hope you get your meds. Good luck, and say hey to your life partner for me. One more thing, have you tried Jim Beam?
December 3, 2008 at 9:15 a.m. ( permalink | suggest removal )
ColdBud (anonymous) says...
If we were able to get rid of the waste, fraud and abuse in other government programs, we would be able to take care of those that truly can't take care of themselves.
December 3, 2008 at 9:25 a.m. ( permalink | suggest removal )
wjhamilton3 (anonymous) says...
It's pretty shallow to say that people who are mentally ill will commit crimes and end up in jail without saying at the same time that the mentally ill are commonly victims of crime.
They probably cause more crime by being easy targets that as criminals. They're often poor and live in areas with crime problems. Many can't keep a functioning vehicle, so they have to walk long distances. They can't assess risk accurately and often can judge the character of the people they deal with. Most are on SSI or some sort of public assistance, so they have small amounts of money or groceries, which is enough to motivate a criminal to attack or defraud them.
The police find dealing with them to be time consuming, unproductive and frustrating. They make poor witnesses in criminal cases. They're often repeatedly abused by the same people. When they're victimized, it's often ignored by law enforcement.
Their families have often been exhausted by trying to take care of them. Elderly parents no longer have the money, time or energy to stay on top of what treatment is available. It can be an all day effort for one of these people to travel thirty miles to a clinic. Charleston's primary clinic was moved from the Downtown Medical Center a few years ago to a remote location West of the Ashley, with far less and far less frequent bus service, adding two hours to the time it takes many patients to get there.
Any experienced criminal knows the mentally ill are easy marks for robbery, rape and cheap laughs. I've seen them suffer in rural and urban areas.
Most of this is utterly invisible to people who go from place to place encapsulated in their automobile and interacting with the lucky and the safe.
There is another world in Charleston. It has levels of hell in it most people can imagine.
I understand the executives of AIG are enjoying bonuses this year, paid for with out bailout money. I think they should spend a few days sitting in a clinic waiting room.
The financial bailout package money would have paid for a Canadian style national healthcare system for the entire country for 10 years. Maybe that is not what we want, but socialism for banker's bonuses makes less sense to me.
December 3, 2008 at 9:29 a.m. ( permalink | suggest removal )
Missing_Home (anonymous) says...
I think all of those DMH employees that were encouraging people to vote NO to video gambling a few years ago should be the first ones CUT!!!!
December 3, 2008 at 9:32 a.m. ( permalink | suggest removal )
Missing_Home (anonymous) says...
Check this out,
http://www.thestate.com/politics/stor...
look how much some DMH employees are making, I would guess most are under paid, but there has got to be some that are overpaid.
December 3, 2008 at 10:02 a.m. ( permalink | suggest removal )
SCdeacinNYC (anonymous) says...
Maybe if they rolled back that groceries sales tax elimination.....they would have money for necessary programs like these.
December 3, 2008 at 10:11 a.m. ( permalink | suggest removal )
guidedbystewart (anonymous) says...
I wonder how much our legislators care about the mentally ill, apparently very little. I would truly hate to have to live in this State if I had mental health issues. Yet, we have tax free "get your guns" weekend while cutting essential programs and secondary education. What a warped, effed up State we live in!
December 3, 2008 at 10:20 a.m. ( permalink | suggest removal )
AbbyCarolina (anonymous) says...
Look for the jails to fill as these individuals are eliminated from the mental health system.
DDSN has been cut to the bone, too.
Our legislators could care less about our state's venerable populations.
I'll bet the Governor's mansion has beautiful Christmas decorations and a manicured lawn.
December 3, 2008 at 10:28 a.m. ( permalink | suggest removal )
downtownguy (anonymous) says...
I'm a libertarian but public mental health is one of the few essential services that must be provided for. The state will end up paying more for psychiatric patients spending days in the ER, waiting for a bed, or for these patients who commit crimes or become victims of crime (since they are easy targets). How much money will have to be wasted and how many people will have to die before Gov. Sanford realizes that you can't cut these essential programs? There are so many other programs that can be cut before this ($500 million 526 extension, for example).
December 3, 2008 at 10:46 a.m. ( permalink | suggest removal )
Name_Withheld (anonymous) says...
Did they cut the Hunley Restoration?
December 3, 2008 at 10:49 a.m. ( permalink | suggest removal )
RTC (anonymous) says...
Lindsey of the S.C. National Alliance on Mental Illness said, "If folks don't get the treatment they need, the state ends up paying for it."
BS! The state will not pay for it. Have a family member admitted to a psychiatric facility, and see who gets the bill. If you do not have insurance, you are ultimately responsible for your bill. As it is, most insurance companies are only going to pay a portion. The hospitals or treatment facilities will take you to court after failure to collect. I have seen this happen to many people.
