(June 27, 2014) In less than three years, Laura Pogliano spent $250,000 on psychiatric care for her 22-year-old son who has schizophrenia, a number that reflects both state and federal discrimination in laws that allow access to treatment for mental illness (“Mentally ill suffer in sick health system,” USA Today, June 26).
“Every parent I know has to fight for treatment for their child,” Pogliano told reporter Liz Szabo about how state laws prevent people with severe mental illness from accessing treatment. In Pogliano’s case, civil commitment laws kept her from getting her son into treatment when he started deteriorating psychiatrically. In Maryland, where she lives, mandatory inpatient treatment is only available to people who are deemed dangerous to themselves or others – leaving families like hers out in the cold.
“Many patients can only get help after they’ve become psychotic,” said Ron Manderscheid, executive director of the National Association of County Behavioral Health & Disability Development Directors.
When Pogliano's son did manage to meet the standard for treatment, doctors were sometimes unable to locate available psychiatric beds - forcing her into the more expensive private system.
Szabo attributes lack of psychiatric bed availability to discrimination at the federal level in the way that Medicaid and Medicare reimburse treatment of mental illness.
Medicaid funds may be used to treat physical health conditions, but they are more difficult to use for mental health treatment and Medicare limits the number of days people can get treatment for a mental illness in hospitals. “Without federal support, states haven’t been able to afford to keep their psychiatric hospitals open,” Szabo writes.
“By denying hospital care to the mentally ill, Congress has set two standards for health, effectively telling the country that the mentally ill are less deserving of a decent life than others,” Representative Tim Murphy told Szabo. Murphy has a bill that currently aims to help more people get access to inpatient care.
All of this means that people with mental illness wait nearly a decade after their symptoms first appear to get treatment, or like Pogliano, pay exorbitant amounts to get loved ones into care, according to Szabo. Ultimately, this denial of coverage results in many under-treated people who become so ill they often wind up homeless, in jail, or a risk to themselves or others.
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