Sunday, March 15, 2009

The NAMI Mental Health Report Card: Grading the States 2009

The National Alliance on Mentally Ill Mental Illness came out with their report card on how each state is taking care of mental health issues. The national average is a big, fat D. As the kids would say, "epic FAIL!".

Only 6 states scored a B (sorry, no A's): Connecticut, Maine, Maryland, Massachusetts, New York, and Oklahoma. Nice to see in Maryland we moved from a C in 2006 to a B.

What prevents us (all states) from doing better?


Anonymous said...

Thank you for posting this.

FYI - The actual name of the organization is National Alliance on Mental Illness.

Would you mind editing your post to reflect that?


Midwife with a Knife said...

We have a mental health care system?

Anonymous said...

Eh, frankly, I'd put CA as higher than NY for parity reasons alone.

/2 cents.

Sarebear said...

Money, lobbyists, it's not a "sexy" topic, it doesn't have a bunch of cute kids dying of it (well actually . . .) but what I mean by that is image problem/perception/stigma etc., etc.

Oh, apparently, accordant to some recent survey/study, something, Utah is the "happiest" state.

I forget what show I was watching, it was a national one . . . but they were like what's with Utah and Wyoming etc. being way up there, must be the gorgeous country and wide variety of outdoor activities, etc. . . .

Or something.

Going to go see some of said gorgeous countryside in June, I love me that red rock country! Zion National Park, been there before, should be good for my soul, and hopefully I won't feel like a total gimp.

Mike said...

There should be a unified system of health care in general.

An American in Alabama should have access to the same level of care as someone in New York.

It's not the case though.

And I'm pretty sure Utah has a one of the highest levels of depression in the country.,5143,695231614,00.html

Sarebear said...

But uh, yeah, Utah definitely deserves that D.

There was a time when I had turned to every resource I could think of, and I turned to the county mental health system, that had helped me some 8 years before around the time of my suicide attempt, but this time when I had turned to them, the psychologist who talked to me over the phone, eventually told me that, yeah, while I definitely needed help, the feds had cut funding by I forget how many million and the state had only made up a small portion of it, since last I had utilized the county mental health system, which is basically the state's mental health system, and that unless I had certain sources of funding (whatever that meant, he did not say, but I presumed it meant Medicaid or Medicare), I COULD NOT BE SEEN at a county mental health facilty or provider.

I was dumbfounded and completely speechless; to get across to you how I felt in those moments when I felt completely and UTTERLY ABANDONED by society, completely USELESS and UNHELPABLE, completely without HOPE of getting any kind of help, guidance, counseling, therapy, treatment, prescription supervision, ANYTHING . . . . . . that there was NO PLACE left to turn, to go . . . and I quietly thanked him for his time and compassion, and I knew he could hear it in my voice as I could not hide the quaver of the tears that were to burst as I laid the phone back down in the cradle, as I heard his frustrated and heartfelt farewell to me as well.

I then had one of the deepest sobbing sessions I can remember.

There's nothing like it, being turned away from your last hope like that.

There are days, even now, that I wonder how tenuous is the grasp that I have on the access to the help I'm getting? Things are alarmingly piling deep expense-wise in ways that are complicated and not necessarily deductible-meeting either . . .

Sarebear said...

Mike, that wouldn't surprise me. In the LDS church, there's alot of social/cultural pressure on women in various areas that many take to think that they are supposed to be perfect (they/we aren't) as well as much is expected of the men, as well, the holders of the priesthood.

But there's what's required, and then there's social/cultural pressure, and I think too many don't separate the reliqious/spiritual from the social/cultural pressure to perform, be the Molly Mormon, or whatever.

So yeah, that makes sense to me, and I know the state averages roughly 50% LDS/non-LDS I believe. Not that depression is exclusive . . . .

(Polygamists are NOT LDS/Mormons;LDS/Mormons are NOT polygamists, just to make that clear - all the press lately around a certain tv show, I had to add that.)

Retriever said...

Stigma limits advocacy. The main one is that patients who are trying to pass as normal, to hold onto jobs or not embarass their children, can't lobby politicians, educate peers at work or at church, because, if they have a family to support, they can't risk outting themself.

We have a kid who is autistic and bipolar. High functioning but spent nearly a year when 8 psychotic, manic, a danger to himself and others, with no meds working at all for him. My husband was laid off from a job because his company would have had their insurance rates doubled if they continued to keep him on the payroll and insured, because of our kid's diagnoses. Mental health care is expensive.

People still judge mental illness, especially in kids. Social woworkers at least initially assume that the parents are abusing the kid. Neighbors and coworkers assume that the child is ill because of bad parenting. Parents would actually like to blame their own bad parenting because that is actually under one's control as, say, mania is not. They'd be happy if they could just go to a course to improve and Junior would stop seeing snakes and hearing voices.

People like cute, grateful pitiful victims to help. The reality is that people pass the hat to collect money for a piteously bald kid with leukemia and his family, but nobody ever passes the hat for a psychotic eight year old whom the hospital will not admit because (I quote) "your insurance will only pay us 60 per cent as their reasonable and customary charge, but DCF pays 100 percent. " Hence the kiddie psych unit having 95 per cent DCF kids.

Increasingly the move is towards care "in the community" and to closing public facilities like the state hospital that saved my kid's life (when manic and psychotic) because it would actually admit him and keep him there long enough til he was no longer a menace to himself. Where I live (one of the richest communities in the country) none of the private clinicians are willing to treat severely mentally ill children, so one is sent to a child guidance clinic which limits the care and usually provides it with cheap, relatively new social workers who can barely spell the name of the diagnosed condition let alone have any expertise in it.

And my state got a B.

I do what I can in our church, to educate the SS teachers about how to work with our many kids with various mental health issues (we are the most hospitable in the area to them, and bend over backwards to include them, provide one on one shadows, and make equal demands of them so that they are not marginalized--this approach was what most helped my kid). And I talk with parents of the newly diagnosed kids, and badger them to take the various special ed courses on how to do battle with the school system.

But it's a drop in the bucket. You can't talk openly about the truly appalling behaviors of your beloved kid, or people would never feel comfortable around them. You can't tell people why it makes you yourself hideously depressed. You dread any phone call from the school lest it be the dear sweet Buddhist teacher telling you that Junior (hypomanic despite meds tweaking) just told him to STFU.

Most of all you can't testify publically, or write except anonymously or lobby or preach (I am a former minister) for real parity, and greater compassion for these reasons (to recap):

The ill child (and their siblings) are entitled to anonymity. I am uncomfortable with all the mommies writing first person accounts with their real names. I wonder how their kids feel? It may be therapeutic to the mom, but could mortify and increase prejudice against the kids.

employers lay off people with high insurance costs, tho they do not admit it. Sometimes, if one is a valued worker (as I have been), the employer will look the other way. But in cost cutting times, if one advocates publicly, the bean-counters at HR will find a way to get one axed.

At least with pediatric psychiatry, the shrinks really don't know how bad it is or how much stress is on the family or the other kids caring for violent, manic, agitated kids at home. They don't care that spouses lose their jobs because of having to keep piciking up an agitated kid from school, or stay up all night with one and getting too many phone calls at work from MDs.

Community care is like all the " I want a pony" stuff back when people abolished the snake pits in the fond hope of lovey dovey community group homes, etc for the mentally ill. In reality people said NMBY, there weren't the funds, and it is actually harder to prevent abuse and bad care in group homes than in large institutions.

Excuse the rant, in my mother tiger mode tonight....