The only way the state ends up paying is if the person is already indigent and Medicaid eligible.
Otherwise, the majority of people are stuck with an astronomical bill that they can never pay.
December 3, 2008 at 10:54 a.m. ( permalink | suggest removal )
UrGatorbait (anonymous) says...
No name_withheld, that's important stuff along with paying/subsidizing a new football coach. Priorities. Hamilton I don't think it's a stretch to imagine that people with mental disorders will tend to act out in bizarre ways that will draw the unwanted attention of law enforcement and other "concerned" citizens because they are misunderstood or from the stigma attached to the words "mental health" or a combination of both or more than that. You will pay for them when they are incarcerated in a county lock up but they will receive little if no help from an under funded state/county that's more interested in other things like making sure the paranoid folks who need to buy tax free guns(you can only shoot one at a time) are taken care of.
Let a bipolar or schizophrenic or any other mentally ill person come off of their medications and see how their behavior becomes bizarre and will attract the wrong kind of attention become a danger to themselves or become unable to function in life. The former and latter become issues that'll have to be addressed or dismissed. Unfortunately for the person with the illness that is overlooked, they get dumped on the heap.
This state is pathetic.
December 3, 2008 at 11:07 a.m. ( permalink | suggest removal )
UrGatorbait (anonymous) says...
Okay RTC, sick person, uninsured uses emergency room, who gets stuck with that bill because person can't pay? Deny them ER treatment next time? Sick person gets jailed, provided health care, who provides it or do we let them back out on the street?
Mental health issues are medical issues and most insurance coverages for those issues are minimal to none.
Yet the state will provide some kind of insurance to drive yet we can't provide for other things like this?
What a bunch of neanderthals in this state. Duh huh
December 3, 2008 at 11:24 a.m. ( permalink | suggest removal )
RTC (anonymous) says...
Gatorbait, don't misunderstand. I'm not saying people should be denied treatment. I am saying that if I have to go the the ER, I am responsible for my bill regardless of my reason for going. Insurance companies don't pay squat anymore, and the insured person is stuck with a huge bill. The state is NOT going to pay my bill like this Lindsey person implies.
If you don't have insurance or Medicaid, you will be held responsible for your bill.
December 3, 2008 at 11:36 a.m. ( permalink | suggest removal )
guidedbystewart (anonymous) says...
"Let a bipolar or schizophrenic or any other mentally ill person come off of their medications and see how their behavior becomes bizarre and will attract the wrong kind of attention become a danger to themselves or become unable to function in life. The former and latter become issues that'll have to be addressed or dismissed. Unfortunately for the person with the illness that is overlooked, they get dumped on the heap."
Gator I have to agree with your post. When you are not on your pompous high horse, I attend to agree with many of your post.
The thing is, when the government's budget gets tight, they go into reactionary syndrome. People with mental illness are not going to go away, and the state will save more money being proactive in the funding, and would be much more helpful to the person with mental illness. Rather than being reactive and throwing them into prison or mental institution (which does more harm than good), which cause more problems and money in the long run. With proper medication and support, most of these people can live fruitful and productive lives.
I dated a girl for an extended period of time that was bipolar, so I have some experience in the subject matter. She would have to see the psychiatrist once a month and father had to work two jobs just to pay for the insurance. I am kind of worried about her now since the State is starting to make the cuts. She was normal about 85% to 95% of the time with proper medication. Without medication, well let me say it was a different story.
Anyways, Mental Health funding is an essential program. Without it, you have more people on the streets, more people in the prison, and more problems period!
December 3, 2008 at 11:47 a.m. ( permalink | suggest removal )
vividsplendor (anonymous) says...
Our Legislators Shame us! We are a laughing stock of the nation!
If I may add an alternative perspective regarding a comment in this story, "Lawmakers acted this fall in response to a $500 million shortfall blamed on the slumping economy"...I would say this is innacurate. The shortfall should be blamed on ANTISOCIAL BEHAVIOR of the SC LEGISLATURE:
Deceitfulness, Impulsivity or failure to plan ahead, Irritability and aggressiveness, Reckless disregard for safety of self or others, Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations, and Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another. The only diagnostic criteria for anitsocial personality disorder missing here is regarding violation of law...and then again, how would those who are above it be found in violation?
Citizens of South Carolina: Look what is happening right in front of our very eyes! I wonder how many of our legislators have family members that depend on DMH's assistance? I wonder how many do depend on the cigarette industries assistance? It is simple math and open, blatant, disregard for us that is being displayed. South Carolinians: Step up and FIRE these foxes that are "guarding" us. It is WRONG, WRONG, WRONG! I hope that each of you citizens take care of each other the way these abused, forgotten, and disparaged people who need mental health services are connected to each of us whether we like it or not. We are ALL harmed by these terrible decisions. The tobacco companies and high value real estate owners, not so much.
