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Kadner: No state plan to treat mentally ill


From the Herald-News:


Kadner: No state plan to treat mentally ill

Phil Kadner 

January 23, 2012 8:50PM

Updated: January 24, 2012 5:15AM 


Illinois is once again planning to close the Tinley Park Mental Health Center.

This is the hospital that treats severely mentally ill people who don’t have health insurance or Medicaid. We’re talking about people who are potentially dangerous to themselves and others.

And the state doesn’t have a plan in place to treat those people once Tinley Park is closed.

Mental health officials for Illinois say a plan will be in place by the time Tinley Park closes in early July.

During a telephone conference call with the SouthtownStar editorial board last week, state officials basically said, “Trust us.”

Actually, they said the mentally ill will be better served than ever because the state is going to invest in community treatment programs, which are now “the thing” when it comes to treating the mentally ill. Many experts believe they are far more effective than institutional settings.

But Illinois really isn’t going to be investing a lot of money in community treatment programs.

The state spends about $20 million a year to keep the Tinley Park Mental Health Center running. It plans on spending $9.8 million of that money to shift the responsibility to community-based programs.

But wait a minute.

Many of the patients at Tinley Park are too ill to be treated in community settings. They need psychiatric treatment in a hospital.

Oh, yes, state officials said. That’s true. And the state will pay for that care in privately run hospitals.

So how much of the $9.8 million is going to be spent treating people in a hospital?

State officials haven’t decided. They’re working on that.

There’s a state law, the Community Services Act, that clearly says that whenever the state closes a state-operated center for the mentally ill or developmentally disabled, reduces the number of beds at such a facility or cuts staff, any savings realized “must be directed toward providing other services and supports.”

But that doesn’t mean a dollar-for-dollar switch, according to the state mental health officials.

When pressed on about what it does mean, they admitted that Illinois is in dire financial straits and has to make cuts.

So the closing of Tinley Park isn’t a medical decision. It’s strictly a financial one.

Gov. Pat Quinn wants to save money, but he doesn’t want the blame for cutting care to the mentally ill — especially if one of them ends up murdering your Aunt Martha.

The fact is the state has been cutting beds, staff and treatment programs at the Tinley Park Mental Health Center for years. It once offered 100 beds. It now has 75 but only 50 patients, according to the state.

But the state never reinvested the money it saved through the cutbacks.

And although the state has been talking about closing the Tinley Park center for nearly a decade, it hasn’t made plans to replace the services the center offers.

Cook County Jail has become the largest inpatient treatment facility for the mentally ill in the Chicago metropolitan region.

Of the 9,000 or so inmates at the jail, about 2,000 are receiving psychiatric medication. That’s more than 20 percent of the population suffering from some sort of mental illness.

Some of these folks have been declared mentally unfit to stand trial and are merely waiting for a psychiatric bed to open up somewhere. But there aren’t enough psychiatric beds, even with the Tinley Park center open.

The chief administrator at South Suburban Hospital, during a public hearing about Tinley Park’s closing last year, said mentally ill patients who come to the emergency room at the hospital usually have to wait four days for a psychiatric bed to become available in the area.

During that time, they are not admitted to the hospital. They just sit in the ER treatment area, accompanied by someone assigned to guard them, until a bed is available.

Mark Heyrman, a law professor at the University of Chicago, said two agencies that advocate for the mentally ill are planning to file a lawsuit by the end of the month against the state for closing the Tinley Park center.

Those organizations are Mental Health America of Illinois, where Heyrman is a board member, and the National Alliance on Mental Illness-Illinois. Heyrman said violations of the Community Services Act would likely be the basis of that lawsuit.

While state officials like to emphasize that there are only about 50 patients at Tinley Park on any given day, Heyrman contends that 1,900 patients were treated there last year.

And while the state claims there are psychiatric beds available in private hospitals, Heyrman said 1,500 such beds were lost in the last decade because Medicaid fails to adequately reimburse for mental health care.

“The state has no plan to replace Tinley Park,” he said. “That’s the real problem.”