Monday, June 05, 2006
Editorial: Care must wait until it's too late
Virginia's public mental health system operates in crisis mode. Few resources exist to treat people before their illness takes over.
From the RoundTable blog
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Suppose when you awoke this morning you weren't feeling well. You've been dragging for some weeks now, but this morning you have a coughing jag; blood comes up.
Worried that something is terribly wrong, maybe lung cancer, you scold yourself for not heeding the surgeon general's warning as you toss a pack of cigarettes in the trash and reach for the phone. Maybe you can catch this in time.
You call the health clinic. They ask some questions. How long have you felt this poorly? Is this the first sign of blood? Any family members to make you soup?
Then, incredibly, the clinic tells you, sorry we can't help you unless you are in imminent danger of dying today. Call us back when you can no longer breathe.
Of course this won't really happen if your illness is physical. But mental illness is a different story, especially in Virginia and especially for those who lack insurance or have run out of coverage.
Virginia operates in crisis mode. Unless you are in "imminent" danger of harming yourself or someone else, take a number. The queue for noncrisis mental health treatment winds through the time-stretching referral process. In some parts of Virginia, that can take six months.
In the Roanoke Valley, as in the rest of the state, Blue Ridge Behavioral Healthcare concentrates on patients in crisis, some 12,000 last year. The community services board would like to do more, but funds are limited. Last year, an additional $1 million in funds came to the valley just to enhance crisis services.
These are patients whose symptoms bring them to the attention of emergency room doctors or police. Jails have become the state's primary mental health institution.
Many crises could be averted if treatment were initiated sooner. That isn't likely to happen, though, as state and federal budget makers remain stingy when it comes to mental health care.
The problem isn't just money. More emphasis on jail diversion programs can help, because they order into treatment those whose lawbreaking was prompted by mental illness.
So, too, would better laws that allow families to seek court intervention to force mentally ill relatives to submit to treatment even if against their will. Too often, families desperately seek help and are told they must wait until physical harm is imminent. That is too late for much good.
