Mental Health Shredded Safety Net

Tom and Dorothy Lane are convinced their mentally ill son committed “suicide by cop” two years ago because he was worried about his health-care insurance expiring the next day when he turned 26.

What a powerful opening paragraph from the Columbus Dispatch this past Monday.  What an amazing endorsement for expanding Medicaid in Ohio.  We would be able to serve more people in Ohio who may fear that their insurance and medicine will run out with expanded Medicaid.  The Dispatch did a lengthy look at the Mental Health system in Ohio and the reality that half of those who need treatment can not find help for their mental health issues.   They looked at the large number of people who are not on Medicaid but have private insurance have a hard time finding care for their mental illness. 

The Dispatch estimated that taxpayers pick up $1.3 million from the Franklin County jail because of untreated mental health care. This does not include the billions of unreimbursed care at the emergency rooms throughout Ohio that taxpayers pick up.   The Dispatch mentioned the significant cuts to the Mental Health system since 2007.  One of the surprising advocates has been Governor John Kasich. The Dispatch mentioned that Kasich's brother is mentally ill.   He approved a budget that cut mental health agencies in 2011, and most agencies were happy that they did not receive a bigger cut.   The Governor's rhetoric has been very good, but the actions have not followed suit.  The Governor was quoted in the article as saying, "We haven't done that. The resources haven't been there.  We need to live up to the promises the state of Ohio made," referencing the promises made in the 1980s when many of the psychiatric hospitals closed. It is sad that we can only get good public policy when a relative of a powerful elected official has a disability, is gay or has experienced trauma in their own life.  What happened to empathy for those less fortunate or those who face huge challenges in our society?  Do we have to know a relative to have any ability to imagine how laws or budget cuts will impact their life? 

The article is well worth the read, and has a great deal of information supplied by advocates at the National Alliance for the Mentally Ill.  One of the sad things not mentioned in this article is that we know what works and we know how to serve the population.  We are not going to prevent all tragedies, but with resources we can take care of many of the issues associated with mental illness.  We could do a much better job spotting people who need help and then pushing for evaluation and regular contact with behavioral health professionals.  We could provide housing and some degree of stability to the population. We can provide counseling and medicine to those who feel that is the right path.  We can provide long term nursing care to those who cannot function with the chaos of our world.  But we do not have money to take care of our disabled citizens properly.  One step toward fulfilling the promises made in Ohio toward providing community services to our mentally ill that the Governor referenced is to fight for expanded Medicaid in this state.  

Brian Davis

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