We are failing our mentally ill at their darkest hour.
Why? Because too many of us still think it’s the mentally ill who are failing.
A new report from the University of Utah’s Gardner Institute gives a comprehensive overview of mental health in Utah. The short version is that we’re near the top in the nation for having a mentally ill population and at the bottom for offering them treatment. Rural areas in particular face both of those extremes.
Even more shameful is the neglect of vulnerable young people. Four in 10 depressed adolescents receive no professional help at all. Suicide is the leading cause of death for Utahns between the age of 10 and 24.
Cut down in their prime by a culture of ignorance.
In the spectrum of aberrant behavior, where does poor judgment end and bad brain chemistry begin? It’s the wrong question that ignores an immense volume of knowledge. In truth, professionals can diagnose accurately and treatments can be lifesavers. This has nothing to do with morality.
But first, those afflicted have to walk the lonely path. Just to admit to a depressive or psychotic episode is to become a pariah. Employers blanch. Friendships dry up. Family becomes estranged.
Add to that an absence of affordable care, and it’s no wonder so many people are forced to self-medicate with alcohol or illegal drugs, often ending in a death spiral.
The Gardner report buries its recommendations in an appendix at the end, an acknowledgement that there aren’t many quick fixes. For instance, two-thirds of Utah’s counties don’t have a single child and adolescent psychiatrist. It’s too much to expect that everyone who needs a psychiatrist will have one, so the fallback is to better educate pediatricians and other practitioners in handling those cases.
Coverage is also an immense deficiency. In another sign that society doesn’t recognize mental illness as real sickness, insurance companies often offer a wide variety of reimbursement options for physical illness, but then force their insured through limited, less affordable options for mental health care. Why does the brain get a lower standard of care than the pancreas?
The one quick fix is the one Gov. Gary Herbert and the Utah Legislature keep trying to stop. Medicaid is the largest funder of mental health care in the country. State leaders’ refusal to let the federal government fund 90 percent — out of fear the other 10 percent will become too expensive — is completely illogical, not to mention inhumane.
The math is undeniable: Paying 10 percent of treatment is so much cheaper than paying 100 percent of non-treatment. The cost to society of not taking Medicaid expansion is incomprehensibly high. It increases homelessness and addiction and clogs jails.
Gloom doesn’t have to be doom. Fear doesn’t have to be paralysis. Hope can replace a squeezed trigger.
The tools are there. All we need is resolve.
