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Sun Feb 19, 2012, 01:53 PM

Alabama will shut down most of its mental health hospitals by early 2013.

ATLANTA — Alabama will shut down most of its mental health hospitals by the spring of 2013 in a sweeping plan to cut costs and change how the state’s psychiatric patients receive treatment, state officials announced on Wednesday.
The decision to close four hospitals and lay off 948 employees is a bleak reminder of Alabama’s shrinking budget. But it is also the latest example in a longstanding national effort among states to relocate mentally ill patients from government hospitals to small group homes and private hospitals.

Mental health advocates believe patients often get better care in smaller, less isolating facilities. Since the 1990s, Alabama has closed 10 other mental health treatment centers.

“What’s unusual is how many hospitals in Alabama are being closed so fast,” said Bob Carolla, a spokesman for the National Alliance on Mental Illness. “The trend has been to downsize much more gradually.”

http://www.nytimes.com/2012/02/17/us/alabama-plans-to-shut-most-mental-hospitals.html?_r=1&ref=health

Sadly, the Community Mental Health centers which are expected to to handle the patients, are also facing budget cuts.

Exact scenario happened in the 70's, when many state hospitals were closed, and patients ended up with few resources.

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Reply Alabama will shut down most of its mental health hospitals by early 2013. (Original post)
dixiegrrrrl Feb 2012 OP
TheMastersNemesis Feb 2012 #1
FarPoint Feb 2012 #12
Auntie Bush Feb 2012 #2
liberal N proud Feb 2012 #6
Ratty Feb 2012 #10
FarPoint Feb 2012 #13
elleng Feb 2012 #3
stockholmer Feb 2012 #4
eppur_se_muova Feb 2012 #5
xxqqqzme Feb 2012 #7
pinto Feb 2012 #8
dixiegrrrrl Feb 2012 #11
pinto Feb 2012 #14
xfundy Feb 2012 #9
madrchsod Feb 2012 #15
dixiegrrrrl Feb 2012 #17
madrchsod Feb 2012 #18
dixiegrrrrl Feb 2012 #19
meanit Feb 2012 #16
jis6255xe Feb 2012 #20

Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 01:56 PM

1. Send Them To The Churches

Just send them to the churches so they can be prayed over. That is what "faith based" health care is all about. Maybe we can exorcise them of their demons. Sprinkle a little holy water on them.

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Response to TheMastersNemesis (Reply #1)

Sun Feb 19, 2012, 02:57 PM

12. I like that idea.

No, it's not for clinical management but to place the problem at the feet of it's owners.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 02:08 PM

2. Too many of those patients ended up in JAIL!

They were unable to make good decisions and consequently broke rules and ended up in prison for years and years. Not the way to treat sick people...but they are Rethugs and don't give a damn for the unfortunate or sick...how I hate them!

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Response to Auntie Bush (Reply #2)

Sun Feb 19, 2012, 02:15 PM

6. Or just living in the streets

Begging for every bite the get.

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Response to liberal N proud (Reply #6)

Sun Feb 19, 2012, 02:36 PM

10. Not in Alabama

They'll just bus 'em off to the blue states.

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Response to Auntie Bush (Reply #2)

Sun Feb 19, 2012, 02:59 PM

13. Exactly.

Jails are the largest provider of mental health services in American.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 02:08 PM

3. Right, Been there, Done that.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 02:09 PM

4. If the 'States are the laboratories of democracy', then the southern ones are run by Mengele's ghost

 




Yet another example of the grinding, relentless national suicide of America, all done with unflagging resolve and a 'gospel of wealth' chorus.

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Response to stockholmer (Reply #4)

Sun Feb 19, 2012, 02:14 PM

5. Actually, I think we're living in a Petri dish ...

and the pathogens are in charge.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 02:18 PM

7. Is there a competition to see

which state is 50th in all categories? Ron Paul's libertarian utopia is under construction in Alabama & Mississippi.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 02:19 PM

8. The financial squeeze on Community Mental Health centers is a problem nationwide.

While larger, in-patient facilities are being phased out, community-based outpatient care centers provide effective treatment in many cases.

