Proposed TX legislation looks to divert mentally ill from prisons...compassionate cost savings?

[HereSince1628]

In the article below a R-state senator suggests that this diversion will reduce daily expenses on each of the diverted prisoners to $12 per day, a savings of $125 per day for each mentally ill prisoner diverted back to the street.

What's missing in this calculus?

How seriously mentally ill are these hundreds of people whose capacity to function in society has them cycling into prison once every 5 months or so? Frequent arrests (5 prison sentences is frequent, isn't it?) shows up on Global Functional Assessments (as in the FL mGFA m-GAF (R) - adapted in 2004 by the Florida DCF Functional Assessment Workgroup from the original M-GAF reported by S. Caldecott-Hazard & R.C.W. Hall, 1995) at the score of 50, the break-point for considering patient institutionalization. That level of function is characterized as indicative of "Serious Symptoms or Serious Impairment"

Can such problems REALLY be dealt with at a cost of $12 per day? An hour of therapy in most metropolitan areas is more than $100. Likewise low cost pharmaceuticals like generic SSRI antidepressants could run $44 per month.

Paint me skeptical, this sounds rather too good to be true.

I find it challenging to believe that a mentally ill adult with serious symptoms or impairments in function, who the senator characterizes as a person with a history of 5 incarcerations in 24 months, could come close to meeting all the constellation of psycho-social needs with a financial commitment equal to a couple hours of therapy and 30 pills.

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LEGISLATURE: Huffman announces legislation to create mental health jail diversion pilot program

http://www.yourhoustonnews.com/tomball/news/legislature-huffman-announces-legislation-to-create-mental-health-jail-diversion/article_723e8c60-8779-11e2-92d5-0019bb2963f4.html


AUSTIN — Sen. Joan Huffman, R-Houston, on Wednesday filed legislation to address the rise in the number of nonviolent people with mental illness in Texas jails.

Specifically, Senate Bill 1185 creates a pilot program to reduce recidivism of individuals with serious mental illness in the Harris County Jail, which is regarded as the state’s largest mental health facility. On any given day, 25 percent of the inmates receive psychotropic medication. Hundreds of inmates with mental problems cycled in and out of Harris County jail five or more times from 2011 to 2012.

“Keeping nonviolent people with mental health issues out of our jails is the fiscally and socially responsible thing to do,” said Huffman. “It costs around $137 per day to keep someone behind bars as opposed to $12 per day for community mental health services. The majority of these individuals in the Harris County Jail never received the services they needed—services that probably would have kept them out of jail in the first place.”

The multi-year pilot program is designed to substantially reduce recidivism by incorporating a comprehensive array of clinical and social support services—easy access to mental health care, chemical dependence services, rehabilitation, and residential housing opportunities. A major benefit of the program is that it takes advantage of Harris County best practices and piggybacks onto existing resources such as crisis intervention and response teams, along with jail-based mental health services.

“As a former prosecutor and judge, I’ve witnessed many stories of heartache involving families with mentally ill loved ones,” Huffman said. “It’s time we erased the stigma of mental illness. It is a medical problem that can be treated by proper care and medicine.”

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[Tobin S.]

1. Unfortunately, what a lot of people do not understand about severe mental illness

is that it costs a lot to treat, even if the patient is doing well. For a lot of people who suffer from mental illnesses, the meds don't necessarily take care of everything. Many people remain on social security disability payments and Medicaid even if they are in treatment. It's not like you're going to put all these guys out on the street, give them some meds, and it will make it all better. Most of them are probably not going to go from a full blown mental illness to perfect members of society with a prescription. A lot of those guys will end up on the street and crawl inside a bottle.

To give people who are not aware of the costs of treating a mental illness, I'll give you a brief overview of the costs of treating mine.

I'm doing well now days and I have been for the last ten years, but I'm still in treatment and it's because of that that I'm doing so well. I was hospitalized three times before I finally got the proper treatment: two 7 day stints and one 3 day stay. The cost of the seven day stays before my insurance was around $10,000 a piece. My share after coverage was $2000 each. It's probably safe to say that the cost of the 3 day stay was at least $4000 before insurance. Note: probably almost all of the people described in the article do not have insurance. After I finally started getting the proper treatment, I went to talk therapy for about a year, once every couple of weeks. That's all my insurance would cover. The therapist charged $100 per session (one hour) and my insurance only covered half the cost. For the last ten years I've been on three psychiatric medications. I have to go to a psychiatrist once every three months for check-ups and to get my scripts. That costs $85 before insurance for a 15 minute session. My share of that is $40, that's my co-pay whether I see the guy for 5 minutes or an hour. One of my medications recently went generic and the other two have been since I started treatment. But for about 9 years my medication cost me $100 a month after insurance, about $350 before coverage. In the months before the one med went generic, just the cost for that one drug went up to $700 a month before insurance coverage. Now that all my meds are generics, it still costs me $30 a month for them with insurance coverage, about $100 before coverage. And I must stress, most of the people in the article will have no insurance! They won't even have jobs. And as I said before, if these guys do manage to get treatment, it doesn't guarantee that they'll be able to fit back into society.

It's fine if you want to help these guys and keep them out of jail, but it's not going to be cheap if you truly are concerned about their well being, which I doubt Huffman is. She's just looking at ways to cut corners. One word: blowback.