Investigative report on collapse of US mental health care system


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Hasn’t this been true for about 30 years?

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This article specifically focuses on the state budgetary problems associated with mental illness while ignoring completely that it was Ronald Reagan who made it a state budgetary problem to begin with:

The Omnibus Act was passed by the efforts of the Reagan administration as an effort to reduce domestic spending. The Act rescinded a large amount of the legislation just passed, and the legislation that was not rescinded was almost entirely revamped. It effectively ended federal funding of community treatment for the mentally ill, shifting the burden entirely to individual state governments.[7]

So yes, this problem really picked up speed about 30 years ago


Does America want to be this kind of a dog-eat-dog society? This situation really sickens me.

Agreed, it’s a damn shame the article didn’t mention the root of this evil, but then again, it’s USA Today, not Democracy Now, etc.

Aside from that issue, it’s terrific to see a mainstream media outlet like USA Today actually put all of our collective noses in it and show us where we are today. And, we’ve had plenty of time to reverse the damage that sick fuck Reagan initiated, but as a nation we haven’t and it’s a travesty. A sick, foul travesty that should be a wretched embarrassment for all Americans.

As a nation we should get together and…

What was I saying?


Just another of the Republican’s efforts to destroy our society and replace it with right-wing bible waving gun nuts…

Ronald Reagan nailed the coffin shut on mental health funding in this country but now it’s time pull the nails out and resurrect it. Lets focus more on caring for the mentally disturb and not so much on gun control. : PoliticalDiscussion

I was going to say (and not trying to be a wiseguy), just how old was that newspaper?

My insurer, Anthem/Wellpoint, made a unilateral change to how they adjudicate visits to mental health professionals. In the past, visits were always treated like a visit to your GP, as a co-pay. You pay your $20 and see your counselor.

The change Anthem made was to start treating mental health services as an out-of-pocket expense applied to your deductible. In one fell swoop, seeing a counselor went from a $20/week cost, to a $75-125/week cost. This has made it financially impossible for us to get any regular treatment.

Thing is, they didn’t tell customers or the healthcare providers about the change. They just started denying the claims from the providers, who in-turn started sending multi-hundred-dollar bills to unsuspecting patients.

When we called Anthem to ask about the change, their excuse was that they had discovered that they had been doing the mental health claims wrong for 30 years and were simply correcting the system to the correct way. Uh huh.


I would be thrilled to have a chunk of my taxes go to funding mental health services, because otherwise (as a public servant) we end up providing unskilled psychiatric intervention anyway.


Collapse? It barely existed in the first place.

“Falling through the cracks” implies a generally strong foundation in need of a few fixes. Perhaps a more apt metaphor might be “falling off the tightrope into the abyss.”


Unfortunately, the situation is much worse than this article depicts. Many of the problems we see today began when we stopped treating patients on an inpatient basis long-term. The government requires that people be able to “participate in the life of their community.” This is what happens when the community does not want the mentally ill and there is no refuge for them. I agree that patients should not be tucked away and forgotten, but they shouldn’t be thrown onto the streets and expected to bootstrap their way to mental health.

I am a clinician working in an inpatient facility. We are focused on crisis stabilization, and we are good at what we do; I see a tremendous improvement in most of my patients. But the fact remains that there are very few placement options for them; institutionalization has not been replaced with independent living, but with ‘personal care homes’, which are often unlicensed and sometimes provide deplorable conditions for patients. For the price of a patient’s disability check, they usually get no better than a few meals a day (Vienna sausages, baked beans, or a sandwich) and boarding in a home that is falling in on itself or is housing more residents than it can reasonably hold. There is very little supervision, and little to no therapeutic care. Unless the chronically mentally ill live in an environment that supports medication compliance, quality of life and hospital admission rates will continue to worsen. Even when people are ready for help (which is a hard place to come to for many), the resourcefulness and tenacity you need to acquire services is mind-boggling.

We have to have other options besides standard outpatient counseling/psych care, intensive outpatient programs, and acute inpatient facilities. Assertive Community Treatment and other efforts are improving outcomes in locales across the country, but we need systemic reform to mental healthcare and healthcare parity. If people worked on the inside like I do, they’d know how much money we’re wasting with poor policy and how burdened existing inpatient facilities are with the result of poor outpatient programming.


Thank you for your post. What would be a proper and feasible response to this problem in your opinion?

I was an adult when Reagan became President and watched firsthand what HALVING the mental health budget did in my city. Everyone was dropped at least one level: in-patient care went to group homes, group home patients were put on the street and told to come back to the facility daily to receive their medications, those who were already on out-patient status like that were just left to fend for themselves.

The adjoining neighborhoods (Edgewater/Uptown) which happened to house many of the group homes and other mental health care sites have still not recovered. And the entire city has had an explosion of homeless people, which had been relatively few up to that point (our winters make it a very short term solution).

Younger people probably don’t realize that the numbers of homeless we see as “normal” now simply didn’t exist before 1980. There were some, of course, but not like what we have now. It is directly linked to the slashing of the mental health care budget.


At the same time, I just heard a story on the radio yesterday about bringing back forced treatment for individuals who are seen as dangerous to themselves or others…
Here it is (Laura’s Law): not exactly new…
O.C. first large county in state to adopt Laura’s Law - Los Angeles Times
It is mandated assisted outpatient treatment: counseling and/or medication
I guess that it is a good thing since I have seen the frustration of families who want to help a loved one and cant get them the help that they need (even when they get violent and dangerous).
The thing that scares me about this sort of thing is that it might make it easier to send politicos off to the gulag… (The whole history of abuse via forced commitment, etc.)

It’s a tough line, because of course people should have personal autonomy as much as possible. It’s such a gray area when someone feels they’re better off without meds and they’re not violent, but they’re not actually functioning the way they think they are.

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