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Monday, April 23, 2007 08:51 PM

CarlosT, We're Not Going To Invest in Mental Health Services

The United States of America very deliberately divested itself of mental health services in the 1980s and 1990s. First, the state psychiatric hospitals were emptied and closed down. Why? because they cost a lot of money. Not only that, but states were looking at much higher costs, as people began suing the states starting in the 1970s for all kinds of reasons related to mental health. If a person was released from a state psychiatric institute and killed someone, or beat someone badly, the victim and/or victim's family immediately got a lawyer and instituted a lawsuit against the state psychiatric facility. Patients were suing claiming medications or treatments (like ECT) had permanently damaged them. One state institution had its own farm, where patients grew food and raised chickens. The state was told they had to pay the patients minimum wage to work on the farm or else the patients were being exploited. They closed the farm down and costs for feeding the residents skyrocketed.

Meanwhile, voters were demanding lower taxes. States looked for ways to cut their budgets. One day, beancounters said "Since when is the state in the health care business? There is no socialized medicine in the US. Why is the state paying for an entire hospital system which is becoming more expensive by the day and which will be exorbitantly expensive as more lawsuits are filed? We can't protect the state from lawsuits so long as the state is overseeing mental health care inside of crowded hospitals. We can't pay for all the staff that is now required under law (staff-to-patient ratio) to care for all these patients. We can't afford to pay for benefits for all these workers."

And so the states got rid of their psychiatric hospitals. My mother worked in a psychiatric hospital and voted for the Republican candidate for governor who promised to lower taxes. She promptly lost her job once the new Republican governor lowered taxes by making huge cuts in state-sponsored hospitals. He later closed the hospitals entirely. But hey, my mother's taxes were lowered, weren't they and that was the main thing, right?

The state is never again going to go back into the mental health business with a hospital system the likes of what we had. It would result in much higher taxes, and the costs would escalate with each lawsuit. In our litiginous society, anything having to do with health is highly charged and mental health makes it even more highly charged. You'd be surprised what people would sue over -- physical restraints, e.g., became a favorite target of lawsuits. In the 1940s, you could put someone in a straitjacket. Not in the 1970s. The entire medicolegal protocol around physical restraints became cumbersome. The result? More attacks inside the hospitals on other patients (who sued) and on staff (who went into the comp system and went out on di$ability).

The 1990s saw "managed care." Before then, people could see therapists and psychiatrists as often as they liked. That was very expensive. Much cost has been cut by the insurance industry by strictly regulating the number of mental health visits per year, or the amount of money spent per year on mental health.

This is how it is going to be. Insurance companies and states are relying on medication these days as the main treatment for mental health disorders. The college shootings were a tragedy, but as far as states and the insurance industry are concerned, they were a hell of a lot cheaper than running an extremely expensive hospital system, or than by paying for years worth of twice weekly therapy sessions. People may lament the dead, but the majority of citizens, if presented with a steep rise in taxes to support a state mental health system or a steep rise in insurance premiums to return to the days of the much more liberal use of talk therapy, would not restore those things. And politicians know it.

Wednesday, April 25, 2007 08:32 PM

Maureen Dowd Continues to be Obsessed With Democrats Masculinity

She is unmarried, she does not live with a man, yet she obsesses over the marriages of Democrats and of the masculinity of male Democratic politicians.

She really needs therapy.

Sunday, May 6, 2007 07:35 PM
Original article: Rosie's view

Not Carrie Fisher

I think she's become brain-damaged due to the drugs and alcohol in her system. She used to be smart-funny-crazy, now she's just crazy-crazy-crazy. Plus she hangs out with self-loathing gay Republican political hitmen. R. Gregory Stevens, the guy who OD'd on OxyContin and cocaine in her house was an acolyte of Karl Rove (and head of something called "the Bush-Cheney Entertainment Task Force," believe it or not. Guess the Force wasn't with him that night). Carrie described Stevens as a "dear friend." There is already one person on The View who loves Karl Rove's friends and that is one too many. They don't need another.

When I saw Donna Hanover's name I thought "Now that sounds interesting." In a presidential primary year where her ex-husband is a candidate, the idea of Hanover sitting right up there onstage every day seemed like a great idea. But you know, I bet that when push came to shove, Hanover would back off and refuse to discuss her marriage and divorce. That wouldn't be any fun at all.

Wanda Sykes sounds like the best bet to me. I love her on "Curb". She is good as a standup, but she is far better when she has a foil to bounce off of. But I don't know if the women of The View could live up to being on a panel with Wanda. I don't think they're brave enough or smart enough to handle being Wanda's foils.

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