More States Paying the Price of Cuts

One of the sadly recurring, and enduring themes of so-called “mental health reform” in this country,  is the inevitability of a number of problems as state hospital beds are foolishly cut in this country and staff positions are cut as well.

They include: 1) a rise in staff assaults; 2) poorer and likely below JCAHO standards of care and supervision of very disturbed and at times violent patients on wards; 3) the absurdity of INCREASING costs in states hospitals as staff, thinly spread have to work more overtime to cover understaffed wards and hospitals, and, 4) the increasing danger to which psychiatric hospital workers are exposed to needlessly. As an aside, the dangerousness of inpatient psychiatric staff work, ranks right up there with the injury rates of roofers, loggers and underground miners, some of the most dangerous jobs nationally. (Open disclaimer, my father was a mining engineer and I know of what I speak from personal experience…).

In a Nov 23rd article recently entitled, “Despite reports of violence,n new staff state hospitals in Rick Scott’s budget,” The governor of Florida has exemplified the adverse funding trends at the state levels in a number of frankly anti-mental health funding initiatives or lack thereof.

This article was from the Tampa Bay Times newspaper which has been publishing for quite some time now, a series of articles detailing the stark state of state hospital inpatient care in Florida’s system. In a telling quote, the article states: “In his annual budge request to the state Legislature, released Monday, the governor doesn’t provide for any new workers in the state hospital where one employee can supervise as many as 15 mentally ill people.” In my humble opinion that is clearly grossly inadequate, below any decent standard of care. So I ask, where is the Joint Commission for the Accreditation for Hospital Organizations? Where is the federal government and Department of Justice? Much as i hate to invoke the need for such heavy handed outside intervention, it is intentionally legislative neglected situations like this by huge entities such as states that will not answer to anything else other than federal lawsuits and such, this sounds like an “appropriate” field for federal judicial oversight akin to the voting rights takeovers by the feds in the Civil Rights era. And those are “fightin’ works” in the South.

The article goes on the state unequivocally that in their series their “reporting showed an crease in violence corresponding with more than $100 million in budget cuts over the last five years.”

Instead of funding for staff, which is more expensive, the not so wise, cut corners to look good governor, opted to call “for $1.3 million for new security cameras and $350,000 alarms for staff work with patients, ‘to increase the safety of staff and health of residents at state-run mental health treatment facilities. The lack of radios and alarms is among the problems identified by reporters.'”

I find this state of affairs nothing short of appalling. At the state hospital I work at, all this stuff, the protective gizmos of alarms that ALL staff wear, and many many stragetically placed CCTC monitors is STANDARD stuff and has been for YEARS. I cannot conceive of a system and its governing bodies and officers exposing hard working inpatient psychiatric hospital staff to such dangers and inadequate protections. “Governor Gizmo” will be my new appellation for Gov. Rick Scott of Florida. I wonder how he will handle a coming, almost inevitable tragedy involving the life and/or health of an inpatient psychiatric staffer at any level to a grievious injury. Will he acknowledge the obvious cause? I doubt it.




Author: Frank

I am a older child, adult, geriatric teaching psychiatrist with over 30 years' practice experience in North Carolina, first at Duke as clnical teaching faculty, then in Western NC as a primary child psychiatry specialist. I have taught and supervised child psychiatrists and psychiatrists in training and many other mental health professionals and taught at two medical schools. I have served in many public and private practice settings. My primary interest is in observing and documenting the ongoing mental health reform efforts in the State of North Carolina and documenting its sucessess and failures at all levels. My favorite pastime among many others is spoofing my friends and kids with my deadpan sense of humor.

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