Alabama To Close Most Hospitals For Mentally Ill: Pros and Cons

Alabama will shut down most of its hospitals for the mentally ill by May of 2013. While there has been a national movement to relocate those with mental illnesses from state-run hospitals to group homes and private hospitals, Alabama’s announcement has occurred at a time when the state is in dire financial straits. As the New York Times reports, Alabama has been reducing state funding for mental health services by 36 percent since 2009, the second highest rate in the nation; in 2013, financing will be reduced by an additional 25 percent, or $29 million.

According to the Birmingham News, it costs about $140,000 to care for an individual in a hospital, but $60,000 in a community-based setting. In addition, Medicaid will reimburse the Alabama Department of Mental Health for most of the costs of community care, but not for patients in state facilities.

Four hospitals for the mentally ill will be shut down next year and 948 employees laid off. Since the 1990s, Alabama had already closed ten other centers for those with mental health issues. Two mental health facilities, one for criminals and the other for geriatric patients, will remain open. By next spring, 524 mentally ill residents will be transferred to group homes and community centers which are, say state officials, “less expensive and give them more freedom.”

Mental health advocates with responded carefully, noting that state hospitals are too often places where those with mental health issues are kept separated, isolated and in effect warehoused. Conditions at the state facilities were indeed “so poor,” say advocates, that treating people in the community would be better. But the question remains — considering the drastic cuts to funding for mental health services in Alabama — will there be sufficient funds for people in the community centers? As the New York Times quotes Bob Carolla, a spokesman for the National Alliance on Mental Illness, “What’s unusual is how many hospitals in Alabama are being closed so fast.”

While saying that moving individuals into community settings is “more humane,” James Tucker, associate director of the Alabama Disabilities Advocacy Program at the University of Alabama, also expresses concerns about whether “there will be time to build up the infrastructure needed,” to support both patients being discharged from state facilities and new people entering the system.

It remains to be seen is how those 524 mentally ill individuals will be transitioned to the group homes and community centers and if these will be adequately staffed and by individuals with sufficient training and support for everything from crisis situations to giving people medication. There are addtional concerns if individuals are placed in private facilities — or are in group homes where their care is contracted out to private agencies — as, under such arrangements, they have less recourse than they would in a public facility to question treatment that is below the standard of care.

Is the state of Alabama, under the pretext of providing community-based care for individuals with mental health needs, actually shortchanging their care?

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

Ilene W.

9:28AM PDT on Apr 4, 2012

This is another example of how the Medicaid Institutes for Mental Diseases (IMD) Exclusion is harmful to those with severe mental illness. If you are on Medicaid and need specialized treatment in a rehabilitative hospital, you are covered, but if you need specialized treatment in a psychiatric hospital or long-term residential addiction treatment facility, Medicaid does not cover it. The states are balancing their budgets in the short term, on the backs of people with severe mental illness and the communities in which they live, or in this case, the communities to which they will be released. Michigan closed all of their state hospitals to save money, and now they treat the most seriously ill, in prisons, at three times the cost.

Please learn more about the Medicaid IMD Exclusion. www.paulslegacyproject.org

send a green star

Brian M.

11:07AM PST on Feb 29, 2012

When mental health services are cut, when facilities are closed; the immediate result is a fairly rapid increase in crime and incarceration. Those that need to be cared for will be cared for, one way or another.

Sarah M.

3:59PM PST on Feb 27, 2012

Alabama is the worst possible state to live in now.

Dijana D.

8:43PM PST on Feb 22, 2012

I'm not sure if this is the best decision...

I Care F.

4:25PM PST on Feb 22, 2012

Making A Killing: The Untold Story of Psychotropic Drugging

http://youtu.be/UDlH9sV0lHU

I bet Whitney Huston Died from One of those Drugs.!
I was on one of them that was mentioned in the news A very very long tome ago.!
And I had to rush myself to Hospital My Blood Pressure Hit the Roof I was Boiling
Hot and i couldn't Breath
I was about to pass out in Emergency room they placed me on a bed and when a
Psych Dr (as no other Dr was Qualified with knowledge of those Tablets) come to check me out

She recommended I have cool showers.!!! I'm Like What the HELL.!!

I took myself off it immediately .!

Janice C.

2:08PM PST on Feb 22, 2012

How can the mentally ill be relocated to group homes when group homes will be financially affected by these cuts. Group homes won't be able to stay open with and almost 50% cut in funding over the next two years. This whole program is ludicrous!!!!!!

Charlene T.

10:11AM PST on Feb 22, 2012

The governments always seem to cut the programs for the people who can't or don't have a say in the way they are treated...

Suzen R.

9:55AM PST on Feb 22, 2012

This is great to hear. No one should be incarcerated unless they have committed a crime.

Donna H.

7:52AM PST on Feb 22, 2012

Hmmmm, puts me in mind of the UK's 'care in community' act. In reality there was no care, the mentally ill were simply turfed out into the street to fend for themselves.

Nina A.

7:34AM PST on Feb 22, 2012

Thanks for the article.