Proposed cuts to state mental health programs would hurt the most vulnerable

April 03, 2011

I felt just terrible Monday morning, March 24th, as I drove to work, listening to Linda Raines, executive director of the Mental Health Association of Maryland, and Lori Doyle, chief operating officer of Mosaic Community Services, Inc., on WYPR's Maryland Morning radio program talking about the proposed cuts to the mental health budget.

I have been a community psychiatrist for 20 years and have seen services to my patients shrink for the last 15 years, as the money to the Maryland Public Mental Health System has shrunk each year. Many people do no realized how common chronic mental illness is, that it affects approximately 2 percent of our population with a large proportion of these people disabled by their illness and treated in the Maryland Public Mental Health System. These people are a disenfranchised segment of society who cannot advocate for themselves. They depend on a web of supports to successfully live in the community, a goal that we as a society have agreed to pursue since deinstitutionalization became popularized in the late 1960s.

Yet, for these people to have a meaningful life in the community, high quality programs run by qualified staff are needed to provide these supports. As funding for community programs has shrunk over the years, my patients have missed programming that fostered their socialization and built relationships with one another. They have shown great resilience to the ongoing turnover in their care providers. I have noticed that staff at all levels, including residential aids, case managers, therapists and psychiatrists, last about two years before becoming burned out and moving to higher paying jobs with lower caseloads.

My heart breaks for my patients as they have so little choice in their lives over who are their providers, how much access they have to leisure activities, how they get to their needed medical appointments, and who will take them to the grocery store. I don't think the general public understands what it takes to help people with chronic mental illness have meaningful lives in the community. The selling of deinstitutionalization to the public seems to have been based a false promise — discharging people from expensive long term institutionalization only to provide them with what is in some ways a worse situation — to be in the community leading a life of loneliness, insecurity and impoverishment. Let us do better for the vulnerable population of chronically mentally ill of Maryland.

Elaine Weiner, Catonsville

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