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State of Mind: America 2002

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Lichtenstein Creative Media.

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April 23, 2003

State of Mind: America 2003:

Special in-depth report on the Crisis in Mental Health Funding reported by Rebecca Roberts, of public radio's The World.

The news is the same from every corner of the nation- lawmakers are slashing budgets, and mental health programs are among the first to go.

Montage of news stories

NARR: In Texas, which already ranks a low 47th in the nation in per capita spending for public mental health care, the state mental health department will lose more than one dollar of every ten. Lynn Lasky is president of the Mental Health Association in Texas. She says today, the state mental health department can only serve one out of every three poor, mentally ill Texans eligible for services. The proposed budget cuts will drop that percentage even lower.

LASKY: We're very distressed. Knowing that right now people with untreated or under treated mental illnesses are committing suicide, end up in our jails, hospitals, homeless shelters or foster care.

NARR: In San Francisco, the biggest public hospital is planning to close its 24-hour Mental Health Rehabilitation Facility. Also slated for closure here is the Tenderloin Self-Help Center. George Vey comes to the center every day.

VEY: I'm schizophrenic, I'm scared of large crowds. But this place makes me, like, really at home. If it's closed, it would be a terrible thing. Because these are the only people that I know, and, um I kind of like, uh, get unstable when I'm starting walking on the street. I think I'd be in jail right now.

NARR: Some states are already feeling the effects. In Omaha Nebraska, a regional mental health center closed its doors April first, flooding homeless shelters, emergency rooms, and other hospitals. Mike Anderson is Vice President of Behavioral Services for Alegent Health Care, which operates the only other psychiatric facility open to most Omaha residents.

ANDERSON: We've certainly seen an increase in the number of psychiatric emergency assessments that we've done at Emmanuel Medical Center. And we've noticed an increase in both the special care unit volume as well as adult, geriatric, and child/adolescent.

NARR: On February 1st, Oregon cut prescription benefits for one hundred and ten thousand of its working poor. After a major public outcry, those benefits were partially reinstated. But Oregon did eliminate coverage for methadone treatment and outpatient addiction services. At the CODA treatment Center in Portland, Gerald Parker, a heroin addict for 35 years, says he is weaning himself off methadone more quickly than he originally planned.

PARKER: This coming off methadone it isn't easy. It's like coming off heroin, but it's harder. And I'm going to try to keep off it, but I don't know. If the pains and aches come, I'd have to start using again. I've got a gram of heroin in my house right now that I'm keeping there, just in case.

APPELBAUM: We are on the verge of a crisis in mental health care that we haven't seen in our memory. The states are systematically pulling back from their safety net function, a historical role that they've played for almost 200 years.

NARR: That's Paul Appelbaum, chair of the department of psychiatry at the University of Massachusetts medical school and president of the American Psychiatric Association.

APPELBAUM: The irony here is that as we're fighting merely to maintain current levels of funding, what we're fighting for is to try to preserve some semblance of a system that everybody at the get go acknowledged was inadequate. We already have jails and prisons serving as defacto mental hospitals in many parts of the country because their public health systems have been disassembled over the last twenty years. We have learned that it's often counterproductive, even if all you're interested in is saving money, to cut services to people with serious mental illness. The illnesses don't go away, and the people don't go away.

NARR: That's a lesson echoed by mental health care providers and patients around the country: cutting mental health care funding only saves money in the short run. Long term, keeping someone in acute care -- or in jail-- is significantly more expensive, both financially and in social costs to the community. Lynn Lasky in Texas:

LASKY: We know that treatment works. Treatment success rates for serious mental illnesses range from 60-80% compared to 40-50% success rate for treatment of heart disease. People recover from mental illnesses when effective mental health treatments, medications, and services are available. And so part of that is just educating the public and our legislature that treatment does work and it is much more cost effective to provide funding for treatment than it is to deal with the fallout of untreated mental illnesses.

NARR: For the Infinite Mind, I'm Rebecca Roberts.

The Infinite Mind is supported in part by major underwriting from the John D. and Catherine T. MacArthur Foundation, the National Institute of Mental Health, and the Nonprofit Finance Fund. Additional underwriting in the form of unrestricted educational grants from Eli Lilly and Company and Bristol-Myers Squibb. Major underwriting for State of Mind: America 2003 was provided in the form of an unrestricted educational grant from Solvay Pharmaceuticals. Additional support was provided by Tom and Edwina Johnson, The J. B. Fuqua Foundation and the Turner Foundation.

The Infinite Mind is non-profit production of Lichtenstein Creative Media, in association with the New York Foundation for the Arts and WNYC/FM.