Imagine if you will Mary and Joseph,
hungry, cold, and tired. They seek refugee at a inn unfortunately though, they
heard those words; " I’m sorry there’s no room for you here."
Could you imagine hearing that, and how scared you would be? In the case of
Mary, and Joseph there was a happy ending. Sadly, that’s not the case with the
mentally ill in our country. Many people are lucky that their livelihoods are
never threatened, but for the mentally ill it’s a reality. Everyday across
this country, persons with mental illness are turned away, and refused services.
Too often they are never given another glance, or thought until it’s too late.
If you look hard enough for them though you will find them. They are the ones
that end up in your street’s, your prisons, or worse yet dead. You may ask
yourself how I know, I know because that’s me you’ve turned away. If it’s
not me, it’s a friend of mine, or just another person lost in a deeply flawed
system. We are often thought of as crazy, psycho, or nuts, but were not. We are
consumers of mental health services; our livelihood depends on those services.
Mental disorders affect 1 out of 5 Americans in any given year.
(Surgeon Generals Report) Furthermore 25% of the population can expect to
experience one or more disorders within their lifetime. (Danielle Nierenberg)
I don’t wish that on anyone though, to have to live with our nightmares,
in our worlds. It’s hard enough living with our disorders without the constant
threat of services being cut. However, among individuals with mental health
disorders, more have lost insurance then have gained it. Even more report
decreases in health benefits. Worse yet, individuals with worse mental health
consistently report deterioration of access to care. (Ronald Sturm)
Mental health centers around this country are struggling to keep their
doors open, and even consumers with insurance have suffered. When before it paid
to have insurance, and receive quality care, it seems that those with insurance
receive the short end of the stick. Unlike years before, Medicare only pays for
50% of mental health services. As for Medicaid, I had begun to wonder if I was
even on it. If it hadn’t been for receiving prescriptions through the
Medicaid, I would have thought it useless.
That brings to mind one of the biggest problems we consumers have to face,
prescriptions. Medicaid allows us 3 prescriptions a month. I’ve often thought
that was nothing short of absurd, given the fact that most consumers take
anywhere from 5 to 15 prescriptions a day. HMO’s were thought to be the cure
all for this, since they pay for all prescriptions. I wonder what the cure all
is for consumers that have to get pre-approval for medications, which can
sometimes take weeks. Those are weeks that consumers have to go without
medicine. This creates havoc for the consumer, often leading to hospitalization,
or criminal activity.
Who is responsible for this? Look no further than the Health Care Authority.
Every year the Health Care Authority plays God with consumer’s lives. Each
year they go before legislation demanding money, and threatening to cut services
if they don’t receive that amount of money. They even go as far as sending out
letters to consumers detailing which services are being cut. During this time,
we consumers live in a fearful sort of limbo, waiting to see what the Health
Care Authority has in store for us. Its only after they receive their money,
that we get letters telling us to disregard those former letters. To me, it’s
almost like blackmail, or ransom, with we the consumers as the victims. Last
year was no exception, the Health Care Authority went before legislation,
demanding money and threatening cuts. In October, we received letters telling us
that they were cutting prescriptions, within all of the programs. This cut not
only affected me, but many of my friends as well. When we found out that the
Health Care Authority had received their blood money, we felt sure those cuts
wouldn’t stand. Imagine our surprise, and shock when we found out that those
cuts were permanent. I’ve often wondered what gives the Health Care Authority
the right to play God with our lives. I’ve also wondered why it is, that they
are never held accountable, for how that blood money is being spent.
Although, the Health Care Authority isn’t the only ones to blame. Our
government, the very people we elect to serve us, help us, and protect us decide
whether we get the funding needed to keep us stable, and alive. In a starkly
worded report by the Bazelon Center for Mental Health Law warns that most public
mental health systems have all but disintegrated. It further states that states
generally haven’t given sufficient priority to mental health care, and
services. (State Health Watch) Chris Koyanagi policy director for
Bazelon Center was right when she was quoted by saying this; " We are
standing on the verge of a big black hole. The system is getting to a high level
of crisis. Community clinics are closing, and people can’t be admitted to
hospitals in a time of major crisis. (State Health Watch) Furthermore,
she g0oes on to say, " The problem will continue around the country
until it is recognized that it’s more cost effective to treat people." (State
Health Watch)
It seems our time of high level crisis is coming soon. Congress is once
again considering deep Medicaid, and mental health cuts. The House and Senate
have been working on a budget resolution that would slash Medicaid spending by
93 billion over the next 10 years. Next year alone it would cut 53 million in
mental health funding. (National Mental Health Association) I wonder
if those politicians that were elected by us have given any thought, to what
that would do to an already deeply flawed system? I dare say, they haven’t
given us a second thought. I have painted a grime, but true story. It’s the
kind of story that most people don’t want to hear. Mental illness is one of
those things that people think if they ignore it, or pretend it doesn’t exist
that it will go away. That’s just simply not the case. Mental illness will
never go away, just the same as diabetes, or heart disease will not go away. I
believe the sooner people realize this, the flaws in our mental health system
can be rectified.
