Unfortunately, it often takes events such as the recent shooting at QuikTrip and the Kaufman case to bring to light the flaws in our mental health care system. Pete Earley — who watched his bipolar son travel through the system in Florida and elsewhere — addresses the problems he saw in the new book “Crazy: A Father’s Search Through America’s Mental Health Madness.”
I have not yet read Earley’s book, but he concludes that this country needs to return to some form of the state hospital system — providing something other than jails that can house people with severe mental illnesses. I’m not yet sure if that is the right approach, but he is right that the system needs changing. He spoke to Salon.com about our system:
“What we’re really doing is we’re re-creating old state asylums in jails. You follow me?
“What makes me angry is that we decided the old asylums were horrible places, so we shut them down in favor of community treatment centers. And, unfortunately, even though that sounds good, community-based treatment centers are not equipped to take care of people with severe mental illnesses. So what’s happened? Well, we’re dumping people in nursing homes, we’ve dumped them in rest homes, we’ve dumped them in awful assisted living facilities. . . .
“I’m not saying that the old asylums were good, because they weren’t, but the point is, have we really helped or changed these people’s lives? We haven’t. We’ve simply hidden them better.”
Posted by Melissa Cooley
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24 Comments
I don’t think all are as out of sight as you might think. Several seem to have access to computers and the internet to post on this blog.
Melissa — you obviously did not do your homework on this one. The reasons the state hospitals were closed down because the people advocating for the people in those facilities said that it was better for the people to be in the community and out of the hospitals.
A rest home and a nursing home are one in the same. Would you like to provide a list of the facilities that you believe are so bad? They need to be reported if you can back up your statements. As far as assisted living facilities go unless these people have money or insurance they are not in an assisted living facility. These are pretty good places to live and again if you have a list of the assisted living facilities that you know are horrible (your words) then you need to report them.You make accusations and complaints but you do not say what the solution is. How do you propose taking care of them? Where would you take care of them? It is pretty easy to complain but a lot harder to provide a solution. Don’t just lay out the problem and think that you have done something good because you have not.
One thing that is needed are good ‘drop-in’ centers where a person can get counseling and medications in a less-threatening environment. That would be much less costly than a residential facility and can also be more acceptable to a person who would bristle at “incarceration”
How do you propose to fund these programs? You along with others have said that education is the number one priority. You have not been advocating for those with mental health needs or others in need of services. You talk about them but you never step up to the plate to really make a difference.
When was the last time you advocated for as much funding for these people and others as you have for education? That’s right you have not. Talking about these people make you feel good but truly advocating for them is another story. If you talked just half as much about them as you do for education then perhaps some things could change. Until then stop pretending that you care.
Ruby – I have advocated for the funding. If done right it can be cost-effective in that a drop-in costs much less than a residential facility and that a drop-in facility can prevent more costly problems later on. I know people dealing with such problems and do what I can for them. However, I cannot prescribe medications nor can I legally dispense them.
Ruby?
When was the last time YOU advocated funding anything?
Kansan came up with half of why the de-instituionalization movement came about. True, Liberals thought “let’s have them in the community, it will be a better quality of life”; Conservatives said: “Look at all the money we can save, if we do this” – thus was created a uniquely bipartisan effort that at its base had two different reasons for the mission.
I am going to estimate that the total number of people in the U.S. at any one time with a severe and persistent mential illness is about 5% of the population. Given a population of 300 million, that makes for 15 million people. These folks have expensive treatment needs and are there enough of them (and their families) that they can be adequately advocated for?
Insurance companies right now are fighting a fierce fight, with what I suspect is a sympathetic government, to limit their costs on paying for chronic medical conditions – not just mentally ill people, but also people with diabetes, etc.
These are complex problems, folks. There are no simple solutions that can be easily pulled out of one’s hat.
What is at the foundation of this problem and any solution, is the moral/ethical question of what kind of country do we want to be? No one, certainly in the current administration, appears willing to start this dialogue.
I disagree with this poor father that it is: State Hospitals or jail. There are many other alternatives. Many of them work and are much more cost effective AND humane than the false dichotomy offered.
It is time for this discussion to occur. I thank Melissa for bringing it up.
I agree, DD. There are alternatives that are more humane and cost effective. The problem is that many families don’t know how to access the services that would help their loved ones with severe and persistant mental illness the most. I have clients who live independantly with the help of independant living services (HCBS) and home health services. They are assessed everyday and their medication is managed by qualified nursing staff, we act as the liaison between the the client and the doctor, and we can often head off a crisis before it becomes full blown and requires hospitalization. This system reduces the need for emergent and acute care services, so it saves taxpayer money and is much better for the client.Group homes are another alternative, the ones I go to are all licensed and meet the needs of their clients very effectively. The Kaulfman’s were the exception and really drives home the fact that all group homes need to be licensed and strictly regulated, and that’s the state’s responsibility. As far as I’m concerned, the state is just as responsible for the abuse that occured as the Kaulfmans were.Unfortunately, many of those with mental illness fall through the cracks, because they are unable or unwilling to put themselves into the system, and their families can’t force them into it. Also, it’s just easier for society just to ignore the man walking down the street, pushing a grocery cart full of junk and talking to himself. We don’t understand it, so we make him invisible and pretend he’s not there.
The mentally ill will never get relief from degenerate Freudians or the drug companies!
PS: I am perfectly sane, Brian.
V.L.R.B!!!
Ian,
I never pointed to you explicitly. You may well be legally sane, but I think you might also be a bit delusional and paranoid. Just an amateur diagnosis, of course.
Degenerate Freudians? What country and century do you live in, Ian?
