Pubdate: Sun, 03 Nov 2002 Source: San Antonio Express-News (TX) Copyright: 2002 San Antonio Express-News Contact: http://www.mysanantonio.com/expressnews/ Details: http://www.mapinc.org/media/384 Author: Editorial Bookmark: http://www.mapinc.org/rehab.htm (Treatment) TEXANS MUST END 'INHUMAN' PRACTICES In a draft of a report released by state public health officials at a May 24 meeting, physician E. S. Cox noted that confinement of the mentally ill in jails is "barbarous, cruel, inhuman and heathenish." As the Associated Press reported, Cox and his colleagues, meeting in Galveston since May 12, urged the state "to make all haste in providing accommodations for them." If the words sound a bit archaic, there's good reason: That May meeting chaired by Dr. Cox took place in 1916. What's disturbing is that the good doctor's admonition is as pertinent today as it was 86 years ago, perhaps even more so. In 2002, in a state that spends less money per capita on public mental health services than 46 other states, jails and prisons remain the "warehouse" of only resort for many people with schizophrenia and other debilitating illnesses of the brain. In 2002, an estimated 16,000 to 24,000 Texans suffering from mental illnesses are behind bars. More languish behind bars, in fact, than are being treated in psychiatric hospitals. Most who are locked up are there not because they committed violent or serious crimes, but because this state has never implemented a comprehensive mental illness care and treatment system. Bexar County residents can be proud of an exemplary jail diversion program that Sheriff Ralph Lopez has implemented, a program designed to identify the mentally ill who end up in jail and try to direct them to more appropriate services. In Bexar County and across the state, however, those services often don't exist. Jail, a horrible place for the mentally ill to be, is all that's available. (Bexar County, by the way, receives less funding for mental health services than most urban and rural counties in Texas.) Far too many Texans can't find the care and treatment they need. Thousands are on waiting lists for essential services. In 2002, many people with serious mental illnesses - and family members trying to care for them - are still forced to tolerate an infuriating "revolving door" of repeated hospitalizations, abandonment to the streets and often incarceration for vagrancy, drug abuse, trespassing or disorderly conduct. Texas mental health advocates are adept at laying out for lawmakers what the state needs to do to "make all haste in providing accommodations" for the mentally ill. They tirelessly explain that Texas needs to make new-generation medications more readily available; strengthen jail-diversion programs like Bexar County's and open up more community-based options; fund programs that provide early treatment for at-risk children with mental illness; and maintain funding for the Texas Department of Mental Health Mental Retardation. They point out that state funding for mental health services, when adjusted for inflation, has declined 6 percent from 1981. They also are realists. They know that in 2003, the state will be $5 billion to $12 billion short of the money lawmakers need simply to meet current obligations. Every agency has been instructed to cut and not request more money. Agencies will have to engage in unseemly dogfights merely to hang on to current levels of funding. The advocates also know as Dr. E. F. Cox knew nearly a century ago that over the years Texas often has balanced its budget on the backs of those least able to fend for themselves. Here at the beginning of the 21st century, it's time for Texas to inaugurate a new tradition. Despite the budget difficulties, lawmakers should invest in smart, effective care and support services for Texans coping with mental illness. It's an investment guaranteed to pay dividends. - --- MAP posted-by: Derek