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Letter: Treatment, NOT lock them up
As a long time advocate for people living with serious mental illness symptoms, I am compelled to respond to Froma Harrop’s recent article in The Dakota Scout.
While people are certainly entitled to their opinions, it is a slippery slope when an author takes it upon herself to determine the living conditions of people she has never met. What I heard her say is that we should just lock people up rather than fix the mental health system.
Harrop is correct that the Community Mental health Act has failed these citizens, who happen to be someone’s child, parent, sibling, spouse, friend. She is correct that Congress has never fully funded community mental health centers. Congress funds what it deems important. Its failure to fully fund mental health tells us that this is not an important issue for them. As a former nurse at 5th Street Connection, part of Southeastern Behavioral Health – one of the 11 community mental health centers in South Dakota – I witnessed the agency do the best it could to help people using the paltry funding it received. The mental health professionals at 5th Street Connection work tirelessly to help people live fulfilling lives in the community. These college-educated professionals work for very low salaries. They do this work because of their commitment to helping others.
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Unfortunately, a very small percentage of people living with serious mental illness have a condition known as anosognosia. Anosognosia causes the person to not know they are ill. It is not denial. For situations like this, a much more humane approach is to place the individual into an Assisted Outpatient Treatment (AOT) program. AOT allows people to live in the community rather than being locked up in a facility that may be hours from their family/natural support system. You can learn more about AOT by going to mentalillnesspolicy.org or treatmentadvocacycenter.org.
Additionally, the law needs to be changed so family members are not forced to watch their loved one slowly deteriorate before their eyes until “they become a danger to themselves or others.” Too often when the person does get to the place of being a “danger to others,” they hit someone, get arrested for domestic violence and end up in jail. Now they are part of the criminal justice system because the mental health system that should be caring for them has failed.
There is also a desperate need for more supported housing for these individuals who, through no fault of their own, have lost the ability to live in the community without help from mental health professionals. People in Sioux Falls have to live in other communities because it lacks supported housing to meet the need.
Another barrier to living successfully in the community is lack of access to effective treatments. There are not enough mental health providers for everyone who would benefit from mental health treatment. Wait times to be seen can be months. Too many people do not have access to insurance that will pay for the treatments. Medicaid Expansion helped close this gap but some people are still uninsured or underinsured for mental health. The lack of a public transportation system that serves the entire community in a timely manner is also problematic. When the provider is not on the city transit system, people have to rely on “someone” to get them to and from the appointment. Or, they just skip it altogether.
In all my years, I have never met one person who grew up aspiring to live with one of these chronic medical illnesses. No one asks to have a mental illness. No one should be locked up indefinitely because of it.