Triggered partly by the debate over gun control, the nation’s broken mental health system is getting overdue attention. But the stigma that still accompanies mental illness makes it much harder for mentally ill people and their families to acknowledge problems and get help. Reducing that stigma so that people can get treated early is even more important as community resources dwindle.
Most state psychiatric hospitals have closed over the past four decades, often with little planning. New psychotropic drugs promised more enlightened and humane care in the community, at far less cost.
But governments never fulfilled their commitment to fund community mental health care adequately. “Deinstitutionalization” remains a misleading euphemism for shifting mentally ill patients from one kind of institution to another: from psychiatric hospitals to county jails and state prisons.
At least 25 percent of inmates in state prisons and county jails are seriously mentally ill. An even greater share of homeless people have mental-health problems.
Ohio’s Mental Health Act of 1988 provided a national model for shifting funds from state hospitals to lower-cost and more-effective community agencies. But between 2009 and 2012, Ohio cut more than $90 million from mental health services, creating gaping holes in the system. The Lucas County Mental Health and Recovery Services Board lost about $4.1 million in state and federal funds.
Mental health needs did not diminish. The county’s 21-agency community mental health system provides mental health and substance addiction treatment to about 25,000 people a year, a much higher number than a few years ago.
Nowhere is the need for mental health care greater than in urban areas such as Toledo. Concentrated poverty aggravates the problems of mentally ill people, who often lack transportation and adequate housing, while suffering from poor general health. Many poor people with serious mental disorders such as schizophrenia go undiagnosed for decades.
An encouraging sign was this week’s first African-American Forum on Mental Health Awareness at First Alliance Church. The forum, “Breaking the Silence on Mental Illness in the African-American Community,” included people with personal experience with mental illness. They told their stories so others would better understand mental health issues, as well as the benefits of treatment.
The forum also focused on how young African-American men with mental health problems are often punished instead of treated. It underscored the importance of trained police officers.
Unfortunately, police officers — instead of social workers — have become first responders to mentally ill people. Without trained cops who know the mental health resources in their communities, random stops and minor offenses can turn into prison or jail sentences.
An estimated 6 percent of Americans are severely mentally ill, according to the National Institute of Mental Health. A far greater number suffer a mental disorder at some time in their life. Improving the mental health system here and around the country includes alleviating the stigma that keeps people from getting help.