Thursday, March 02, 2006


More on the rating of Indiana mental health care

From the Indianapolis Star

March 2, 2006

Mental care scores poorly
By Greg Hafkin
March 2, 2006

Report cards are out for the nation's mental health care systems and Indiana is near the bottom of the class, according to one advocacy group.
The state got an overall grade of D-, placing it in a four-way tie for ninth-worst in the U.S., in a report released Wednesday by the National Alliance on Mental Illness. In two of the four categories ranked -- infrastructure and recovery support -- the state got F's.
"In some ways, I am surprised we scored even this well," said Mitch Roob, the secretary of the Family and Social Services Administration, in a statement. He blamed the problems on previous administrations and said his agency, which includes the Division of Mental Health and Addiction, is embarking on a "transformation process."
Indiana was criticized for having a long waiting list for community services. The alliance also urged the state to give patients and their families a greater say in decisions, and cautioned against plans to transfer control of mental hospitals from the state government to nonprofit groups.
In state fiscal year 2003, about 97,000 low-income Hoosiers were served in community mental health centers, according to the Division of Mental Health and Addiction. The state's six mental hospitals housed an additional 1,100 people in 2004.
While Indiana got a low score, the report did not assess the actual quality of care that doctors, clinics and hospitals provide. The report focused on areas such as policy and financial issues.
Inadequate funding is largely to blame for many of the state's shortfalls, mental health experts said.
"The state economy has been in the doldrums," said Jim Jones, executive director of the Indiana Council of Community Mental Health Centers. "The mentally ill, they don't rank high as a priority for the state."
Indiana's grade compares with a national average of D. Just two states, Ohio and Connecticut, received B's, the highest grade awarded. Eight states failed, including Illinois and Kentucky.
"Advocacy groups are hard to satisfy," said Alan Schmetzer, a psychiatry professor at the Indiana University School of Medicine. "It's always possible to improve, and their job is to show the way to improvement."
Schmetzer, who is former superintendent of Indianapolis' Larue Carter Memorial Hospital, said moving the hospitals to private control is one way the system could improve. Non-profits would have more flexibility with hiring and spending, he said.
But Pamela McConey, the mental health alliance's state executive director, said the plan could have a negative impact.
"Who are the people going to be accountable to if the state is not in charge?" McConey asked. "The devil's in the details, and we haven't seen those details yet."
The state plans to transfer its hospitals in Madison, Richmond and Evansville to private hands. Richmond State Hospital could change ownership as soon as this summer.
More and more people are seeking treatment for mental illnesses, Schmetzer said. "No matter how much supply you have in mental health, there will always be more demand," he said.
Indiana also was commended on a few aspects of its system, such as its Assertive Community Treatment program, introduced in July 2002. The program creates teams that treat patients and assist them in finding jobs and housing. There are 26 such teams in Indiana, and each one monitors about 100 patients, McConey said.

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