There are no easy solutions here, nor are there any quick fixes. One would
think that more money would fix the problem, but that’s not all. Not everyone
sees mental health as a serious problem, unfortunate those people are the very
ones, dictating how much money mental health receives and what services we get.
Therefore, I feel it’s important that everyone working with or for mental
health should receive sensitivity training: such as the governing agencies, our
politicians, and the police department. I also believe its high time, that the
Health Care Authority is held accountable, for how they spend their blood money
from the government. Until that happens, who knows where and how that money is
being spent? Another answer is more laws protecting the mentally ill. Without
more laws, the solutions will be impossible. There should also be more
reinforcement of those few laws we have right now.
About 2 years ago Texas implemented an insurance type program, very similar
to Medicaid. They are one of the first states to try it, and its called North
Star. What North Star does is covers any, and all mental health services, and
prescriptions. People not eligible for Medicaid can still receive this;
furthermore even those on Medicaid are eligible. Of course North Star doesn’t
come without its problems, but it would go a long way in repairing the system,
and protect those consumers that are getting lost in the system.
It was once believed the only thing that could be done for consumers is to
medicate them, and then forget about them. It was unheard of to think that
consumers could become stable, and manage their own treatment. It was outlandish
to think that consumers, could be of support to other consumers, but I feel
consumers are the best, most worthwhile solution for this flawed system. Who
better to help fix the problem, then the very ones that are victims of the
problem? There should be more consumers run services, to ease the workload for
case managers. A known fact is that case managers have a caseload of anywhere
from 75 to 150 clients. It’s also a fact that for every 15 minutes spent with
a consumer; there is 30 minutes of paperwork. To ease the overwhelming paper
work, I think consumers should be able to do some of the paperwork. It would
free up more time for case mangers to meet with other consumers more needy.
One of the reasons AA is so successful is because other people relate to
those facing the same problems. Most people shudder at the thought of attending
a support group, run by a professional instead of someone they can relate to.
Having support groups run by other consumers will free up even more of mental
health professional’s time. Besides that kind of a support group, we should
also include online support groups as well. We are at a time, where many people
are on computers. I discovered online support groups about a year ago, and it
has literally changed my life. My crisis periods were reduced by 50%, and I came
to rely even less on my case manager. I was able to begin to help others like
myself, to the point that I am called on when a member is in a crisis.
Other innovating ideas include warm lines, and crisis hostels. Warm lines
are being used as a form of social support; they are operated with a different
consumer receiving calls everyday. A recent survey in New Hampshire showed those
warm lines reduced the use of crisis teams by 60 to 75%. (Dr. Daniel Fisher)
The crisis hostel is where consumers experiencing a crisis have an alternative
to psychiatric hospitalization. The founders of the crisis hostel believe that
peer counseling can be effective in promoting self healing. It gives the option
of retreating to a supportive place for a short period of time, and enable
consumers to avoid hospitalization. (National Empowerment Center) What
makes these two ideas so exceptional, is they are totally run by consumers.
Hopefully if the success of these two ideas continue, we will see them being
used all over.
Lastly, we can see that consumers are making a difference, and should in time
become the leaders in the mental health system. Consumers are no long thought to
be inept, and useless, but as solutions to our flawed system. Although I do
believe that the most effective solution, will be what I was able to do here,
and that is speaking out. How else will we know what the problems, and solutions
are, unless we ask the very ones receiving the services? As long as we speak
out, the more it will be seen that this problem does exist, and needs to be
addressed. For too long consumers have kept quiet because they didn’t know
they had a right to speak up. They have asked themselves what can I do, I am
only one person. Although, to use the words that Helen Keller once said; "
I am only one, but still I am one. I can not do everything, but still I can do
something. I will not refuse to do something I can do." We are at a time
that we can no longer sit quietly by, and let our livelihoods be jeopardized.
Now the question should be who is with us, and who is against us?
- Mental Health Organization Mental Health: A Report of the Surgeon General 1999
- Nierenberg, Danielle " Mental health often
overlooked" Humanist Sept.– Oct 2003
- Sturm, Roland "Health Insurance May Be Improving- But Not for Individuals with Mental
Illness" Health Services Research April, 2000
- " Slow economy, tight state budget allows mental health system to slowly
disintegrate." State Health Watch March 2002
- National Mental Health Association " Congress Considering Deep Medicaid and Mental
Health Cuts" March 2003
- Fisher, Daniel M.D, "Warm Lines: An alternative to
hospitalization" National Empowerment Center
- " Crisis
- Hostel: Alternative to psychiatric hospitalization
" National Empowerment Center