Reps. James Smith, D-Columbia; Ken Kennedy, D-Greeleyville; and Mike Pitts, R-Laurens deserve applaud for their standing up to speak the truth about the harm caused by these insane cuts.
Shame on the 109 house members who voted to approve these cuts. Double shame to Bobby Harrell, R-Charleston for his ridiculous arguments against raising the cigarette tax to undoing property tax relief.
"Wednesday, October 22, 2008
COLUMBIA - A plan to cut nearly $500 million in spending is on its way to the state Senate after the House on Tuesday voted down one proposal after another on everything from raising the cigarette tax to undoing property tax relief."
December 3, 2008 at 2:17 p.m. ( permalink | suggest removal )
UrGatorbait (anonymous) says...
Thanks for clarifying RTC, I appreciate it. GBS, pompous, eh? Yes I can be but I speak from experience on this subject also. My brother is bipolar, my mom is on meds and sometimes I think I am but am on meds for depression(anger without enthusiasm). It runs in the family but is treatable and other than my brother refusing his meds because well, he is who he is and it's his choice to take 'em or not. Most mental illnesses are treatable and the vast majority of folks who are receiving meds and counseling, function like well, whatever you can define "normal" as.
It's a sad day for medicine and the citizens of SC that truly need our help. We can't afford to care for our own and we spend how much on crap to bailout crooks, other countries poor and ill plus maintain an ill advised foreign policy folly? Chants of Rah Rah Go USA!! seem to obfuscate those "minor" issues. The mission is here at home. How can we care for others when we can't care for our own? What kind of back azzwards message does that send?
December 3, 2008 at 2:48 p.m. ( permalink | suggest removal )
Thefutureisnow (anonymous) says...
This is just rediculous.
December 3, 2008 at 3:46 p.m. ( permalink | suggest removal )
luvmydogs59 (anonymous) says...
For anyone who needs medication (of any kind), check out the Partnership for Prescription Assistance program through the pharmeceutical companies. www.pparx.org. They will help you. This is how I get all my medications for various conditions, as I have no insurance and am waiting on a hearing for social security disability. Without this program, I'd be totally screwed. It's a Godsend....trust me!
December 3, 2008 at 3:58 p.m. ( permalink | suggest removal )
ysillyme (anonymous) says...
luv#59~
If you are a certified loony, Hell I'd buy your meds. Quit whining and stay totally "screwed" your words, not mine!
December 3, 2008 at 5:22 p.m. ( permalink | suggest removal )
iceman1978 (anonymous) says...
When I lived in Turkey you could purchase most anti-depressants over-the-counter and not have to worry about insurance or a doctor visit. If they're going to cut mental health funding they can at least make it easier for these people to get medication when they have no insurance.
December 3, 2008 at 5:40 p.m. ( permalink | suggest removal )
yird (anonymous) says...
Jim I Slander; You are without exception the nastiest meanest spirited SOB on these P+C posts.
Now your treatment(government supplied)and medications may not be as available as in the past and you come across as
someone looking for sympathy, from those you scorn repeatedly like veterans, and retirees who are getting what they earned from the government but are vilified for it by you in previous posts.
============================================================
Posted by guidedbystewart;I would truly hate to have to live in this State if I had mental health issues. Yet, we have tax free "get your guns" weekend while cutting essential programs and secondary education.
============================================================
You apparently do have mental health issues otherwise why would you with your claimed analytical capabilities stay in a state peopled by gun toting rednecks, capable of speech limited to two syllables,and educational levels barely above 6th grade?
Mental illness seems to increase coincidentally with the pressure of surviving in a materialistic society where a BMW for Daddy and numerous computerized gadgets for the offspring are deemed essential.
Once upon a time in the (real) fairy tale world, food shelter and clothing were deemed imperative for survival.
Anything else was considered a luxury. Today the constant desire for more junk coupled with the inability to acquire it without taking on crushing debt has to cause severe stress.
Does not stress and anxiety contribute to mental dysfunction?
Unlike GetSerious, I know nothing about mental illness but I do know it's incidence has grown exponentially in the past few decades. I lived in a county in NC where the staff and budget for MH jumped something like 800% in five years.
Can any of you super smart folks,(obviously educated somewhere other than this backwater state)explain why, with all the folks getting more education and becoming so sophisticated, mental illness is on the rise?
December 3, 2008 at 6:59 p.m. ( permalink | suggest removal )
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