The Cost of Mental Healthcare

Posted on January 14, 2013
Across the country, there’s been a lot of talk about violence and mental health and how the two intersect.   New York has been no different, with the tragic Sandy Hook shooting happening not far to the east; two fatal subway shovings, one in Manhattan and one in Queens; and the shooting of firemen in Webster, New York. All of the perpetrators in these incidents have been labeled mentally ill, and all have been used to illustrate the need for comprehensive care for people who live with mental health issues.
Alongside regular reporting on the violent shootings and new information on the alleged perpetrators in the subway assaults in December, The New York Times highlighted the recent stress on New York City’s mental health system in the wake of Hurricane Sandy. The tragedy in Connecticut prompted Mother Jones to update an older article about how the majority of mass shooters in this country’s history showed signs of mental illness before their attacks.
I suppose it’s not surprising that as a society we speak more of how to deal with or support or help those with mental illness in the wake of dramatic, violent events, but the truth of the matter is that our mental health system has been receiving cuts for years now - certainly since the recession began in 2009 - and aside from that, budgeting for mental health care is not a priority in our society.
For four and a half years I worked on Fountain House’s Mobile Outreach Team. It was a group of members and staff that drove around the five boroughs of New York in a van, visiting 142 adults with mental illness who lived independently in their own apartments. Usually the work was relatively routine: conducting safety inspections, checking in to make sure people weren’t isolating themselves, giving support to homebound people who couldn’t get out to see a social worker, or simply being a few friendly faces that helped people feel connected to something larger than themselves.
Other times we did have to intervene in crises, bringing people in to see their psychiatrists or taking people to psychiatric emergency rooms. Sometimes we had to call 911 when someone had stopped taking their medications and we were seriously concerned about their safety or the safety of others around them. Hospital staff, police officers, and first responders we worked with ran the gamut from professional and helpful to rude and unhelpful and everywhere in between. I was struck time and again by how much work needs to be done to get services to those with the most serious mental health needs quickly, competently, and compassionately. There were too many times that we had to try to persuade police not to send a troop of officers in to speak to one scared, paranoid person in a room or that we received a phone call after taking a seriously ill person to a psych ER, only to find out they’d been discharged mere hours later because they weren’t “sick enough.”
All this came to a head for me when, in July of 2011, we were told that our contract to provide outreach to our community had been cut due to budgetary reasons. For years, during audits, we were told that our team did good and necessary work, but that didn’t spare us from the cuts. Our members and staff were devastated, and now these 142 people are not receiving the same support they once did.

Similar cuts have been made to other agencies in New York. While I can’t say for certain if these cuts directly led to any tragedies, I can say that our society is neglecting some of its most vulnerable people. It’s imperative that we strive to improve our day-to-day mental health services and don’t make them the first cuts when times get tough. We’re doing a disservice not only to those with mental health needs, but to each and every one of us. As a community, we can’t afford to think of mental health only when a tragedy occurs; we must realize that it’s a day-to-day reality for one in five of us.

Ian Campbell
Active Reachout, Fountain House


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