Wednesday, July 18, 2012

Mental Health Care In Louisiana...or a lack thereof

I've managed to not get political on this blog for the most part since I started it in January of 2007. And I plan on going right back to not spreading my political views all over the internets after this. For the most part, I keep my politics to myself, unless I'm talking to other people who are like minded and I know that. The reason is, I have made friends all over the world through this blog over the five and a half years I've been blogging and I am SURE that some of those friends have very different political views from me. And I don't even mind talking politics with people, but I know it can turn into a quick ugly debate on a public forum like a public blog when a lot of people start to throw their opinions in one place. So I keep it off the blog for the most part to stop the temperatures from rising and to hopefully keep the peace.

But today I learned something that I just think needs to be common knowledge. I really thought about this and I thought to myself that I really can't imagine how democrats, republicans or anyone in between would find this to be a good idea. Now I'll preface this by saying that I'm not a fan of our governor here in Louisiana, Bobby Jindall. I just don't like the man and I have no problem saying that. Regardless of what political party he is a part of, he's made some awful decisions and the one he's made most recently truly broke my heart. He's basically cut all public mental health care in Louisiana. Sure there is some mental health options available but let me tell you about them.

This is how the mental health system works in Louisiana. I work at a private psychiatric hospital. We are one of a very small handful of private psychiatric hospitals here (as in 2 or 3 in the state). We are not funded by the state and mostly take patients who either have private insurance or pay privately. I hate working for a private facility sometimes because it runs very much as a business and wants to make money and does all it can to not take people who can't pay for services, but that's how the private sector works.

Let's say, three years ago, we had a number of public sector services for patients with mental health issues. After Hurricane Katrina, we lost a lot of services, but we did still have quite a few inpatient beds throughout the state connected to the LSU healthcare system which has operated as our charity system, we had outpatient detox services for substance abuse, we had an inpatient hospital for children and adolescents with over 100 beds, and two state psychiatric hospitals with hundreds of beds in addition to outpatient mental health clinics in each parish.

Governor Jindall has slowly cut all of that. A couple of years ago, he started by closing the child and adolescent hospital with 100+ beds. He followed that with closing the detox program last year and then laid off numerous employees of the mental health system closing basically all of our inpatient charity beds in the state. What we had left as far as state funded beds were the two state psychiatric hospitals. Today, I found out that Bobby Jindall is now closing Southeast Louisiana State Hospital here in Mandeville which is the largest state funded mental health hospital in southern Louisiana. Actually, the only in southern Louisiana. We now have one left in central Louisiana and it's basically a hospital for those with chronic mental illness.

So what we're left with now in Louisiana is a really HIGH need for mental health services, patients who need care, and nowhere for them to go. There is our hospital which is a private hospital, another private psychiatric hospital, and then a few medical hospitals that have very small psychiatric floors/units (which are also not state funded.) I can tell you now what's going to happen. Of course as a private hospital, if a patient walks in and is suicidal, we cannot and would not turn that patient down even if they didn't have insurance. So the private hospitals will start taking in patients with no insurance now. The corporations who own these private hospitals will see that they're no longer profitable hospitals and will pull out of Louisiana. It's a simple business model problem.

I already talk with patients EVERY DAY who come in saying that they're feeling suicidal because they can't get on their medication. When I ask them why they can't get medication they say it's because the mental health clinics have a EIGHT MONTH WAITING LIST right now to see patients!!! Who do you know who is depressed/bipolar/schizophrenic/has anxiety can go or should go 8 months without medication? NO ONE!! And that's Jindall's plan. He says that services should be moved away from an inpatient care setting and should be instead focused on giving preventative outpatient care. THAT'S NOT HAPPENING!! AND you'll never stop some people from becoming suicidal/homicidal/psychotic even if they are on their meds. Life happens. We need those inpatient beds!!

So we have this circle of "I feel suicidal and depressed"...."you need to be on medication"..."there's a 9 month wait for me to get on medication"...."then we need to get you inpatient right now to keep you safe and stabilize you"...."there are no inpatient beds available"....See what the conclusion to that problem is? It's not going to be nice!

And to add insult to injury, Jindall has cut medicaid funding to mental health hospitals by 3% along with these bed cuts as well. As a private hospital, we have just started to take medicaid which we didn't before because of it's poor funding, so that we could relieve some of that stress to the Louisiana mental health system. Right after we start taking it, Jindall announces that he will cut the amount that mental health hospital treatment will be paid by medicaid. I don't know what he has against the mental health system, but it truly disgusts me.

