Unkind cuts for mentally ill
WHEN THE STATE began closing its hospitals for the mentally ill decades ago, it promised that patients would be able to get vital daytime services – education, recreation, and supported employment – in community settings. This was reassuring to the mentally ill and their families, who feared the consequences if patients released from the hospitals lacked these programs and the safe social contact they provide. Now these services are at risk as the state targets them in its effort to bring spending in line with declining revenues.
No one envies officials the task of cutting the $29 billion budget by almost $1 billion, and the list of reductions might have to grow if revenues continue to fall. But some programs are so central to the state’s mission of providing for the most vulnerable that they deserve special consideration. If the state cannot find the funds to sustain the day programs, they should be at the top of the list for restoration if Congress includes expanded Medicaid funding as part of a new stimulus package early next year.
Under the state plan, hours at clubhouses for the mentally ill would be reduced, and day rehabilitation programs would be eliminated for the 2,600 adults who use them. Without these services, many will have nowhere to go but the street, where they are often victimized.
Loss of the services is likely to cause some of the mentally ill to spiral downward to the point where they will need hospital care. The cost of that care will offset some of the savings gained by shuttering the programs.
Since the 1960s, community-based treatment has proved to be better for most patients than hospitalization. But dropping the day programs strikes at the very meaning of community-based treatment.
READER COMMENTS
December 10 -
Unfortunatly it’s almost impossible to care for a mentally ill family member for the average person. To not enable a family member with a mental illness is so unbarebly difficult and sometimes impossible that family memebers can’t do it. Nevermind the education it requires to be able to understand thier diagnosis and be able to understand why they behave certain ways that often frustrate thier family members. A lot of the mentally ill that will be forced onto the streets are middle aged, that means that thier parents are in thier 80′s if even alive. Would you rather the government fund somewhere productive for these people to go and attempt to be positive people in thier community or to have no where to go and bring the level of safety down and the homeless, panhandling, dumpster diving, paranoid, corner sitters up around our communities? I vote continue to fund this increadibly beneficial service, not for me as a provider, but to the people who need it the most as most families just cant do it. These poor people have already been through enough not being blessed with your good health, lets be a little less selfish!
December 09 -
It is always a shame when fiscal realities necessitate a cut in services to needy people, but my biggest question is… where are the families of these needing help?? Why can people just dump off family members on the state? A previous poster says day treatment costs about $60/day. That is only slightly higher than daycare for a young child, and many families seem to be able to keep their kids in those situations ok. Obvioulsy some families do not have access to resources to afford that.. but plenty do as well. Why is it suddenly everyone’s on the financial hook for what should be a private matter?
December 09 -
Some folks are getting confused about the intended purpose regarding this article and forum. Day Treatment and Detox are 2 completely different services. Day Treatment is the best and most valuable resource the Commonwealth can offer severely and persistently mentally ill folks. It provides the education, structure and support that most of us take for granted. It is a relatively low cost service that actualy saves the Commonwealth money in the long run. It costs an average of $60.00 per day for someone to attend day treatment whereas it costs and average of $600.00 per day to place someone in an inpatient mental health facility. The net result of discontinuing day treatment services will be a gross increase in the number of folks who will end up being hospitalized repeatedly. It’s called preventive services and it actually works. I would be rich if I had a nickle for every person who improved their lives and stayed out of the hospital due to the services they received at day treatment.