Clinician's Digest

Clinician's Digest

Mental Health Systems Under Stress

By Rob Waters

January/February 2012

As the U.S. economy remains mired in the worst funk since the 1930s, public services for the country’s most vulnerable populations—children, the elderly, the mentally ill—are being cut or disappearing at a time when the need for them is greater than ever. Faced with gaping deficits, states have slashed $1.6 billion from mental health programs over the past four years, according to a report by the National Alliance on Mental Illness. Cuts to the Medicaid program, now being debated in Washington, may well worsen the situation.

In Detroit, the county mental health program has lost $30 million in state funding over the past three years, forcing numerous cuts to the agencies it supports. Detroit Central City Community Mental Health, which provides outpatient treatment and reentry programs for people leaving jails and psychiatric hospitals, lost a quarter of its funding and cut its staff by a third. Charlotte House, a transitional housing program for people with psychiatric disorders discharged from the county hospital, closed its doors.

California has cut mental health funding by $765 million, or 21 percent, since 2009. On December 1 of this year, 38,000 elderly residents—a quarter of them with dementia and almost half with mental health diagnoses—were slated to lose access to the health centers they depend on for daytime meals, therapy, and healthcare. This cut, being challenged in court, may force the closure of 300 centers that are intended to keep fragile…

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