March 29, 2006

Greater Need, Less Help - Alabama

If you live in Alabama, the message is very clear: don't get sick.

Birmingham News reported this week that demand for mental health services is climbing quickly, but resources are being cut significantly.

In a story titled "No room for mentally ill Commitments up, but cuts in psych beds limit treatment" the Birmingham News stated:

"There is the frail, silver-haired senior citizen who won't take her life-saving medicine, the obese woman convinced she's married to a celebrity and a wiry twenty-something who tried to kill himself and wound up in jail.

These are just a few of the mentally ill patients who came before Jefferson County Probate Judge Alan King in a recent week for involuntary commitment hearings. King must decide if the patients are safe at home, or if they need intensive treatment at a place like the state-run Bryce Hospital in Tuscaloosa.

In five years, King has handled more cases than his predecessor did in 12 years on the bench, a trend seen around Alabama. ''It's just incredible how the cases have increased,'' King said.

Statewide, admissions to public psychiatric hospitals have jumped 39 percent in five years.

At the same time, public and private treatment resources for the mentally ill have shrunk, pushing counties to do more with less. Though commitments for children and adults who need acute care for mental illness are on the rise, private hospital beds for them have decreased by about 285 across the state, to 845 beds.

The result is some patients do not stay hospitalized long enough to get stable. They may return months later, sometimes cycling in and out of facilities or even jails, officials say."

They also report that typically between 40 to 50 people are waiting for admission for treatment.

The cause of the rise in mental health treatments, suggests the state's commissioner of the Department of Mental Health and Mental Retardation, is rising methamphetamine use, which can cause psychotic-like symptoms, and the reduction in private treatment beds due to a decrease in federal Medicaid payments.

However, the newspaper reports, advocates for the mentally ill say another reason for the explosion in commitments is that the state has not expanded community treatment options as promised. After closing several large institutions in 2003 and reducing the numbers of mental patients at state hospitals to comply with the federal Wyatt lawsuit settlement, officials pledged to invest the savings in group homes, county mental health centers and local services to allow the mentally ill to live independently.

In Alabama, as in the rest of the country, jails and prisons become the de facto placements for untreated mental patients.

Additionally, state officials say that funds that might have gone to community services have been needed to add staff at the hospitals. And they say, the mental health department has been experienced soaring medication costs for its many patients. Still, the department has expanded community (nonhospital) spending from $120 million five years ago to $152 million this year, while facility or hospital spending has decreased from $136 million to $133 million.

Source; Birmingham News


My cousin was diagnosed as paranoid schizophrenic 30 years ago. She has been in and out of mental institutions for 30 years. She has refused to take medication for over 20. She now has diabetes and is blind from cataracts. She doesn't believe she has diabetes or cataracts and refuses to take medication for diabetes. Her caretaker and guardian, her mother, died two months ago. We are in the process now of having her committed to Decatur. Knowing she will not take medication when she gets out, the cycle will start again. She was in Decatur 7 months ago after she had gone into a diabetic coma.Her eyes were examined and the Doctor said he could not determine the extent of damage to her eyes until cataract surgery was done. She refused the operation. We are trying to have her put involuntarily in a nursing home so they can at least try and give her medication. The hospital social worker said she did not think she would qualify, but filled out the paperwork for Level I and then a Level II evaluation will be done. We think she needs long term psychiatric care, but Decatur has said in the past she could not go to Bryce. The family is very concerned for her future. We are afraid Decatur will let her out and she will go home alone, blind, diabetic, and not on medication. I am in the process of becoming her legal guardian and want to have cataract surgery done, but this will be difficult. She hates the family and unless she is in an institution she will not comply with our requests for her to accept any type of treatment. It has amazed me how difficult it is to try and get help for her that will break the cycle of going in and out of the hospital.

Posted by: Sandra at April 9, 2006 07:47 AM

I am interested in knowing if you received guardianship and how you did it. I am trying to help a lady who doesn't what any money to gain guardianship of her daughter who is wandering the streets because she is schizophrenia. Please reply to me by email.

Posted by: Shirley Norris at October 31, 2007 09:16 AM

Post a comment

Please enter this code to enable your comment -
Remember Me?
(you may use HTML tags for style)
* indicates required