Archive for Friday, August 25, 2006

Menninger blasts mental health policy

Psychiatrist sees many failings by state

August 25, 2006

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When Dr. Roy Menninger addressed a Thursday meeting of the League of Women Voters of Douglas County, he looked for something nice to say about the state approach to caring for the mentally ill.

He didn't find much.

"I'd say Kansas has a system that's a little better than average," said Menninger, a psychiatrist whose father, Dr. Will Menninger, grandfather, Dr. C.F. Menninger, and uncle, Dr. Karl Menninger, started the world-famous Menninger Clinic in Topeka in the early 1920s.

That's not much of a compliment, he said, when the nation's mental health system has degenerated to a point where limiting hospital stays trumps actual care.

Menninger went on to blast states - including Kansas - for closing many of their hospitals for the mentally ill. He called the closings "a terrible social experiment."

Kansas closed Topeka State Hospital in 1997. Since then, he said, the number of mentally ill people in prison or wandering the streets has risen dramatically.

"One-fourth of all people in prison are thought to be mentally ill," he said.

Menninger said he welcomed the modern availability of psychotropic drugs but was saddened to see how they're being used to limit stays in psychiatric units.

That's certainly the case at Osawatomie State Hospital, where, he said, true care has taken a back seat to efficiency.

Menninger also criticized the state's community mental health centers for pretending they can care for people with chronic illnesses who resist taking their medication.

He called the centers "a great idea, but premature," "grossly insufficient" and woefully underfunded.

About 30 people attended the evening forum. Many shared stories of being "drugged" while hospitalized, having trouble accessing services and, because of their illnesses, being treated like second-class citizens.

"I thought Dr. Menninger provided us with a very realistic and objective perspective on the mental health system in Kansas," said Kay Hale. "He didn't pull any punches, and he told the truth."

Hale is a member of the Douglas County League of Women Voters' board of directors. She serves on a committee that's studying the state's mental health system. The study is expected to take two years.

The Menninger Clinic closed its Topeka operations and moved to Houston in 2003.

Comments

prioress 8 years, 11 months ago

Good point. We are still paying for Reagan-era decisions to "declare people well" and send them home to save money in the health care system. Another example of the law of unintended consequences.

Christine Pennewell Davis 8 years, 11 months ago

It is nice to see a Dr. come out and say this all sucks and the people in charge are to blame because they care about that bottem line and not the peoplePeople need to get their heads out of their arss and take a good look around.

BDub 8 years, 11 months ago

That "bottom line" isn't helped any when a mentally ill person released from the hospital winds up in prison. Cost of housing and feeding someone in prison with very likely an inadequate level of mental health care vs. cost of housing in a hospital with much better level of care is probably about the same, but I'd guess it might cost even more to house a prisoner. It'd be interested to see some figures if someone has them.

Having people live as independently as possible in the community is the best goal, but there are always some who still can't function well enough to live in the community, and for them we need hospital care. Part of the problem is that they got overzealous in closing too many hospital beds. Another is that they failed to then provide enough funding to provide care in the community to help those people to make it on the outside.

When money is more important to our policymakers than the people are, they can't help but create problems like this. But of course, policymakers rarely see past the end of their noses.

bd 8 years, 11 months ago

AMEN!!! sybil!

They pulled out of Topeka because of money -hypocrites!!!!!!!!!!!!!!

TheOriginalCA 8 years, 11 months ago

prioress, this has little to do with past presidents, but EVERYTHING to do with the fact that overall knowledge about mentall illness (not to mention public awareness) is light years behind the rest of medical science.

Sybil, that was an awesome comment!!

I guess I should qualify my comments by stating that I am the proud paarent of a very loving and FUNNY 10 year old who is Autistic with psychosis. He has been in the hospital 8 times now in the past 30 months for a total of 4 months of hospital time. Living in Michigan (formerly Lawrence) it sometimes takes an entire week to find an available bed for him. During that time we have to keep round the clock vigilance hoping that he doesn't jump out a window or do something harmful to someone else. Michigan has had devastating budget cuts in this area and there are many free standing Mental health facilities closed and boarded up.

This is also going to add to the problem of hoelessness by eventually forcing more mentally ill citizens out onto the streets because there is no where for them to get help.

gphawk89 8 years, 11 months ago

"he welcomed the modern availability of psychotropic drugs but was saddened to see how they're being used to limit stays in psychiatric units"

That's what the drugs are for - to help these people get back on their feet and out of the hospital. What, does he want everyone with severe depression, schizophrenia, bipolar disorder, dementia, and so forth to just stay in psych wards as long as they're having problems? Some mental illnesses last for years, if not the rest of your life. You could place a severely depressed, suicidal person in a psych ward for a month and, without drug intervention, at the end of that month they might be as or more depressed as when they were admitted. Limiting stays in psych units is especially a good thing if the person is paying out-of-pocket.

Wilbur_Nether 8 years, 11 months ago

Dr. Roy is trained as a scientist, so were I to wager on the situation, I would wager that he is looking at the data. BDub's reveals true global, systems thinking with the point that allowing the burden to be carried by the judicial system creates long-term costs that are disguised as part of the cost of maintaining the corrections and other social costs. I suggest to sybil that my pulling their clinic from Topeka and moving to Houston they actually improved their ability to provide excellent care to those in need--remaining in Topeka would eventually have forced them to close their doors and discontinue their research.

aeroscout17 8 years, 11 months ago

gphawk,

Yes that is what the drugs are for. They are however only part of some treatments; the rest requires more comprehensive measures that require hospital stays.

Unfortunately, with the current funding and bed availibility patients are often released prior than when they actually should be. The result is people who are not well and relying strictly on drugs to partially enable them to function.

I have first hand knowledge in this with one of my children.

gphawk89 8 years, 11 months ago

aero,

I agree. Hospital stays are sometimes necessary, expecially if the person is suicidal/homicidal. Most psychotropic drugs take a few days (or even a few weeks) to kick in, making short hospital stays a must. But the idea should be to let the drugs kick in and then get the person out of the hospital so they can get on with their lives. Roy just made it sound like he'd rather keep people in the hospital for longer periods of time instead of finding the correct drug to help them.

And if one drug is not working, or only partially working, the psychiatrist should try another. There are a variety of psychotropic drugs on the market for various mental ilnesses - some work better than others; it depends a lot on the individual patient and how their body/brain reacts to the drug. The idea should not be to make the pateint BETTER but to make them WELL again. It's just a matter of finding the right drug, or combination of drugs, and sometimes that can take a while.

And yes, bed availability is a big problem. Most of the remaining few wards here are completely full most of the time.

danah 8 years, 11 months ago

I agree with the message aeroscout added. I have been trying to get real therapy for my loved one to supplement the medication and unless I could drive hundreds of miles weekly, or arrange for pick up and delivery to a day program, we could not participate. Most of the care is dispensing medications only. I have asked repeatedly for support from the mental health facilities for other services that are not funded.

Also, the worst problem my family has experienced is when a person in my family with mental needs is critically ill they are treated "less than adaquately" by the hospital staff. If a family member was not available to provide one on one advocacy and companionship 24/7, the patient's hospital stay would be terminated. We desperately need a medical/psych unit at hospitals, staffed by those who have training in mental disorders and to help coordinate services for the "whole individual".

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