If you haven't been following the N&O this week, they've been doing a special on the past few years in mental health reforms in North Carolina.
http://www.newsobserver.com/1181/story/958236.html
Check back at that link, there are more stories on the way and that'll link you to all of them as they're added, but I wanted to put this up here and hear everyone's thoughts.
Okay, so deinstitutionalisation was put into law by the Community Mental Health act. Throwing people in big huge hospitals and keeping them there wasn't working. But then instantly tossing them all back out on the streets also sucked.
The community mental health movement looked to put minorly mentally ill people in communities, where they could actually live on their own in social environments, and caretakers could deliver medications, ensure compliance, and check up on these people without locking them away. Sounds FANTASTIC in theory.
First, after shutting down all the huge hospitals that could ensure 24 hour care, individuals with extremely severe mental disorder now had nowhere to go. Autists, violent schizophrenics, catatonic schizophrenics, severe bipolar individuals, and anyone who has a severe mental illness in addition to a comorbid drug problem, they are all screwed. The burden of their care falls back on their families because these people cannot care for themselves to even the minor level that would allow them to live in these mentally ill communities.
Second, the care of these outpatient mental communities fell to private companies. They charge ridiculous prices for minimal services. (Check out that first article, "Reform wastes millions, fails mentally ill" to get an idea of what I mean there.) Yes, things as minor as shopping and child care can be severe concerns for mentally ill individuals, and it's great that people are helping them with these aspects of their lives, but to charge that much? Come on!
The mental health reforms of the past few years haven't been all bad. We've done great on instructiung police officers and emergency room personel on handling severely disturbed or mentally ill individuals with proper care. Now these professionals can look after everyone's safety. But because of the lack of a place for severely mentally ill people now, when Junior with schizophrenia flips out and starts threatening his family, the police can only take him away for a few days, send him to the hospital, get his Thorazine dose upped, and he goes right back into a bad situation with people who can't properly care for him.
So what's the solution? Live-in caretakers that can aid a family in treating a mentally ill individual? Going back to the hospitals? I don't see a good solution to these issues.

2/28/2008 10:13:20 AM

The problem is we followed the Michigan reform, which at the time had been highly lauded, brought in the mastermind from Michigan to institute it here, only to find out the Michigan plan completely sucked.

2/28/2008 10:40:43 AM

Quote :

"furikuchan: They charge ridiculous prices for minimal services."

Yeah, I read that installment of the series in the N/O.

I wouldn't call it charging. I'd call it stealing.

Filthy thieves.

2/28/2008 8:42:31 PM