(MintPress) — Mental health facilities are bearing the brunt of cuts to budgets in state and local governments, resulting in closures of psychiatric help centers throughout the nation, leaving medical hospitals and prisons to deal with severe mental health patients.
The debate over whether such moves are beneficial or detrimental to communities is not divided along clear party lines, with some critical of psychiatric hospitals’ medication methods and others who claim a general lack of mental health services.
Those favoring such cuts point to a need to trim back the budget, of which social services take up a large portion. Consolidating and creating what is seen as efficiency within the system has been the chosen option for many states faced with budget shortfalls.
But those within the medical health field claim, in the long run, it will only inflate the costs for states and communities. Sarah Steverman, Director of State Policy at Mental Health America said in an interview with MintPress that nationwide cuts to community mental health centers will likely lead to an increase in crime rates and costs for local prisons and jails, citing statistics that show untreated mental health often leads people to commit crimes.
In states like Colorado, emergency rooms are filling up with patients whose symptoms are more suited for mental health clinics. A lack of open psychiatric unit beds in the state, however, is mental health patients little options when it comes to presumed immediate needed care.
Chicago’s mental health plan
In April, Chicago Mayor Rahm Emanuel made the move to close six of the 12 mental health centers in the city. In an attempt to provide relief for those whose clinics were on the chopping block, Emanuel instituted a policy to provide free Chicago Transit Authority (CTA) one-month passes for travel to clinics on the other side of the city.
“At the two clinics that have now been closed, we gave each of the patients a CTA card … so they could get to the new place and start that transition easier,” Emanuel said at an April press conference. “One of the concerns I heard from the patients was, ‘We’re gonna be going to a new place.’ So we made changes. We’re giving them a CTA card for the first month so the inconvenience was least disruptive to them.”
The state of Illinois as a whole cut its mental health care by 31.7 percent — $187 billion — from 2009 to 2012, according to the National Alliance on Mental Illness (NAMI).
Chicago’s Cook County Prison is already considered the largest jail in the country. That, Steverman says, is reason enough to reconsider cuts to Chicago’s community mental health centers.
“If they continue to cut mental health services in that city (Chicago), that’s where people are going to end up,” she said.
Steverman claims cuts to mental health services will be passed down the line to county jails, where people with mental illnesses will only be subject to experiences that will exacerbate their symptoms and conditions, rather than correct them.
In a report issued by NAMI, Cook County Sheriff Tom Dart is cited as “accusing it (the state) of allowing the jail to essentially become a dumping ground for people with serious mental health problems.” Dart was specifically reacting to cuts in 2011.
In the face of widespread protests following the cuts to Chicago’s clinics, Emanuel held a press conference, claiming the cuts will allow for more patients to be seen.
“We’re actually adding patients who were denied service because we didn’t have the resources. We added patients — a little over a thousand. And because of the reforms, we’re putting $500,000 into psychiatric care that we could not do before, but always had debated,” Emanuel said, according to the Sun Times.
While measuring the impact throughout the entire state, NAMI said in its report that state cuts would trickle down, cutting more than 5,000 from mental health services.
Cuts throughout the nation
Chicago’s struggles represent the larger picture, with cuts to mental health services across the board. According to the NAMI, the 10 states that slashed mental health funding from 2009-2012 did so with drawbacks from 10 to nearly 40 percent, with South Carolina’s mental health allocations decreasing by 39.3 percent.
Steverman said cuts to local, community mental health services mean those who need holistic help, intended to target core problems and assist people with housing, physical and mental health services will not be received. That could cause manageable mental illnesses to spin out of control, at which point individuals could find themselves in a hospital setting.
“If people are able to get to the core problem early, it will often mitigate the problems,” she said.
Those cuts are being blamed, in part, to long waiting lines in emergency rooms, as well as cuts to medicaid that have causing hospitals to close down psychiatric wings, citing a lack of reimbursement.
According to NAMI, temporary increases in Medicaid through stimulus funds ended in 2011, causing a $14 billion decrease to states.
“Medicaid is the most important source of funding of public mental health services for youth and adults, leaving people with mental illness facing the real threat of being cut off from life-saving services,” NAMI indicated in its report.
In a National Public Radio (NPR) story, Anthony Weiss, author of the Annals of Emergency Medicine study, said Colorado hospitals are seeing a surge in mental health patients because of vast cuts to programs intended to specifically help those in need — and the knowledge that psychiatric wards will not yield the reimbursements necessary.
“The reimbursement for mental health care within the country is among the lowest across the different disease states,” he told NPR, “and so it’s not, in some cases, economically viable to support these type of (psychiatric) units.”
Yet some hospitals are moving ahead with re-implementation of such units, not necessarily to only offer necessary services, but to free up emergency rooms to better serve those seeking immediate medical attention that cannot be addressed by mental health professionals.
Moving forward, mental health groups will continue to advocate that short-term cuts affecting mental health programs will not help the country’s fiscal picture in the long-run — a claim those facing budget shortfalls may not immediately act on. But with hospitals realizing the benefits of mental health prevention services, it could add one more powerful player — the healthcare industry — to the discussion.