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NAMI EASTSIDE |
NAMI Eastside News - From the Editor The NAMI Eastside
News “From the Editor” column is penned by Susan Rynas. You can reach
Susan via e-mail at sgrynas@yahoo.com (include "Newsletter”
in subject line) or contact the NAMI Eastside office at 425-885-NAMI (6264). FROM THE EDITOR: JULY - AUGUST 2002 Early intervention and easy access to treatment for individuals with a mental illness needs to be a primary value and goal of a vital, healthy and truly caring public community mental health program. A major flaw in our current delivery system involves inadequate early treatment, including deficits in accessibility as well as continuity and length of care issues. If treatment is not early and lengthy enough to make a positive difference then, by default, it becomes its opposite -- delayed or denied treatment that pretty much always makes a negative difference. This is not the difference families are anticipating for their ill family member. The Washington state Department of Social and Health Services (DSHS) is asking the federal government for more flexibility in allowing the state to determine who will and will not qualify for needed mental health treatment under the joint federal/state Medicaid program. It submitted Waiver 1115 on July 1st seeking essentially blanket authority to make significant reductions in the coverage and benefits provided to its poorest, sickest, oldest, youngest and most disabled citizens. The waiver could potentially remove many federal guarantees of the Medicaid program especially since many of the benefits received by individuals disabled with brain disorders are considered to be within the “optional” category. Mental health advocates are constricted in our ability to make a strong, statistically relevant case for our family members since the multi-leveled mental health delivery system provides little validly reliable consumer outcome data. In other words, what is the effect on consumer outcomes for the services provided to them with taxpayer dollars? Simply put, do people stay the same, get worse, or get better? Additionally, what are the best treatment modalities for specific disorders? Most taxpayers would not object to subsidizing something that works, alleviates hardship and suffering in the life of an individual, and moves a person toward recovery. Yet family members are left to demonstrate the “monetary” value of investing in disabled mentally ill people without basic information necessary to do the best job possible. WE KNOW our loved one’s intrinsic value but unfortunately are asked to justify such “optional” expenditures to our elected representatives who must balance the budget. Courageously endured brain disorders are not “optional” or transitory disabilities. Most often, they are life long and must be accommodated, respected and treated with appropriate therapies, both medically and psychologically. Individuals depending upon Medicaid for their mental health care should not be subject to enrollment caps, wait lists, reductions in overall medical benefits, co-pays and premium payment requirements. Subsisting at a poverty level low enough to qualify for Medicaid can induce stress enough in itself to exacerbate a mental illness. Lowering the bar even further will move some recipients from crisis to catastrophe, from barely coping to active relapse. When do we put a floor under a rapidly accelerating freefall in the delivery of necessary mental health services? Must we wait until crisis moves to catastrophe? What are our values in relation to health care for those in need? Do we value such care? If so, what is the need and how do we pay for it? Fundamental questions based on values are not being asked. Instead, programs are being cut without any real knowledge or understanding of the consequences (except perhaps in dollars saved short term). What are the costs in human terms? Currently? In the future? Do taxpayer dollars spent on direct services to needy human beings have the same “value” as taxpayer dollars spent on other things? It is my contention that dollars spent on direct services to real people have more value. Furthermore, since funding for the community mental health system is based upon the number of Medicaid individuals served by any particular agency, additional reduction in Medicaid clients imposed by enrollment caps, wait lists, co-pays, and premium charges will inevitably cause further cuts to a system already seriously under funded. Even fewer individuals will gain initial access to treatment and those already enrolled will be allocated even less treatment hours. We are rowing the lifeboat backward! Advocates are seeking major reform of the publicly funded mental health delivery system. We are seeking a dedicated stream of dollars for the treatment of citizens with mental illnesses. We want the budget balanced without the poor and disabled paying the ultimate price that often occurs in treatment denied-with their very lives. We reiterate that we want aggressive initial treatment for our family member’s mental illness. We want easy access to care and treatment lasting long enough to make a difference. We want a real possibility for recovery. Mental illness is no option for those persons and family members affected by it. Treating it appropriately should not be either. Till next time, take good care. Susan
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