Johnson City Press Monday, December 22, 2014

Out of My Head

Some with mental illness need a safe place to live, receive care

November 21st, 2011 11:11 am by Jan Hearne

Our mental health care system is flawed, and now officials want to close Lakeshore Mental Health Institute in Knoxville. If state lawmakers approve the proposal, the facility will shut down June 30.
“Moving these mental health services into the community where our patients live allows them to start the process of recovery near family, friends and local community mental health support services,” Tennessee Department of Mental Health Commissioner Douglas Varney said,
I have to ask, what if they don’t have families and friends? What if their families and friends have given up on them or are incapable of taking care of them? And, in this era of budget slicing and dicing, are the “community mental health support services” going to be sufficient, or are these poor souls going to end up on the street?
The article I read said, “With a decades-long background in mental health, Varney believes it can work.” Believes? Really? We’re not talking about bringing Tinker Bell back here, we’re talking about human lives that will be radically changed by this move.
On Tuesday, Varney told the state Legislature that closing the facility would not only save money but was “morally right.” Does that mean treating patients at Lakeshore (formerly Eastern State) has been morally wrong since 1886? Why now the epiphany? And why does it frighten me when bureaucrats speak of morals and money in the same breath? The only morally right course is to make judgments independent of budgetary concerns.
Even though drugs have revolutionized psychiatric medicine, they only work as long as they are taken at the right time and in the proper dosage. Too often, without close supervision, people who suffer from mental illness quit taking their medications, leaving family members or friends (if they have any) to deal with difficult, and in some cases, tragic, situations.
Some people need residential treatment facilities, not for five or 10 days, which is the norm at Lakeshore, but for months or years, and, if you ask me, that is where our mental health system is woefully lacking. Some people cannot make it on their own.
When someone suffering from mental illness is in crisis, there should be a long-term, comprehensive care option where lengths of stays are not determined by insurance plans. This is what I consider “morally right.”
There needs to be a safe place for people to go, a place where they will be fed and sheltered and cared for, where their medications will be monitored and they will be safe.
Lakeshore may not be that place now, but it could be. Once it is closed and its land and buildings disposed of, there’s no chance the kind of comprehensive care I’m talking about will be available.
Community mental health centers cannot provide constant oversight. I don’t mean this as a criticism of the many hard-working mental health professionals who care deeply and struggle to help while dealing with reduced budgets and staggering case loads.
It is a criticism of a state bureaucracy willing to cut costs at the expense of our most vulnerable citizens.

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