By James G Baker, MD, MBA
There is little doubt that the funding for mental health
care in Texas is inadequate for the task. But as we try to improve the
quality of care for people who struggle with mental health challenges as one
strategy for reducing the chance of future tragedies like Newtown, we must keep
in mind that our conservative Texas legislature is generally more interested in
how dollars are leveraged, not on how many are spent.
So we need to offer up the most cost-effective approaches to
improving mental health care and increasing public safety. Here are three
possibilities:
First, the legislature can pass laws that make it easier for
family members to get help for a mentally ill loved one before he becomes
dangerous. Families need to be able to ask courts to compel a loved one
to take necessary medication, attend counseling sessions, and go to substance
abuse treatment.
Second, the legislature can expand and reform Medicaid in
Texas under the Affordable Care Act, virtually eliminating the current barriers
to obtaining care for mental illness. The sad reality is that access to
mental health is so difficult that many get treatment only after getting
themselves into jail, a much less cost-effective approach than providing the
care through Medicaid.
Finally, the legislature can support Medicaid waivers and
new state programs that increase the availability of housing for people with
mental illness, especially for those who have had previous run-ins with the
law. There is a significant overlap in the homeless population, the
population with mental illness, and the population involved with the criminal
justice system. Housing is the most critical factor in helping people
with mental illness adhere to treatment, and severely mentally ill individuals
who adhere to treatment are no more dangerous than the general population.
Each of these three approaches offers the potential to
reduce the suffering of people with mental illness (and their families), to
improve public safety, and to reduce the price that each of us pays due to
untreated mental illness. In addition to reducing the possibility of new
tragedies down the line, they are win-win-win for patients, families and
taxpayers right now.
Dr. James Baker
recently retired as CEO of Metrocare, the public mental health and
developmental disabilities center for Dallas County, and now practices
psychiatry full-time in one of the center’s clinics.
Thursday, February 14, 2013
Mental Health and Public Safety
Labels:
Affordable Care Act
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Medicaid
,
Mental Health
,
PPACA
,
Public Health
,
Public Safety
,
State Funding
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