He also cut funding to libraries last month closing many libraries in many small towns throughout Louisiana but that's a WHOLE different post and I won't go into that now. I should however mention that we are one of the states with the HIGHEST number of state employees who have a car paid for by the state! We also have one of the highest tourism rates, big casinos, and lots of tax money coming in, so why is our mental health system basically completely failing, our schools completely failing, our streets basically undriveable, our coasts eroding? What ARE we spending money on exactly? Where is that money going?

I'm going to end this and get off of my high horse now, but today I was actually scared by our governor. I don't often get scared by politics. Angry? Yes. Befuddled? Yes. But scared by a politician? I did though. And there has been talk of him possibly being on Romney's ticket as VP and I just thought it's important that people know how Bobby Jindall has treated our state. Not very well. Unless you're in the upper echelon and in Louisiana, unfortunately that's not very many of us. /rant


DesLily said...

ALL politics scare the "chit" outta me!.. I don't write politics either, everyone has the right to their own opinions.

Amanda said...

Wow. I think you're right - this goes beyond party lines. I don't understand the point of this sort of thing? Why cut that funding? Why actively prevent people from getting help? Healthy people are more productive people! And so on. I could go on, but yeah, I just agree with you 100% Chris.

Daphne said...

I too work in mental health and it's always a battle to make sure that those that need the care, get it. I sympathize with you -- if you're setting up new systems of care, then those systems need to work the entire way through, you will have what happened in CA: hundreds of people with severe mental illness sent out to the "community" where there were not enough services available for them. Thus, so many people with terrible mental illness symptoms, homeless and hopeless with no help, and a society that says, "Get the homeless off the streets" but doesn't want to pay to get them well again.

Debi said...


Jenny said...

I used to work in a mental-health adjacent field, and I saw how terrible these problems were just after Katrina and how the situation deteriorated in the years that followed. Jindal is the absolute damn worst. When he was in charge of Louisiana's vaccination program he dragged us from something like 6th in the nation to, I believe, 49th. He's incompetent, and every move he makes is for political effect because he thinks he has a shot someday at being a viable national candidate and he doesn't want anyone ever to be able to say he put funding into social programs. Of course never mind the needs of the actual residents of the actual state he's meant to be leading.

UGH forgive the rant. I just hate that guy. He's messing up everything. LSU just broke into the top tier in the university rankings and Jindal's taking their legs out from under them. Because of course he is. Because why invest in education? That doesn't help anyone.

Vasilly said...

I am pissed off and heartbroken over this! What the hell is Jindal thinking about?! How are people supposed to get the help that they need to be productive in their lives without affordable mental heath care? Having a great mental health system helps not only the patients who need it but their families, their communities, and Louisiana. I really don't understand the logic of some of these politicians.

Snowball said...

My heart breaks for Louisiana. Her people have been through so much.

These days everyone needs to be political - in self defense. It seems like across the entire country, the most vulnerable are being thrown to the wolves.

There is much more to be said, but this is not the forum. (I tend to get riled up)

csmith said...

I work at Southeast on the DNP unit which is a adolescent unit for kids who have a duel diagnosis. This program is the only one like it in the state. Its basically a last chance for these kids who would otherwise be on the street murdering, stealing, abusing others in society. All have failed multiple psychiatric hospitalizations and outpatient treatment. There is a waiting list. The program makes money. The staff is exceptional and often gets hurt. But these kids learn over the course of a few years how to trust adults. love themselves, and respect others. Staff is their family as most come from horrific home situations. Many were sexually and physically abused. The 20 beds allotted for DNP is in the 50 children's beds going to "private" facilities in NO. Essentially no more DNP! Also these kids go to special school district on hospital grounds. There is also a substance abuse inpatient treatment center as well as 5 group homes and a Methodist home for children. All will end with the closure of Southeast. Never mind that DNP is court ordered to be open. Never mind that Southeast operates in the black EVERY year and the money it makes goes into the state general fund! You probably also heard the state has wanted to sell this prime realesate land for years. The timber alone is worth a fortune (over 1000 acres here). They will trade mental health services, lay off about 1000 employees (not 300) for a freakin shopping center!!! I'm glad I believe in Karma!

Bookfool said...

I don't know what to say. What a horror. You have good reason to be upset and thanks for the warning about Jindall.

Kristina said...

Let me just say that I'm proud of you =) When I first read "I've managed to not get political on this blog..." I thought oh no this is gonna be ugly. However, that was the most clean, most informative rant I've ever read! Thank you by the way, for informing us about something we might not have known about by not living there. What a sad sad story. If we are talking about cutting funding, I'm pretty sure this is the last area that should happen in. I love your posts Chris!