Sunday, 23 December 2012

Mental health treatment saves lives, advocates say

Ohio has cut funding for mental health programs in recent years

7:35 PM, Dec 22, 2012 |

Written by Russ Zimmer
A few days after a deeply troubled young man shot and killed 26 people, including 20 children, at an elementary school in Newtown, Conn., Ohio Attorney General Mike DeWine called for teachers and school employees in Ohio to receive training for dealing with an “active shooter,” but he also acknowledged that increased awareness and security are only part of the solution.

“All these problems overlap. ... These are society’s problems,” DeWine said. “The fact that we have people who have mental health problems, who have anger problems, all these other things, it just happens that they may come into a school.”

Mental health advocates say Ohio has so far failed to integrate mental health into the larger health care picture and to support community-based treatment after transitioning away from asylums more than 20 years ago.

“Nobody should be surprised that people who have these illnesses who get absolutely no care end up in a bad situation. Very few ever do what happens in Connecticut, but many take their own lives,” said Terry Russell, executive director of the Ohio chapter of National Alliance on Mental Illness. “What’s really sad is we know we can save these lives if treatment was available — the right treatment — and we don’t do it.”

When Paddy Kutz first started with Mental Health America of Licking County in 1981, the Central Ohio Psychiatric Hospital in Columbus was home to more than 5,000 patients. Now, in place of that asylum sits Twin Valley Behavioral Health Care, which has beds for 176.
“That has all changed because of treatment, because of medication, because of case management, because of housing support, because of mental health consumer services in the community,” said Kutz, executive director of MHA-LC.

But the resources haven’t kept pace with advancements in care and technology.
“There’s never been enough money in mental health,” she said. “Look at how much money goes into heart and cancer. The money into mental health is always minimal.”

The national alliance found that between state fiscal years 2009 and 2012 about $26 million, or 5.1 percent, was shaved off mental health funding in Ohio. The Kasich administration restored some of that funding for Medicaid services for the current budget. That didn’t change things for people who made too much to qualify for Medicaid but didn’t have private insurance.

In the wake of the Sandy Hook Elementary School shootings, there appears to be public support for padding mental health budgets. According to a Gallup poll, 84 percent of respondents think increased government spending on mental health screening and treatment would be at least somewhat effective in preventing future school shootings.
Russell said there needs to be a continuum of housing for the mentally ill. Patients might need a couple weeks for medications to take hold and for them to be stable. At that point, they should be moved into housing with fewer restrictions, he said. Ideally, they would continue moving along until they reached a point where they achieved as much independence as is appropriate, he said.

The mental health system in Ohio is designed for acute hospital care followed by continued recovery outside the hospital setting, said Trudy Sharp, spokeswoman for the Ohio Department of Mental Health.

On any given day, about 1,000 patients are in the six state-run hospitals. About six out of 10 patients are court-ordered and could be there for weeks, months or years, Sharp said. The rest are civil commitments, and their stays average less than two weeks.

Dr. Howard Goldman, a professor of psychiatry at the University of Maryland, is editor of Psychiatric Services, a monthly research and policy journal. He said the abandonment of the asylum model was the right move, but the reticence to fully fund community-based services has undercut some of that improvement.

“There was an aggressive push nationally to close state psychiatric hospital and that would have been a better policy if it had been accompanied by the widespread implementation of an array of community-support services,” he said.

Mark Hurst, medical director at the Ohio Department of Mental Health, didn’t dispute that funding could be improved, saying “we can most certainly use more resources” in mental health. He points to the impending consolidation of the mental health department with the Ohio Department of Alcohol and Drug Addiction Services as proof of progress.

The cleaving of mental health from physical health is another problem that continues to plague the medical system, he said. Nobody is served well — not patients, not taxpayers — by acting as if the two are not tied together.

“We don’t treat behavioral health disorders or physical health disorders,” Hurst said. “We treat people who have these disorders.”

No comments:

Post a Comment