The cost of not caring: Nowhere to go ~ The financial and human toll for neglecting the mentally ill is the first in a new series of articles being produced by USA Today tackling this hugely critical issue (by Liz Szabo). Rep. Tim Murphy, R-Pa. (a child psychologist) declares that, "we have replaced the hospital bed with the jail cell, the homeless shelter and the coffin. How is that compassionate?"
Mental health services and programming has taken it on the financial chin as an unfortunate lesser of evils political choice among state programs that have traditionally provided funding. According to Robert Glover, executive director of the National Association of State Mental Health Program Directors, $5 billion was cut from 2009 to 2012, while 4,500 public psychiatric hospital beds were eliminated (a 10% reduction).
Mental illness is still not broadly well understood in a way that even starts to approximate its impact on society. The USA Today article estimates that approximately 10 million Americans with serious mental illness are not receiving care. While at the same time, individuals with serious mental illness have a probability of dying 23 years younger compared to others.
The costs to society are dramatic: in excess of $440 billion a year. And only about one-third of that total goes to medical care. Much of it reflects disability payments and lost productivity. And that amount does not include lost earnings or tax revenue spent on prisons.
The timing is not good. State budgets are already being stretched and the national focus is on how to take costs out of the system – not add more. Medicaid expansion is likely to help identify greater need for mental health services without any commensurate plan in place to address those needs.
Yet we simply cannot afford to continue down the care delivery path we have forged. Mental illness is often a root cause for various physical illness and chronic conditions. Tragic events like Sandy Hook Elementary, Virginia Tech and Fort Hood remind us of the potential incident costs of untreated mental illness – but a fitting analogy of those events to the broader problem might be comparing the tragedy of an airplane crash to the number of traffic fatalities across the country each year.
Recently in true Washington partisan fashion Republicans and Democrats illustrated their shared compassion for those suffering from mental illness by drafting legislation designed to promote political distinctiveness rather than policy progress (though it should be noted that in this instance the Democratic initiative has to be viewed as politically reactive). Here’s hoping maybe someday that will change and this country can start having the very serious and much needed conversation on how to address this terrible crisis.