Missouri View: Crisis at hand in mental health

The News-Press front page has sounded the alarms for months: “Mental health patients increase” ... “Cuts force mental health changes” ... “A perfect storm.”

Now, as Missouri lawmakers brace for two more years of extremely tight finances, that coming storm has arrived. It is causing real harm to the system and the people needing services. And the worst may be yet to come.

As reporters Alonzo Weston and Jennifer Gordon have recounted:

More than $100 million in state cuts to mental health over the last three years has led to downsizing of programs, closings of psychiatric hospitals and emergency facilities, and rationing of care dependent on who is the greatest threat to themselves and others.

Heartland Medical Center’s facilities are swamped, with its 44 inpatient psychiatric beds typically full. That frequently results in mental health patients taking up beds intended for other patients or holding mentally ill patients in a crowded emergency room until a bed opens up somewhere — sometimes, as far away as Columbia.

Some mental health patients have had to cut back on needed follow-up treatment because of Medicaid’s low reimbursement for psychiatric care. There also is a shortage of psychiatrists, psychologists, social workers and other mental health service providers. Without a regular provider, these patients often end up in Heartland’s ER when they are in crisis.

Our helping agencies — Family Guidance for Behavioral Healthcare, the Social Welfare Board, Northwest Health Services, The Center — collectively are seeing hundreds, if not thousands, of patients without the money or insurance to pay for needed care and medications.

Solutions start with recognition of how serious these problems have become. St. Joseph’s legislative delegation would be wise to invite our local mental health providers to provide a detailed accounting of their challenges — and of their best thoughts for how to stretch the available state dollars.

Among our top concerns: The state must get out of the crisis mode that consumes too much money providing emergency services, when dollars spent on preventative care would improve more lives at a lower cost.

Every issue that comes before the General Assembly has a built-in constituency and lobbyists to represent it. But we’re convinced our mental health patients are best served by informed and passionate advocates from our own legislative delegation — people elected to serve all of our residents, especially those who cannot advocate for themselves.

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