Fitzgerald is a lifelong
Although some patients were treated for long periods without improvement and transferred to a state institution, most did get better. They were placed in residential facilities and eventually returned to their families, Fitzgerald said.
So what happened? Several complex economic factors contributed to the downfall of the mental health system in
Inflation created skyrocketing costs. As a result, psychiatric hospitals became private, for-profit enterprises. Eventually the insurance companies partnered with managed care companies to keep costs even lower. In the 1990s, the state changed the funding streams for mental health in a two-step process of realignment and capitation.
Corporations stepped into the market because they could provide mental health services for even less. The Psychiatric Health Facility, or PHF, proliferated. The PHF, pronounced "puff," started out as a low cost mental health solution for rural areas before appearing in cities. The Santa Cruz PHF is run by the
"PHFs have very low regulations, they are exempt from high facility costs and they can't treat anyone who needs hospital-level care. As a result, their staffing requirements are low. They don't pay well and they're not unionized," Fitzgerald said. "They also can't have more than 16 beds."
The PHF's metrics are based on length of stay and remission rate. As a result, Fitzgerald said, PHFs are incentivized to release patients early and not re-admit them.
Just as important is the fact that the
By opting to limit the number of beds and services available, the
Unfortunately, a leadership void in the mental health community exists. Namely, the state of
"Somebody once said, 'Every system is perfectly designed to achieve the results that it gets.' The death of
(c)2016 the Santa Cruz Sentinel (Scotts Valley, Calif.)
Visit the Santa Cruz Sentinel (Scotts Valley, Calif.) at www.santacruzsentinel.com
Distributed by Tribune Content Agency, LLC.