The State of Mental Health

February 6, 2003
Posted at: 8:45 p.m. CST

JONESBORO, Ark. -- If you or your child were sick, really sick, what would you do? Just going to the doctor would be easy enough, but for the thousands of people who struggle with "mental illness", the process is anything but easy.

"Life was good. We didn't have any problems."

Pauline charton was not prepared for the minefield that lie ahead for her son, Ian. Ian Charton's life was on the fast track to success, until he was diagnosed with schizophrenia, a mental illness whose victims often experience a "break from reality," sometimes hearing voices. Ian became paranoid. He couldn't work, wouldn't eat and didn't even trust his own family.

"He was a really good athlete. He was on the uca track team," Pauline Charton said, showing a picture of Ian when he graduated from the University of Central Arkansas in 1990.  "It came out of the darkness just like a freight train and mowed the whole family down because we had no, no inclination. I didn't even know anything about mental illiness beyond depression."

"In order for me to access help for my son," Pauline Charton said. "And it's a physcial illness, schizophrenia, we know it is a biologically based brain disorder, my health provider told me, you're going to have to call the sheriff and have him picked up and I had to do that."

Though he hadn't committed any crime, Pauline said he was treated like a criminal by Arkansas' mental health system, a a system some liken to a "sinking ship."

Dr. Laurence Miller, medical director at the Arkansas State Hospital, testified in a class-action lawsuit brought about by the American Civil Liberties Union on behalf of inmates awaiting forensic evaluations, or tests to see if they are fit to stand trial. The ACLU said the state violated the rights of mentally ill inmates by making them wait months to be evaluated.

"When I testified, I likened it to rearranging the seats on the Titanic," Miller said. "Everyday, it's sort of who can I get in? How can I discharge somebody else? What can we do?"

"I basically agreed (with the ACLU)," Miller added. "I said that patients were in jail. They were there too long. We'd tried lots of things, but we didn't have sufficient resources to really take care of what we needed to."

There are 90 acute-care beds here at the Arkansas State Hospital. That's 90 beds to serve the entire state and many of those are taken up by long-term care patients who shouldn't be in acute care. Forensic patients, people alleged to have committed a crime, are taking up beds that should be open to other people in dire need of mental help.

"Look at the surrounding states," Floyd Johnson, Jonesboro direcotr of public saftey, said. "See how many beds they have for mental folks. We don't have the beds."

Arkansas doesn't even come close to the number of beds found in state-operated mental health hospitals in neighboring states. Missouri has nine such hospitals with 407 beds. Tennessee has five mental health hospitals with 1,161 beds.

"We're the only state hospital in the state. Not many years ago, we had 7,000 beds here in an older building--not this building," Miller said. "7,000 beds between this campus and the campus down in Benton. And we now have 202 beds."

U.S District Judge Stephen Reasoner, a Craighead County native, ruled in May 2002 that the state was in violation of the constitutional rights of its mental patients, and ordered the state mental hospital to begin performing mental evaluations within 30 days of a trial judge's order. County prosecutor Brent Davis thinks that it may be tough for the state to fulfill the court's mandate.

"I think that most people associated with the system will find it hard to believe that can ever happen," Davis said.

Davis points to a murder trial involving the death of Poinsett County resident, Millie Shifflett. The trail was held up in August of 2002, and continued until October because a mental evaluation was ordered for the defendant. The mental evaluation wasn't completed in October. So the case was continued until January 2003. The evaluation has yet to be done.

"So now we have a March trial date," Davis said. "We've been waiting in excess of four months, now nearly five months, and we just hope to get it in within the next six months so we can try this fellow for capital murder."

"I think it's reversed," Johnson said. He doesn't agree with Reasoner's judgement. "I think we need to be looking at more beds, more staff and be able to treat the folks that have not committed a crime that actually need help that don't have insurance, that don't have Medicare, that can't go to a private institution or their families aren't financially able to support them."

Psychiatric hospitals that are open for the mentally ill, like St. Bernards behavioral health, are Becoming far and few between. Many are closing their operations to new patients.

"We don't turn anybody away at the front door because they don't have the ability to pay," Lee Simpson of St. Bernard's said. "We're sticking it out, but there's alot of facilities around the state that are saying. We're not going to do it."

< P> "I think there's a 60% reduction statewide in psychiatric inpatient beds in these medical hospitals that have closed and most of them within just the last 12 months," Bonnie White, of Mid-South Health Systems, said.

The federal government limits medicaid reimbursement for adult inpatient care, hospitals can no longer continue to underwrite the cost of indigent care, or charitable care, so they're closing psychiatric units. Community mental health centers have lost $2.5 million in state funding for the past two years.

"You know we said two years ago, it was really at a crisis point and i didn't think that it could get even more difficult, but it has," White said.

Pauline Charton found it increasingly more and more difficult to get help for her son. Five years after he was diagnosed with schizophrenia, Ian lost the battle.

"Unfortunately we lost him to suicide," Pauline said. "He was miserable. And you know we as a society failed him and I include myself in that."

That is why Charton works for NAMI, the National Alliance for the Mentally Ill in Little Rock. As executive director for the arkansas division, she hopes to let more and more people know about the plight of the mentally ill.

"I want us as a society to let our government know, our legislators while they're in session, and let them know that, hey we have a population out here that we've abandoned and it's been for too long and we have to do something about it," she said. "Let nobody else go through what me and my family went through. Let's make it better cause we can. We can."

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