Bacon's Rebellion

Democracy Thrives in Sunlight

Institutional Neglect

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by

James A. Bacon
in

Sounds like Virginia’s mental health system is way past due for an overhaul. Reports Bill McKelway with the Richmond Times-Dispatch:

Thirty years after a nationwide push to end the warehousing of mentally ill people in state hospitals, Virginia still faces a daunting task. Virginia is spending more money per capita than any other state on institutional care, its jails are teeming with mentally ill criminals, and community-based systems of care are lacking in all regions of the commonwealth.

The problem entails more than money. According to McKelway, Chief Justice Leroy R. Hassell Sr. said “civil commitment procedures, outmoded state laws that require findings of dangerousness, and shortcomings in community-based care are affecting every branch of government.”

The average caseload of a caseworker in Virginia is twice the national average. Patients wait more than a month on average to see a psychiatrist. The state cannot adequately track the care patients receive, much less its sucess or failure rate. And at any given time, about one-sixth of the 25,000 inmates of state jails suffer from mental illness.

In sum, the mentally ill aren’t getting the treatment they require, and Virginians are paying for housing more than necessary in institutions and jails. It strikes me that this is a case where improved services can be paid for, at least in part, through economic efficiencies.

(Photo credit of Eastern State Mental Hospital in Williamsburg, circa 1942: PBS.)

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2 responses to “Institutional Neglect”

  1. Citizen Tom Avatar
    Citizen Tom

    Increased funding is necessary. Unfortunately, it will be difficult to obtain. We still have attitudes that need changing.

    Many people still see mental illness as a moral defect. Until you have actually seen a formerly sane person lose touch with reality, it is difficult to appreciate the simple fact that our brains can malfunction. Yet such a malfunction can have a devastating effect upon a person’s behavior.

    Here is a comparison. Consider how drugging someone can affect his or her behavior. Drugs work because they interfere with the brain’s chemistry. Something as simple as the ingestion of alcohol, for example, can rob a normally upright citizen of their normal inhibitions. Similarly, sometimes a person’s brain chemistry can be out whack for no apparent reason. The culprit is often a malfunction in the brain’s chemistry; sometimes this defect is treatable with a counterbalancing drug.

    Unfortunately, we still have much to learn about the brain. Although our medical personnel now have new drugs that they can now use to treat the mentally ill, we still have much to learn about how these drugs work. In addition, the diagnosis of mental illness is often just guesswork. Medical personnel still have little in the way of lab tests. Too often, they hazard a guess; then they give their patient a drug they think might work and hope for the best.

    What is expensive about treating mental illness is that some people need to be confined for their own protection. Our society should accept this as a moral obligation. However, even if we do not accept the moral obligation, we should still consider that it is a false economy to leave the mentally ill without protection.

  2. Ray Hyde Avatar
    Ray Hyde

    Well said, Tom.

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