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Thomas Insel is the Director of the National Institute of Mental Health
No question: this year’s big biomedical story was Ebola. Headlines, Sunday news shows, multiple Congressional hearings, a Presidential visit to NIH—autumn seemed to be all Ebola all the time. Thus far, the death count from Ebola has been one in the U.S. and over 6,000 in Africa. Less noticed, deaths from suicide in 2014 will probably surpass 40,000 in the U.S., roughly one every 13 minutes. According to a recent World Health Organization report , there are 800,000 suicides globally each year, with 75 percent of those deaths in low and middle income countries. For the week after the suicide of Robin Williams, the nation focused on this issue, but for 51 weeks this year, suicide remained the silent epidemic.
What were the mental health stories of note in 2014? As always, finding the top ten is both unfair and unsatisfying. But that will not keep me from trying. Read about the top 10 in mental health.
New Mexico Mental Health Services
Why can’t we get the help we need?
Las Cruces Sun-News Editorial: Changes should bring resolution to mental health, 11-15-2014
We’re hopeful that the recent resignation of state Human Services Secretary Sidonie Squier, along with the recent election of Hector Balderas as attorney general, will bring a quicker resolution to the ongoing investigation and state takeover of mental health service providers.
In the summer of 2013, the state Human Services Department froze Medicaid funding for 15 mental health agencies in New Mexico after an outside audit reported as much as $36 million in fraud or overbilling had taken place. La Frontera, an Arizona company, was contracted to take over management of many of the clinics where funding had been frozen, and the audit was turned over to the Attorney General’s Office for criminal investigation. . .
At a time when New Mexico was ranked dead last in the nation for childhood well-being, Squier too often turned a deaf ear to the problem. We hope her replacement does better. Read entire article here.
But the problems do not begin or end with Sidonie Squier’s resignation – John Harris must restaff and reopen the 5 West psychiatric unit at Memorial Medical Center!
John Harris, LifePoint CEO for Memorial Medical Center speaks to the Dona Ana County Commission
Wednesday, November 12, 2014
John Harris, the CEO of Memorial Medical Center has a problem. He just can’t find a doctor to staff the psychiatric unit (his words) called 5 West. He also says the psychiatric unit is open and staffed, but oddly they can’t admit patients to the unit. So what’s the big deal? MMC ships psychiatric cases that come in for emergency admitting to either Mesilla Valley or Peak Health hospitals, neither of which is qualified to offer any medical care that the patient may need in addition to psychiatric evaluation. The big deal is that LifePoint agreed with the county when it leased MMC to continue to operate the psychiatric unit. That means keeping it properly staffed, with an admitting psychiatrist available, and operating at all times. What a way to run a hospital! Click here to read the resulting Sun News article.
On Wednesday, November 12, 2014, John Harris, CEO of Memorial Medical Center (MMC is managed by LifePoint), spoke before the Dona Ana County Commission. The agenda called for Mr. Harris to speak on the controversy surrounding behavioral health issues at MMC. Specifically, the widespread understanding that its 5 West psychiatric unit was closed in October of this year. Mr. Harris was allocated 10 minutes to clarify the situation or misunderstanding, as Mr. Harris puts it.
It is telling that only 2 minutes of his allocated 10 minutes were spent actually discussing behavioral health and 5 West. He said categorically that 5 West was not closed and, in fact, stated later in his talk that it was open and fully staffed. However, he then said that the unit can’t take patients because there is no staff psychiatrist to admit them.
To reiterate, John Harris says 5 West is opened and staffed but is not taking patients. One of the county commissioners asked Mr. Harris to “define open,” at which point Mr. Harris launched into a whole host of disconnected excuses about why the unit is unable to operate.
First, there is a nationwide shortage of psychiatrists. He emphasized this for most of the 2 minutes he spent on the behavioral health issue. But MMC is “actively recruiting” for a psychiatrist. However, a website search for an open psychiatrist position on both LifePoint’s and MMC’s websites found no such job advertisement. When asked how the hospital is recruiting, Mr. Harris alluded to recruiting “agents.”
NAMI’s position is that LifePoint is using a backdoor approach to eliminate a unit that does not actively earn money. Public psychiatric units, are by definition, not big income earning facilities. It’s highly questionable when a hospital has to close a unit because it “can’t find a psychiatrist.” It certainly reflects questionable, not to say very poor, business management practices and sends a clear message that mental health is not important.
While Mr. Harris spent 2 minutes on MMC’s behavioral health position, he spent the rest of his allotted time, 8 minutes, extoling the strides MMC has made in beefing up their cancer, cardiac, and neonatal units (their website is now promoting their “Vein and Vascular Center”). It is worth mentioning these facts from the Centers for Disease Control:
How widespread is mental illness?
Mental illness results in more disability in developed countries than any other group of illnesses, including cancer and heart disease. In 2004, an estimated 25% of adult Americans reported having a mental illness within the previous year.
What is the economic effect of mental illness?
The economic cost of mental illness in the United States is substantial, about $300 billion in 2002.
It is time for Memorial Medical Center to step up and take responsibility for what they have done and take immediate steps to properly staff and maintain 5 West – that, Mr. Harris, means actually admitting and treating patients who are experiencing mental health crises. That does not mean offloading them onto private hospitals such as Peak Health or Mesilla Valley Hospital where they can’t receive medical treatment that may be associated with the patient’s mental health crisis.
More About New Mexico Mental Health Care
If you think the state’s service are adequate, watch this movie. If you think services are inadequate, watch this movie. Remember, many people who experience mental illness first exhibit problems in youth, just as they are entering their most productive years. Since many of these illnesses can be treated effectively enabling many people with those illness to lead happy and very productive lives with minimal support, why can’t New Mexico families find the resources they need to help their loved ones? We should ask why our government considers the mentally ill as a “throw-away” population.
Families and communities want to know how to prevent future tragedies resulting from mental illness, but these basic steps just make good sense in a compassionate community.
- Fill the gaps in our community mental health care systems. That includes the creation and promotion of crisis services and partnerships between mental health professionals and all first responders.
- Improve communications between mental health professionals, individuals receiving care, and their families. Mental health privacy is important, but health care privacy laws should not stand in the way of coordinated information and action in a crisis.
- Talk about it—within families as well as with teachers, clergy, students and community leaders. Encourage conversation about mental health, about what we are experiencing and what we can do to help. By doing so, we create and promote the space for open and honest dialogue that saves lives.”