I will confess I share your cynicism about pharmaceutical companies. A case in point. All community sample studies indicate that even including spectrum disorders (those diagnoses that don’t meet the full criteria) that Bipolar disorder affects about one percent of the school age population. Pharmaceutical companies are spending money on research to add their products to the approved treatment list for this disorder. The amount of money being spent would make you think that they expect to sell their product to more than 1% of the population.
I have often thought that it is real possible that big pharma adds to the “over-medicalization” of many problems.
To clarify the research described above is testing the usefulness of these mood stablizing medications with school age children and adolescents.
An excellent book I would suggest to anyone interested in Bipolar Disorder is _An Unquiet Mind_ by Kay Redfield-Jamison, PhD. This is a personal story of what bipolar is like from a person who lived it.
I met the author in Atlanta in 2001 and she was one of the nicest people I’ve ever met. She teachs now at Johns Hopkins University.
JR,
I have and do advocate for the Breakthrough Club in Wichita. They do wonderful things for individual not only in the form of medications but they also help them to find jobs and projects they can volunteer for.
It has really helped a lot of people dealing mental illness to become productive citizens.
Many times the problem with those dealing with mental illness is staying on their medications. Not all of them want to live in a group home, so they struggle with staying on their medications.
There are places for them to go, but many of them do not go and do not have family to see that they go to the clinics. This would be the drop in you referred to Ben. They are available they just do not get used.
Mental Illness is so misunderstood because you cannot always see it. There are a lot of people that we all work with everyday that are dealing with mental illness. It is one of the most misdiagnosed and misunderstood illnesses we have.
So you can see JR I do understand it and I do advocate for it. I have even testified in Topeka for more services and funding.
Ruby – I would expand the drop-ins by working in conjunction with shelters, soup kitchensn self-help groups and the like. The latter can be especially helpful because they can connect the patient with a ‘former patient’ who has ‘been there done that’
Mea Culpa Ruby.
Your earlier post seemed inflammatory and critical of others without offering any solutions. It was an attack post.
You should have backed it up with your last post which demonstrates you are part of the solution.
It is clear now from your earlier and latter that you are passionate as to this and that is good.Next time? Look for friends BEFORE you look for enemies!
Yours in humble apology for mis understanding.
Jay
Ruby,I agree, you are to be lauded for your work with the Breakthrough Club. I think consumer owned, non-profits can make a great contribution toward the needs of severely mentally ill folks. Further, I have wondered if such models can be used in leiu of insurance for other groups.
There has been a long-standing experiment in Seattle called “Group Health” where patients’ own their family & speciality practice clinics. I have heard people are satisfied with what they get from these organizations.
Damoon, I think I heard from you once the name of the agency you work for. If you don’t mind, I would like to know who they are – my email below is a hotmail account that I check sometimes. I think, not always, but often private solutions are better than government solutions due to the lack of funding government programs receive. These Gov. programs are given a huge mandate with no matching funds, so many people end up being unhappy with them. There was this mantra from Topeka that money was going to “follow the patients” as State Hospitals shut down. Never happened. Surprise, Surpise, Surprise! (as Gomer used to say).
Thanks.
I wonder if we are getting closer to finding the real reason ruby is so against adequate funding for public education.
I wonder if she is falling for the “either, or” trap. That the state can only afford funding for EITHER mental illness and social services OR for education.
Rather than continually fighting over the sliver sized slices of the pie, ya know we could just make the pie bigger.
But oh hell no, Derek Schmidt is already talking about projected budget surpluses and tax cuts in ks? See preznit bush for how well that worked at the national level.
Laughing. If we are projecting budget surpluses already, and r’s are saying we can afford tax cuts… we can afford to fund education AND social services.
But not if we keep fighting ourselves and letting the anti-public education people couch this as a finanicial issue. I think the conservative religious agenda becomes clear.
It is not a financial issue. It is a war on public education by those who want publicly funded vouchers to pay for the religious education of their children.
You cant have it both ways. Either we have the money or we dont. If we can afford tax cuts, we have the money. And if we have the money and just choose not to fund public education?
I call Jihad on public schools.
Just read nathan, ruby, chuck, hank, outlander, etc. It becomes painfully clear about the christian agenda and public education.
KFG:”Just read nathan, ruby, chuck, hank, outlander, etc. It becomes painfully clear about the christian agenda and public education.”
What pains me is that I know people who are serious Christians and want to do what is right by children and they have no interest in cutting down or into public education. I have a nurse friend, colleague, who is wanting to start a church school for special education kids – she has adopted several such kids herself. I take my hat off to her every day; she is a better person than me. She has no interest in ANY child not getting what they need. I, like you KFG, am not sure that this would be true of all in the religious school camp. I think they may see it as a zero-sum game – we get what we need OR the public school does (which is secular, poor quality, etc.).
“What pains me is that I know people who are serious Christians and want to do what is right by children and they have no interest in cutting down or into public education.”
Maybe they need a PAC, DD. KFG is right: this either/or crap has GOT to stop!
Those of you who posted here,Check out today’s (04-20-06) op/ed section of the paper version of the Eagle.
Our hero, Damoon, got the most ink. Deservedly so, of course.
A link to the Blog posts in today’s Eagle:
http://www.kansas.com/mld/kansas/news/editorial/14380768.htm
I’m desperately looking for a group home for my bipolar son. Can anyone help me with contact information? As several have said, I don’t know how to access needed information or services.Thanks!
I just don’t have much to say right now, but I guess it doesn’t bother me. Basically nothing seems worth thinking about. Nothing notable happening these days. Shrug. Not that it matters. My mind is like a void. I’ve basically been doing nothing , not that it matters. More or less nothing going on. I guess it doesn’t bother me. Not much on my mind.