The State of Mental Health, Part II

February 6, 2003
Posted at: 10:15 p.m. CST

JONESBORO, Ark. -- Doors are slamming all over the state of Arkansas. Centers which once provided psychiatric in-patient care to the mentally ill are closing. With fewer and fewer options, patients find themselves between a rock and a hard place trying to get the help they need from a system many say doesn't work.

"Julie was real social," Marilyn Murray said of her daughter that struggled with depression. "She loved people and she loved to be with people."

It is hard to believe that someone with such a vibrant smile would suffer with such a dark mental illness as depression. Having suffered complications at birth, Julia had difficulty learning, just maintaining concentration was a challenge.

"When she got to be a little older and she sensed the difference between her and the other kids was when her depression started setting in," Murray said.

Julia Townsend Veteto would spend the better part of her life struggling with depression. Two years ago, Julie told her husband she had thoughts of committing suicide. He took her to the only psychiatric hospital in the area, St. Bernards Behavioral Health.

"The doctor that was on call did not know Julie," Murray said. "He was a home and didn't have access to her charts, or anything."

Murray says the hospital did not admit her daughter. Less than 20 hours later, Veteto committed suicide.

"The coroner found a website on her computer that showed how to hang yourself," Julia's husband Roger said.

Veteto's family filed a lawsuit in federal court against the operators of this website, which teaches people how to kill themselves. The family also contends, in the lawsuit, that St. Bernards and some of its providers are, in part, responsible for Julia's death.

St. Bernards declined comment on the case since it is in litigation. Across the state, access to care is becoming more difficult for the mentally ill. In the last 18 months, arkansas has lost 70 percent of its in-patient psychiatric beds. Facilities in Springdale, Fort Smith, Searcy, Pine Bluff and Little Rock have closed their doors due to a lack of funding or medical staff.

With fewer places to go, it's conceivable there could be many more people like Julia needing emergency care. Hospitals are required by federal law to stabilize anyone appearing in an emergency room, including the mentally ill, who often have no means to pay.

"We used to operate a crisis unit across the street and we took a lot of people through that program," said Bonnie White, Executive Director of Mid-South Health Systems.

The crisis unit White speaks of was at George Jackson, now the Arkansas Services Center.

"In terms of expense to the county, say someone was mentally committed 10 years ago, the sheriff spends 15 minutes driving them out to George Jackson and dropping them off," said prosecuting attorney Brent Davis.

"The Sheriff's Department and the Police Department are constantly transporting folks back and forth. We have a facility out here that the state doesn't use," Floyd Johnson, Director of Jonesboro Public Safety, said. "Why can we not have that place open?"

Because the former crisis unit is closed, a trip to the Arkansas State Mental Hospital in Little Rock is now the norm.

"A deputy can devote a day's worth of work in a short period of time," Davis said. "Just being a catering service for the mental evaluation."

"At the very time this hospital was being built, George Jackson hospital, there was a change. A dramatic change in policy at the federal level that said, we're not doing what we should be doing with mentally ill people by institutionalizing them," State Sen. Jerry Bookout (D-Jonesboro) said.

Bookout sees this change as "pivotal" in how the current crisis in mental health developed.

"That policy shift, in and of itself created a nation of homelss people, homeless people just all of a sudden appeared everywhere," Bookout said. "And not just in Arkansas, but in Washington.

"My son went from being a regular clean-cut guy working hard and ended up homeless," said Pauline Charton, whose son died with a mental illness.  Charton holds up a pair of jeans: "This is what he was wearing just a few months prior to his death and he did a good job holding these together, let me tell you."

Schizophrenia caused her son Ian to distrust his own family. All the while, his mother worked desparately to get him help. After a five year struggle with the disease, Ian committed suicide.

"And the thing is, life could have been good for Ian with the correct diagnosis and with early treatment, he could be alive today and his life could be really good," Charton said.

Pauline was a member of the Governor's Mental Health Task Force, charged with developing a plan to improve care for the more than 60,000 mentally ill people in Arkansas.

"Out of this task force report, the Division of Mental Health has asked for $5.8 million to distribute to the community mental health centers to provide for acute in-patient hospitalization for alternatives to in-patient hospitalizations, which means crisis units," Dr. Laurence Miller, director of the Arkansas State Hospital said.

But asking for, and getting are two totally different things. During the last legislative session, lawmakers passed Act 1589, which called for $11.5 million in funding for adult acute care services. But, the funding was never provided.

"It's such an overwhelming problem that you have to prioritize the limited resources that you have," Bookout said. "And when you prioritize, mental health gets the lowest priority."

"One roadblock on the journey to fixing the state's mental health system lies here with the state legislature. Lawmakers have to answer to their constituents back home and mental health issues are not a high priority with voters.

"Unless it touches you personally, it's in your family, or a good friend, or your provider, it's often not on many people's radar screens," Miller said.

"We have to get outraged as a society," Charton exclaimed. "Because mental illness affects one in five people. It's out there. It's happenning and they cannot help it and it's going to touch your life."

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