Tuesday, September 16, 2008

Putting Families and Doctors at the Center of Treatment

In the wake of recent preventable tragedies in Washington State, the venerable Seattle Post-Intelligencer has done an outstanding job of restoring reason to the debate on mental illness.  In both reporting and editorials, the paper has examined what the state can do, instead of dwelling on the tragic events.

Here is what the paper’s editorial board concludes:

“For all the strengths of our system here, including mental health courts and the early adoption of parity for mental illnesses in health insurance, we can do better.

“The Skagit killings highlighted the near impossibility of committing dangerously mentally ill individuals to treatment. P-I reporter Carol Smith found Washington is one of the few states where families and doctors cannot directly petition to have a mentally sick person treated against his or her will. Families and physicians should be put in the center of treatment efforts.

“We’re also a state where involuntary treatment is almost never performed in the community instead of a hospital. The community practice in other states makes enormous sense: By requiring treatment when someone is still well enough to be in the community, there would seem to be a good chance of staving off worsening illness.

“Smith and reporter Daniel Lathrop also discovered the state spends $1.8 billion yearly on mental illness or its aftermath, but only about $530 million on direct treatment. One result: Not enough hospital beds for the mentally ill. Overall, the spending pattern is a warning signal that we need to refocus.

“It’s still possible we need to spend more. But money must be spent effectively and not be tainted by politics, as when King County government last year structured some funding from a new mental health tax to fit a powerful union's organizing efforts.”

At the core of this sound reasoning is putting families and physicians at the center of treatment efforts.  If more states take this message to heart, much can and will be accomplished.