State of Mind
By Kandace Power Graves
Treating the mentally ill saves money, anguish
|
'The human suffering is immeasurable. Unless you have experienced the
gut-wrenching feeling that family members go through ... you can't imagine what
it's like.'
-- Bea Piker, president of NAMI Louisiana
|
America prides itself on being open-minded, on the cutting edge of technology,
and a country that embraces quality of life. When it comes to brain disorders,
however, the non-profit National Alliance for the Mentally Ill (NAMI) says the
country's systems are failing.
In Louisiana alone, about 180,000 people each year seek the state's
help for treatment of mental illnesses such as depression, bipolar disorder,
schizophrenia, obsessive-compulsive disorder, manic depression and anxiety
disorders. Thousands of others seek help through private insurance and still
others' symptoms go unchecked because they lack access to treatment or because
of a misunderstanding of mental illness.
"Mental illnesses are not uncommon," says NAMI Louisiana President
Bea Piker. "Most of the world has experienced this. Statistics tell us that one
in five will experience severe mental illness in their family or encounter it
with someone they know." The sad part, she says, is that modern treatments for
a range of brain disorders are quite effective and much less expensive than the
economic and social costs of allowing such conditions to go unchecked.
The roadblocks to effective treatment include restrictions on
coverage that bar a patient from trying newer, more expensive but more
effective drugs until they have first tried and failed on older drug regimens.
Furthermore, the quality and availability of services and treatments for the
mentally ill vary greatly depending on location. Other problems that stem from
untreated brain disorders include homelessness, poverty, suicide and
incarceration. NAMI hopes to change that with a national effort to educate
people about the realities of mental illness as well as spearheading efforts to
bolster state laws dealing with services and treatment for the mentally ill.
There have been some successes. In 1996, the U.S. Congress passed
the NAMI-supported Mental Health Parity Act, which essentially states that
insurance coverage for brain disorders should be equal to that afforded for
other serious physical disorders. Previously, the caps on annual and lifetime
benefits for mental illnesses were as low as $5,000 a year and $50,000
lifetime, compared to $1 million lifetime coverage for other physical
disorders, with no annual cap. The law went into effect in January 1998 and
expires Sept. 30, 2001. To date, 28 states have enacted some type of mental
health parity law -- Louisiana passed one in 1999 -- that seek to end what NAMI
calls "health insurance discrimination against individuals with mental
illnesses."
The grass-roots advocacy group now has developed an Omnibus Mental
Illness Recovery Act (OMIRA) that seeks to replicate in each state the most
effective standards and programs for recovery. The model legislation can be
introduced in state legislature as a whole package or as separate initiatives
(for states that already have adopted some of the principles in previous
legislation).
Dealing adequately with brain disorders not only is a social issue
but it also is a huge drain on public and private resources. National
statistics indicate that mental illnesses cost the nation more than $120
billion a year in medication, hospitalization, lost productivity and wages,
family caregiving and suicide. Brain disorders are more prevalent than heart
disease, cancer and diabetes, and account for 21 percent of all hospital beds
filled each day. Ironically, with proper treatment and support, mental illness
have a higher treatment success rate than, for example, heart disease. With the
right treatment, success rates reach 60 percent for schizophrenia, 65 percent
for major depression and 80 percent for bipolar disorder, compared to 45
percent for heart disease, according to a five-year study conducted by the
Schizophrenia Patient Outcomes Research Team. Despite the figures, in many
locations treatment isn't available or adequate until patients are in a crisis
situation.
In Louisiana (as well as other parts of the country), Piker says,
the problem is intensified by the prevalence of mentally ill patients who end
up languishing in jail without treatment while their families battle red tape
in their efforts to have them transferred to a mental treatment facility or to
receive treatment while jailed.
"The question becomes: Do you spend your money up front (with the
most effective treatments) to save it in the back, or do you just not spend
your money now and spend it 10 times over later?" Piker says. "The human
suffering is immeasurable. Unless you have experienced the gut-wrenching
feeling that family members go through ... you can't imagine what it's like.
"A lack of education for the community is an ongoing situation. The
community really needs to be educated more on the myths and the real sufferings
of people who have mental illnesses and their families."
Part of her focus is to make police and other public servants more
aware about mental illness in an effort to have more patients referred for
treatment instead of hauled off to jail. Untreated brain disorders cause
patients to act in ways they normally would not; often they are disoriented,
confused and frightened. Nationally, taxpayers dole out $6 billion a year to
jail a half-million mentally ill people.
"It's a seriously complex social issue," she says. "A lot of it is
lack of service for people with mental illness, lack of understanding, lack of
treatment facilities. There are efforts to work in Louisiana with the secretary
of the Office of Mental Health to make some drastic changes in how things are
done." Those efforts, however, are just getting underway.
"We all know that treatment needs to be better," Piker says. "We
have a crying need because more and more people with mental illnesses are
ending up in the jails. It should not be that way. It's a major problem for
families here. Rarely does a week go by that I don't get a phone call from
someone who said their son, daughter, father got picked up because they got off
their medication. After they get into the legal system, it is a nightmare to
make sure they get out of jail and into a treatment center or while they're in
jail, that they get treatment."
Patients normally are picked up for minor offenses such as
disturbing the peace or wandering around confused, but trying to get treatment
for them can take up to 3 months.
"For the patient, what happens is they remain in the symptom stages
of their illness," she says. "Their symptoms are painful and very real. Any of
us who would be in jail would be scared; to be mentally ill, it's all magnified
many times over.
"For the family, to know [their loved one] needs treatment, and not
being able to get to them and know they are deteriorating in there is
devastating."
She admits that overcoming such red tape probably is a "political
hot potato," but the rewards to the social and economic fabric of the community
is well worth the effort.
"With the right treatment, chances are good these patients can be
normal," Piker says. "Chances are nil when they are in jail ... or when the
system makes them decline to a state of crisis before it will intervene."
Presently, NAMI Louisiana is planning a statewide education program
to inform the public and communities about mental illness and the model
legislation package, and the Mental Health Coalition is studying the effects of
Louisiana's implementation last year of the parity law.
|