Strictly a layman's point of view, yet I've a brother who's accessed care, both in-patient and out-patient. In his situation, consistent out-patient care and his participation in his care has precluded the need for in-patient treatment.

What's really troubling about any decline in community based mental health care is that it leads to the *least effective* alternative - access to care via incarceration in city and county jails.

That sort of short term, crisis oriented approach rarely benefits anyone, the community or the person with a chronic mental health condition. I see the need in "harm to self or others" situations, yet again, many of those instances can be precluded by on-going, effective out-patient care.

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Response to pinto (Reply #8)

Sun Feb 19, 2012, 02:45 PM

11. From my years of experience in Mental Health

I know how this is going to end.
Badly.

The county/city jail Mental Health program consists of calling out a crisis worker to determine if the jailee is
"really crazy or jus faking it".
In the event the person is "really crazy" there are few options, other than hospitalization.
In the case of danger to self and others, there will be zero options, no more 72 hour holds.
the jails will end up being the "holding/observation" sites.
Hell, back in the 1990's, when we DID have the option of placing a 72 hour hold,
our Mental Health center bosses were strongly encouraging us to not use a hold,
because of the charge back to the center for every patient we sent to the state hospital.
Yep..the local Mental Health center got dinged money for every admission, even for 72 hours.
So people who needed to be confined, for their own safety, were often left to remain in the community,
until they acted out, someone called the cops, and in many instances, the cops opened fire on the poor patient.
I am not exaggerating this.
The local cops were truly terrified of people who were acting out. Saw that, a lot.

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Response to dixiegrrrrl (Reply #11)

Sun Feb 19, 2012, 03:13 PM

14. We still have a small, county in-patient unit for 72-hour holds here.

And the hold is still used when needed. Yet, as you say, assessment is erratic depending on the situation.

I think the systemic problem is consistency and coordination among the different agencies apt to be involved. And coordination with longer term care and treatment.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 02:30 PM

9. And they'll go to for-profit jails

where most repug "leaders" belong.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 03:18 PM

15. i have extensive knowledge of community based facilities

some are very good and some are very bad. major factors in this is how much money the state is willing to spend on private for profit faculties. can these private for profit companies pay a decent wage to attract quality employees. is the state willing to monitor and fine these companies for violating the rights of the clients and or covering up such violations.

i have a funny feeling that alabama will fail those in need and the families who love them.

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Response to madrchsod (Reply #15)

Sun Feb 19, 2012, 04:12 PM

17. I will say that we did get frequent oversight from the state certification agency

and one of my jobs was Quality Control manager in 2 agencies. Site visits by the state were pretty thorough, actually.
But, they only inspect the programs being offered, and the programs that are needed are being defunded.

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Response to dixiegrrrrl (Reply #17)

Sun Feb 19, 2012, 05:01 PM

18. my wife works for a for profit..

she`s the unions quality/safety chairman. the agency she works for is one of the best in the state but there`s always need for improvement. right now in illinois we are facing the same problem as alabama..our democratic governor wants to close several mental/psychically disabled facilities and several prisons. needless to say the unions are fighting this action.

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Response to madrchsod (Reply #18)

Sun Feb 19, 2012, 06:53 PM

19. I am so glad you have unions there.

Down here, not so much.

Yep, they are balancing the budget on the backs of the poor and defenseless, a trite but true pattern.

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Response to dixiegrrrrl (Original post)

Sun Feb 19, 2012, 03:50 PM

16. If you can pay for it

some for profit hospitals and programs will provide excellent care. But privatizing care for those who have limited or no ability to pay often means substandard care in poorly run facilities. And don't look for "state oversight" of these places to amount to anything. The politicians who make this outsourcing possible will surely appoint likeminded cronies to issue glowing reports on "how well things are now working with the privatized system."
This nonsense of saying that private, for profit companies can do it better and cheaper is an absolute crock of shit.

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Response to dixiegrrrrl (Original post)

Tue Feb 21, 2012, 09:51 PM

20. nvm

 

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