Saturday, September 21, 2002
Report: Mental Health System Lacking Associated Press - September 16, 2002 WASHINGTON (AP) - The U.S. mental health system is in crisis, unable to provide even the most basic services and supports to people with psychiatric disabilities, according to a federal report released Monday.
The fundamental problem: emphasizing medicating people over fostering ways to help them lead productive lives.
The report by the National Council on Disability, a 15-member independent federal panel, provides an overview of the current state of public systems providing mental health services to children, adults and seniors.
Expanding Medicaid eligibility and reimbursable services are the most significant steps that can be taken to improve the system, the panel said.
Mental health systems must develop the expertise to deliver not just medication and counseling, but housing, transportation and employment supports as well.
``Public mental health systems must be driven by a value system that sees recovery as achievable and desirable for every person who has experienced mental illness,'' the report said. ``Systems also must commit to serving the whole person, and not merely the most obvious symptoms.''
The report recommends preventive services and supports such as counseling, peer support, respite care, supportive housing and job training as ways to improve a failing system.
``The recommendations embrace mental health services and supports that transcend the purely pharmacological and medical supports,'' said Michael Allen, senior staff attorney at the Judge David L. Bazelon Center for Mental Health Law in Washington, D.C. The center is a nonprofit civil rights law firm focusing on the rights of people with mental disabilities.
The report found that children who get caught in the public mental health system are underserved and have a much higher dependence on the adult system later in life.
Also, adults whose mental health service and support needs are not met are likely to become seniors who are dependent on inadequate care.
Many mental health systems are crisis-oriented and do not focus on the resiliency of people with serious illness, creating a self-fulfilling prophecy, said Johanna Ferman, medical director at the Center for Mental Health, a nonprofit agency regulated by the Washington, D.C., Department of Mental Health.
``They are not really focused on recovery,'' said Ferman, a psychiatrist who has consulted for mental health organizations and government agencies.
Some of the findings in the report include:
-State mental health systems create ineffective service-delivery programs.
-Homelessness, poverty, criminalization and unemployment increase with misdirected services and supports.
-In many cases, the lack of home- and community-based mental health services results in unnecessary institutionalization.
-In many communities, jails and prisons have become the largest providers of mental health services, and homeless shelters and nursing homes have become a last resort for people with mental illnesses.
-Beyond funding, one of the most significant barriers is that the public mental health system generally works from 9 a.m. to 5 p.m.
Better funding and expanding models such as consumer-directed programs are key to providing better mental health care, the report said.
The report was forwarded to President Bush's New Freedom Commission on Mental Health, which is tasked with studying both private and public sector mental health providers.