Friday, December 7, 2018

Mental Health Pendulum


In the early 1900s, those thought to have a mental illness were housed in private sanitariums. Government would house the “criminally insane” in state prisons staffed with Psychiatrists. The medication prescribed was used to keep patients calm.

Those who scored low on IQ tests were deemed to be “retarded” and were housed by government in secure buildings and staffed with Psychiatrists.

One of the summer jobs I did when I was in college in the 1960s was as a Therapist at St. Louis State School and Hospital. We had 700 patients who had been diagnosed “retarded” living in buildings on the site. The cost of patient care was paid in part with their Social Security Disability checks and the State made up the difference. Our hospital housed bed patients with severe conditions like Hydrocephaly and Microcephaly; The dorm buildings housed patients who were mobile. There were women’s dorms and men’s dorms. These groups were further separated by the severity of their conditions. None of our patients were dangerous. The Downs’ Syndrome and some other patients were educable and attended school. We moved some patients who could take care of their own needs to cottages.

Downs’ Syndrome patients were often kept at home with their families and they did better. Since the 1960s, many other patients with disorders like schizophrenia and bi-polar manic depression have been released to live at home and take their medication. Many States have closed their institutional mental hospitals. Some of these patients have joined the homeless population.

Today, we are dealing with addiction and PTSD and have problems with mass shootings by terrorists and disturbed individuals.  The pressure is on to revisit our loose mental health policies.

The cost of treating addiction is high and uncertain.  Addiction can be cured, but relapses can result in multiple confinements. States are legalizing marijuana use and this “gateway” drug could result in cocaine, methamphetamine addiction. Opioid addiction is also on the rise.

Addicts will not change unless they want to change. Treatment can include bouts of homeless shelter confinement.  

Funding mental illness treatment needs to be done carefully. Just throwing money at the problem will encourage poor quality treatment programs and extend the illness.

Funds for Treating Individuals with Mental Illness: Is Your State Naughty or Nice? New study reveals dramatic eight-fold difference in percentage of state funds allocated to helping mentally ill. (Read full report)

The most generous states for mental health are Maine, Pennsylvania and Arizona.  The stingiest states are Arkansas, West Virginia, Idaho, Kentucky, Oklahoma, Louisiana and Delaware.

(New York, NY, December 12, 2017) Mental Illness Policy Org released the first study to rank all fifty states based on the percentage of state-controlled funds each state spends on mental illness. States that spend a higher percentage of their budget on mental illness are ranked as generous and those that spend a lower percentage are ranked as stingy. This study found the most generous states in mental health spending are Maine, Pennsylvania and Arizona.

The stingiest states are Arkansas, West Virginia, Idaho, Kentucky, Oklahoma, Louisiana and Delaware. The most generous states, Maine and Pennsylvania (5.6%), allocates eight times more as a percentage of total state spending than the stingiest state, Arkansas (.7%).

Percentage of Total State Expenditures Allocated to Mental Illness
1. Maine 5.6
2. Pennsylvania 5.6
3. Arizona 4.8
4. New York 3.9
5. New Jersey 3.8
6. New Hampshire 3.7
7. Montana 3.5
8. Vermont 3.4
9. California 3.2
10. Maryland 3.1
11. Minnesota 3.0
12. Connecticut 2.8
13. Nevada 2.7
14. Oregon 2.7
15. Kansas 2.6
16. Michigan 2.6
17. Missouri 2.5
18. North Carolina 2.4
19. Iowa 2.3
20. Washington 2.3
21. Alaska 2.1
22. New Mexico* 1.9
23. Ohio 1.9
24. South Dakota 1.9
25. Tennessee 1.9
26. Georgia 1.9
27. Indiana 1.8
28. Colorado 1.8
29. Virginia 1.7
30. Mississippi 1.7
31. Nebraska 1.7
32. Utah 1.7
33. Hawaii 1.6
34. Wisconsin 1.5
35. Alabama 1.5
36. Illinois 1.5
37. Rhode Island 1.4
38. South Carolina 1.3
39. Massachusetts 1.2
40. Texas 1.2
41. Florida* 1.1
42. Wyoming 1.1
43. North Dakota 1.1
44. Delaware 1.0
45. Louisiana 1.0
46. Oklahoma 1.0
47. Kentucky 0.9
48. Idaho 0.8
49. West Virginia 0.8
50. Arkansas   0.7

https://mentalillnesspolicy.org/national-studies/funds-for-mental-illness-is-your-state-generous-or-stingy-press-release.html


Comments

The effectiveness of handling mental health issues cannot be measured by the amount of dollars spent in the list above. It is measured by effective treatment history dealing with the total cost of the cure and how long addicts can stay “clean”. Addicts must first want to end their addictions and next must determine how they will accomplish this.

This is not unlike our excessive cost of other healthcare issues and our excessive education costs.  Patient behavior is often the key to avoiding health problems.  We are all responsible for our own preventive medicine. Students are likewise ultimately responsible for their own education.  Bad schools have bad students.

Norb Leahy, Dunwoody GA Tea Party Leader

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