January 17, 2003--
I think you’ll find the enclosed article on care of
the chronically mentally ill in the Winter 2003 issue of the Virginia
Quarterly Review to be of timely and strong interest. Written by
a noted mental-health policy expert, Dr. C. Knight Aldrich, U.Va.
Professor Emeritus of Psychiatry and Family Medicine, it makes an
urgent plea for reform, calling for funding of community mental
health centers to become a permanent federal responsibility.
federal government should provide for full care of the severely
mentally ill, “not as an experiment but as an ongoing responsibility,
was with the medical care of veterans,” Dr. Aldrich writes.
He adds that it is unrealistic to expect communities, especially
poor communities, to bear these costs. State governments “have
consistently made it evident that they cannot or will not adequately
support care,” he says.
his plea with stories of schizophrenic patients abandoned by society
to homelessness or jail, he notes that most community centers struggle
to provide good care but have been forced by budget cut after budget
cut to limit services. Both private and public mental hospitals
now discharge patients so rapidly that doctors and nurses can’t
do their full work to prevent future crises.
community mental health center should have emergency, in-patient,
day hospital, clinic, rehabilitation, and housing and transportation
services geared to the special needs of the schizophrenic and other
chronic mental illnesses,” Dr. Aldrich writes.
federal government should either operate the facilities outright
or contract with non-profits to do the job, he says.
“In the long run…a reformed system will more than pay
for itself, not in direct savings but in the reduction of the indirect
costs of mental illness,” he concludes. “…We have
made some progress in overcoming the stigma of mental illness. Our
next need is a groundswell of popular support to provide the kind
of care that will give [the chronically mentally ill] the opportunity
for recovery or rehabilitation that they deserve.”
Aldrich has worked in and written about community mental health
in several cities around the world and has consulted with state
mental health departments in Minnesota and Illinois as well as the
National Institute of Mental Health.
interviews or additional information he may be reached at (434)
296-4816. To arrange an op-ed excerpt from this article, please
give me a call at (434) 924-6856.
Virginia Quarterly Review, a national journal of literature and
discussion, has been published at U.Va. since 1925.
Bob Brickhouse, (434) 924-6856