The mental health catastrophe is coming

Here’s yet another story about the forthcoming disaster in mental health care that is about to be perpetuated by the Legislature. It starts with one of the best analogies I’ve seen:

Dr. Steven B. Schnee, executive director of the Mental Health Mental Retardation Authority of Harris County, offered up an extended metaphor one day recently to illustrate the consequences of what he considers catastrophic cuts in state funding for mental health services. Schnee is a licensed psychologist whose agency assists more than 45,000 county residents annually through a variety of community-based programs.

“It’s like saying, we’re short money — and we are short money – so we’re not going to put oil in our car. Or we’re just going to put a little bit of oil in the car,” he said, sitting in his fifth-floor office on the Southwest Freeway. “But when the engine blows up and we’re spending thousands of dollars on the engine – because now the car doesn’t work – we go ‘Oh, my goodness! What happened here?’ ”

The way I’ve been thinking about the approach being taken is to go back to the cliche of your household budget and note that there are some parts of it you just don’t cut in hard times unless there truly are no alternatives. For example, you don’t skip eating two days a week, and you don’t turn off your electricity every day at 5 PM, even though doing so would undoubtedly save you a few bucks. Dr. Schnee’s example works brilliantly as well.

If you’ve been paying any attention to this, you’re familiar with the story and the effects of the budget cuts that the Lege is about to visit on us. This particular anecdote was new to me, but it encapsulates the overall problem as well as anything I’ve seen:

Texas, which ranks 49th in per capita funding for mental health, has chosen not to fund community care and other measures that could help prevent men and women afflicted with an illness of the brain from ending up behind bars.

They are people like Tony Daugerty, 62, who was diagnosed 30 years ago with manic-depression and who has been in and out of jail at least 15 times in five years. For Daugerty and others, it’s easier to get arrested than it is to get treatment. Jail also is a more reliable provider of the treatment he needs.

Wearing a standard-issue orange jumpsuit, the balding, bespectacled man sat at a metal table in the jail’s mental health area recently and spoke about his decades-long battle with his illness. During his manic phases he stays up all night, night after night. “I design the solutions to all the world’s problems,” he said.

Daugerty was on probation last year when he boarded a Metro bus carrying a black canvas bag. When he told the driver, “Keep driving or I’m going to blow up the bus,” the driver called the police.

Daugerty is scheduled to be released next month, although the sheriff and members of his mental health unit, not to mention Daugerty himself, know they are likely to see him again.

“We do incredible work at stabilizing these folks,” [Sheriff Adrian] Garcia said, “but it’s a shame that we do the work that we do, at the price that we do it, just to have them go back out into the community and have them deteriorate again. They’ll be back in our facility. It’s a horrible revolving door when there’s a lack of capacity out in the community.”

We reap what we sow. And we’re about to sow a whole lot more.

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