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$11 million in cuts to mental health in PA has its consequences

Mental health facilities in western Pennsylvania are nearly extinct. Budget cuts over the past 30-40 years have forced state-run psychiatric hospitals to close their doors, leaving previous inhabitants to be dealt with by the law, for-profit companies, local hospitals, and outpatient caseworkers.

In the decades bookended by the 30s and 60s, state-run "mental hospitals," as they are commonly referred to, were prevalent, self-sustained micro-communities where the afflicted were able to thrive and even be cured of their mental illnesses in many cases. But as the economic culture of the country began to change in the 70s and early 80s, many of these facilities were closed when budget cuts began targeting what state officials felt were the least needed public services. 

Two of these hospitals, Dixmont and Mayview, were some of the best psychiatric hospitals in the state. That is until Dixmont closed in 1984 and many of its inhabitants were evaluated and decisions were made to either imprison, move, or release them upon their own recognizance. Some of those patients, Dixmont's most severely handicapped, were sent to Mayview State Hospital in South Fayette. Many of them flourished at the state-run facility, able to continue relative treatment and interact with likeminded individuals on a daily basis.

However, when the economy crashed in 2008, Mayview was closed and its guests were sent to jail, shipped off to a different state even further away from their families, or set free to take care of themselves. If they were lucky, some became part of a group home setting that provided minimal stability. But as most semi-state-funded for-profit "public" services go, workers are underpaid and undertrained, supervision is not considered nearly as important as it once was, and the health of many mentally ill patients in group home has begun to deplete quite fast.

Last fiscal year, the state made even more cuts to programs and businesses that have been put into place to help and maintain the mentally ill. Thus, the deinstitutionalization of many continues. From 2005 to 2008, over 300 people were moved out of Mayview, each given separate fates, and it is the common assumption that many are in poor shape, if not dead, five years later.

Experts in the field say that one in every four Americans suffers from some sort of mental illness and that one in every 17 has a condition that can be considered serious, such as paranoid-schizophrenia. Lawrence County executive director of the Human Services Center, Dennis Nebel, says that "this is a system of care under siege." In charge of operating home and treatment programs for the mentally ill, Nebel has been forced to watch his budget get cut almost every year, without exception, regardless of the growing demand of his services.

The entire country faces the same issues as Western PA and we hear more and more about the mentally ill involved in mass shootings, murder-suicides, and other deplorable crimes; however, the state and federal governments continue to cut budget monies for psychiatric hospitals and facilities. Some say that psychiatry itself is a dying field and that there simply aren't enough out there to deal with the pertinent psychological issues these people face on a day-to-day basis. In addition, it is difficult to find group housing for people with mental illnesses anymore, especially for patients who come from poor families or have a criminal background. The criminal justice system has put into place diversionary programs that are set up to slow the amount of mentally ill who have committed crimes worthy of jail time due to overpopulated prisons. And what is probably the most telling sign that the state must reinvent state-funded facilities, is that experienced mental health professionals and doctors admittedly struggle to care for the kinds of patients for which places like Mayview and Dixmont were built. Many of these professionals have even petitioned for smaller state-run hospitals or giant regional facilities that could house over a thousand patients at a time and specialize in those who are deemed incurable or especially violent.

Instead, however, the state decided to cut almost $11 million from basic mental health funding. This is the most devastating cut in the state's history and it begs the question: if we are appalled by the influx of mentally ill found to be committing serious crimes like mass murder and rape, then why continue to cut the budget? 

Source: Pittsburgh Post-Gazette, "Pittsburgh region's mental health system under siege" 22 September 2013

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