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Housing the mentally ill becoming more difficult

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For all of our progress as a society, there are some issues on which we have regressed.

In this edition of the Buckley Report, a difficult issue that was once under control is becoming complicated. Due to recent court decisions and tight budgets, the responsibility of housing mentally hill patients is falling on local jails.


  • Thomas Christopher

    Sadly, as a result of our unwillingness to treat mental illness, dozens died in Blacksburg, Tucson, Aurora, Newtown, the DC Navy Yard, and in the home of a Virginia Democratic state representative in recent years.

  • mojorisin73

    Another reason to legalize marijuana, to treat people with mental illness. It’s been proven to be a lot more effective than having someone on pills with numerous side effects.

    • Matthew Geesling

      Sorry but having them smoke POT as a treatment to replace psychotropic drugs is ttally BS. There are no credible studies or research that would support your statement.

    • Donna Pitts

      Hello, mojorisin73. While some people may feel relief from anxiety/stress if they smoke marijuana, people with psychosis as part of their diagnososis do not; in fact, it triggers psychosis, almost immediately. For these people, marijuana is poison.

      • mojorisin73

        Anti- depression drugs are a lot worse and have far too many side effects for ones with psychosis. The pill companies behind making these anti-depression pills are the same ones that tell you these myths about marijuana that you are telling me.

  • JB

    The government has shown that they do not care about the mentally ill and that they feel it’s bogus to treat or even deal with the mentally ill through their haphazard treatment of the mentally ill with Medicaid reform. I get we have to save money. This being said, why for once do something novel and spend our tax dollars wisely vs. trying to push the mentally ill in asylums or out on the streets where they have to become criminals in order to find housing in jails. The choices for the mentally ill and people who work with the mentally ill are extremely limited and curtailed by the government.

    • Matthew Geesling

      Five Policies that Save Money, Improve Care, and Keep Public and Patients Safer
      •Spend smarter: Spend on mental “illness” not mental “health”.
      •Use Assisted Outpatient Treatment (court ordered outpatient treatment) for those with a history of violence dangerousness or multiple rehospitalizations due to noncompliance.
      •Reform involuntary commitment laws so they prevent violence, rather than require it.
      •Reform Medicaid law to preserve psychiatric hospitals (eliminate the IMD Exclusion)
      •People found Not Guilty By Reason of Insanity and unfit to stand trial should receive mandated treatment

  • Matthew Geesling

    Background: HR 3717 Helping Families in Mental Health Crisis Act

    HR 3713 (introduced by Rep. Tim Murphy on 12/12/13) is the first bill to (1) focus on serious mental ‘illness’ and (2) to address multiple systemic problems in federal mental health policy that favor the largest number of the highest functioning but leave the most seriously unserved.

    Focus on treating the seriously mentally ill, not improving the mental health of all others.

    HR 3717 reorients the $204 billion US Mental Health budget towards treating the 5-8% who are most seriously mentally ill and away from loosely defined, non-evidenced based programs designed to “improve the mental health” of all others.

    HR 3717 attempts to end mission-creep by instilling mission control.

    This is the best way to improve care, reduce violence, sucide, victimization, homelessness, hospitalization, incarceration and needless tragedies. It saves money by reducing the use of hospitals and jails to serve people who can live in less expensive community settings.

    Put another way, the problem is not that we don’t spend enough, it is that we don’t spend it efficiently.

  • Matthew Geesling

    Why does HR3717, Helping Families in Mental Health Crisis Act Prioritize the Seriously Mentally Ill?

    There are now two mental health systems in the United States. One is run by traditional mental health departments and serves the highest functioning. For ex. ending “bullying” is the new cause celebre of the traditional mental health system. The other mental health system is run by criminal justice and serves the most seriously ill. There are three times as many Americans incarcerated for mental illness as there are in psychiatric hospitals. The traditional mental health system largely ignores the most seriously ill causing their transfer to criminal justice. That is a ‘success’ for the mental health system: one less person they have to treat.

    The US Mental Budget is largely spent to improve mental health (make people happier) not to provide treatment to the most seriously mentally ill. We send the worried-well to the front of the line for services and the seriously mentally ill to jails shelters, prisons and morgues. There has been intensive, massive, mission-creep as every life experience is medicalized. This intentional, disastrous and massive migration has caused our mental health system to be simultaneously expensive and disastrous and dangerous.

  • Matthew Geesling

    HR 3717 funds pilot Assisted Outpatient Treatment Programs.

    HR 3717 provides pilot funds for states that want to set up AOT programs. AOT allows judges to order very narrowly defined individuals-only those who have a past histroy of arrest, violence, or needless hospitalization caused by failure to stay in treatment-to stay in mandatory and monitored treatment as a condition of living in the community. It is not an alternative to voluntary treatment, it is only used when that fails.Assisted Outpatient Treatment has dramatically reduced arrest, violence, sucide, hospitalization and homeless in every state that has used it. HR 3717 reqires states to have AOT on books (although not to use it), in order to receive Community Mental Health Service Block Grant funds and allocates $15 million for pilot program funding of up to 50 AOTprograms per year.

  • Matthew Geesling

    HR 3717 Preserves enough psychiatric hospital beds for patients with serious mental illness who need them.

    There is a nationwide shortage of at least 95,000 beds for people with serious mental illness. This is largely due to an obscure provision of Medicaid law called the Institutions for Mental Disease (IMD) Exclusion. It basically tells states, “if you kick someone with mental illness out of your state hospital, we (the federal government, through Medicaid) will pay half the cost of any community care you provide. So the states lock the front door and kick people out the back to make them Medicaid eligible, no matter how inappropriate the discharge is. HR 3717 makes two narrowly tailored exceptions to the IMD Exclusion, to remove the federal incentive to provide substandard care.

  • Harold A. Maio

    Housing the mentally ill becoming more difficult
    It is difficult to know to whom to write. The above is unacceptable. Try “the” Blacks, or “the” Jews to see why.

    The vast majority of us, like you, own our own homes. we are not a generic.

    Harold A. Maio, retired mental health editor

    • Donna Pitts

      Mr. Maio, could you please clarify what you mean by calling ”the” blacks or ”the” Jews, with regard to the current condition of the MH system? Thank you.

  • Zombiekiller

    “Due to recent court decisions and tight budgets, the responsibility of housing mentally hill patients is falling on local jails.”

    The mentally hill huh?

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