Causes lost

"Causes lost" Continued...

Issue: "Orphaned no more," July 30, 2011

The January shooting of Rep. Gabrielle Giffords in Tucson was no accident, Torrey says. In the months leading up to Jared Loughner's rampage that killed six and wounded 24, Pima County shut down beds and made it very difficult for a mentally ill patient to be hospitalized against his will. Loughner had displayed concerning signs of illness such as random outbursts, but he never received treatment.

"It's hard to keep these people on medications because half of them don't even realize they're sick," Torrey said. "They'll tell their doctors, 'I'll be fine, as soon as the CIA stops putting these voices in my head.' And many of these people are the ones who commit felonies and violent acts."

Untreated mentally ill patients often cost states even more money than hospitalization. Broward County, Fla., pays $80 a day to house a regular inmate and $130 a day for a mentally ill inmate. The average Texas inmate costs taxpayers about $22,000 per year, but mentally ill prisoners cost almost twice as much. And the mentally ill are often repeat offenders.

State government bureaucracies, with each department focused on its own budget, continue to cut mental health budgets despite the cost to other agencies. The 2010 Stanley study estimated that in Nevada, a mentally ill homeless man could cost the county at least $1 million over 10 years on the streets before he dies.

Cuts to state psychiatric hospitals also drive more mentally ill people to already-overloaded emergency rooms. In South Carolina, where the mental health budget shrank by $81 million, "hospital emergency rooms have become the safety net for the mentally ill," said a recent South Carolina Hospital Association report, producing "a huge influx" of mentally ill patients for which the ER is unequipped.

Torrey, who for 10 years volunteered in Washington providing services to the homeless and mentally ill, said for-profit privatization isn't always the answer: "They treat the easy patients and they ignore the more difficult patients because those cost more money." Medicare and Medicaid don't cover all the costs for mentally ill patients, so hospitals typically lose money on every case.

The best facilities he's encountered are faith-based, nonprofit organizations that dedicate themselves to treating patients no one else will treat. Church groups run most shelters in the D.C. area, Torrey said, stepping in where the government won't: "Homeless shelters would fall apart without faith-based organizations."

-Alicia Constant is a Virginia journalist


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