David Earl Johnson, LICSW

3 minute read

Cutting taxes can only mean one thing for people suffering from mental illness, there will be fewer and less quality in the services available. This is true for the public system certainly, but it is also likely to spread extensively into the private system. Public dollars tend to account for a significant part of the business for even the private mental health provider. Fewer dollars will mean a continued exodus of providers from direct service. Salaries have fallen hehind the market for master and doctoral level practitioners. That can only mean fewer new providers coming into the field, and more exiting the field for more lucrative opportinuties. The mentally ill account already for at least 25% and more likely 50% or more of the homeless in this country. That number can only go up as the services decline. Many working people end up disabled because they can’t find sufficient services to help them put their lives together. Many of the homeless are disabled with too much pride to ask for help. We as a country can do better than that. The complete report is available at the link. A report card chart with all the states is at this link. NAMI.org

We live in a time where people with serious mental illness are at increased risk. State systems are under tremendous financial strain. As this report goes to press, actions that are being considered in Congress are likely to do more harm than good. Sadly, the promise of community mental health remains unfulfilled. In 1990, NAMI released its last state ratings report. It described a system of services that, despite enormous expenditure of resources, was not “even minimally acceptable.” It detailed great regional and state variations in the existing system of care. Sixteen years later, mental illnesses cause more disability than any other class of medical illness in America. Recent reports from the U.S. Surgeon General, President Bush’s New Freedom Commission, and the Institute of Medicine describe well a “system in shambles” and the “chasm” between promise and performance. Simply put, treatment works, if you can get it. But in America today, it is clear that many people living with the most serious and persistent mental illnesses are not provided with the essential treatment they need. As a result, they are allowed to falter to the point of crisis The outcome of this neglect and lack of will by policymakers remains often horrendous. The number of people with serious mental illness incarcerated in jails and prisons is on the rise. Emergency room use is increasing. The availability of housing is being threatened. Increasingly, access to effective treatments is being limited by many state governments.

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