[Vision2020] Lewiston Letters: Two Topics

[Mark Solomon]

For non Daily News readers, here is my Town Crier column from this 
week on the topic of funding mental health programs.

m.

****
TOWN CRIER II: Community mental health programs are essential

By Mark Solomon

Wednesday, June 6, 2007 - Page Updated at 12:00:00 AM


Two-and-a-half weeks have now passed since the tragic shootings of 
Officer Lee Newbill, Crystal Hamilton and Paul Bauer. Wracked in 
grief, our community has again revealed why I call Moscow home: When 
times are hard we give of ourselves, of our love and caring.

The support of each other through tough times is, for me, the real 
test of a community's strength. It is a rare strength, to be 
appreciated. Another test comes in the aftermath of tragedy when it 
becomes appropriate to ask questions of how such events can be 
avoided in the future. Many letters to the editor have come in with 
analyses and suggestions. For my part I would like to provide a 
little bit of the recent history of mental health funding in this 
country as my contribution to this ongoing discussion.

Two decisions made 26 years ago have imperiled our mental health 
system. In one of his first acts as president, Ronald Reagan killed 
the Community Mental Health Act prepared by Congress to replace the 
expiring federal statute that had established a national program of 
mental health services. Two months later, he eliminated all direct 
funding for state mental health programs, lumping mental health in 
with 82 other federally supported programs, from job training to 
public transportation, in what became known as state block grants. 
Total funding for programs included in the grants was reduced 37 
percent from the previous year's program budgets, forcing states to 
decide how programs would be cut. Support of mental health programs, 
a service to a largely politically powerless constituency, plummeted.

At the same time, a well-intended policy shift was underway on how to 
provide treatment to the mentally ill. Before this shift, most mental 
illness was treated in state mental hospitals that often resembled 
the nightmare described in Ken Kesey's "One Flew Over the Cuckoo's 
Nest." The decision was made to de-emphasize involuntary commitment 
to state hospitals in favor of outpatient treatment in community 
mental health clinics where those being treated could remain 
connected, in as much as they were able, to the community they lived 
in. The problem was that by emptying state mental hospitals, tens of 
thousands of patients were turned out into the streets and into the 
newly established community mental health clinics that were quickly 
overwhelmed by demands for their services. The overworked, underpaid 
public mental health professionals were reduced to prescribing 
psychotropic drugs and hoping for the best as caseloads exploded, 
ending any opportunity for real therapy.

The states, looking to maximize the few federal dollars they were 
being given, rolled their state programs into Medicaid, where their 
dollars brought an additional federal matching grant. The nonmatching 
funds allocated to community mental health clinics continued 
shrinking. This forced many people in need of treatment to seek 
Medicaid assistance, but in order to receive it they first had to be 
judged disabled under Social Security guidelines, a horrendous 
process for the fully able and an insuperable hurdle for the mentally 
ill. Idaho, with a Legislature very much in tune with Reagan's 
conservative philosophy, quickly excelled in the states' race to the 
bottom for mental health funding.

Nonprofits, such as the now-defunct Latah Alliance for the Mentally 
Ill, tried to fill the gap, creating group homes for the mentally ill 
and failing as funding dwindled away. Community hospitals like 
Gritman did their best to help, providing temporary holding rooms for 
those in dire mental distress. But physical health doctors and nurses 
were simply not trained to handle the extremes of mental illness and 
small hospitals couldn't afford to hire mental health professionals. 
The rooms became another form of jail cells, or closed.

Twenty-six years after Reagan's cuts, our jails have become our 
mentally ill holding facilities. Accessible mental health programs 
have all but disappeared. Police officers, prosecutors and judges 
have become caseworkers with little to no tools at their disposal 
other than incarceration.

We once had a vision as a nation of community mental health, a vision 
of health for the individual and the community at large. No one can 
say whether the tragic events of two-and-a-half weeks ago might have 
been prevented if that vision had held. But they might have. In honor 
of those who have been taken from us, let us do what we can to see 
that the right tools for addressing the needs of the mentally ill in 
our midst are made available to those in need and to those who lay 
their lives on the line to protect us.



At 8:56 AM -0700 6/10/07, Joe Campbell wrote:
>There is an interesting letter to the editor today in the Lewiston 
>Tribune, by Patricia Tutty entitle "More care needed" (p. 3F). She 
>writes: "Society needs to pick up the costs of mental health 
>treatment just as it pays for police protection." I agree.
>
>There is also an absurd letter written by George Ghiselin entitled 
>"Homosexuality forbidden" (2F). He writes: "In the New Testament, he 
>[God?] declares homosexuality to be the lowest point in the pathway 
>to perversion. When a culture embraces homosexuality, that's the end 
>of the line." Ghiseline cites no Biblical authority for this claim; 
>he only mentions a book written by a contemporary author, claiming 
>that the fall of Rome was due to the fact that "14 of the last 15 
>emperors were homosexual." This strikes me as nuts.
>
>Two letters, two causal claims. One seems to me to be spot-on, the 
>other crazy. My guess is that someone with a different political 
>perspective would think differently. What do you think?
>
>--
>Joe Campbell
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