by Gerald D. Klee, M.D.
[Spring 2001; Vol. 27, No. 3; Pg 4]
The mental health system in Maryland is collapsing due to insufficient funding and bureaucratic interference. First, it was community mental health services that were almost wiped out in 1997. They are still not expected to recover. I reported on that in the Winter, 1997 issue of TMP. The latest problem is that in Maryland, one private psychiatric hospital has gone out of business and the five others are in bankruptcy or near it, due to inadequate payments for treating Medical Assistance and Medicare patients. This creates a problem of unprecedented proportions, since private hospitals have filled part of the gap caused by the elimination of most State hospital beds. Read Dr Bruce Taylor’s article in this issue for details. The situation is so critical and the space available to discuss it so limited, that I feel compelled to seek assistance from Ogden Nash, a master of brevity and wit, who wrote the following:
The Termite
Some primal termite knocked on wood
And tasted it, and found it good,
And that is why your Cousin May
Fell through the parlor floor today
How does that translate? The house in this story is the edifice of psychiatric services in Maryland, after having been remodeled by government health regulatory agencies. The termites are managed care organizations and state health regulatory agencies. Cousin May represents the many thousands of patients who have fallen through the floor of this termite eaten system.
What can you do to save psychiatric facilities and services from total destruction?
1. Learn all you can about how termites operate.
2. Support Dr. Taylor and other private hospital directors in their efforts to gain adequate funding for services so that their facilities can remain open.
3. Work with other professionals and citizens’ groups to persuade legislators to revive community mental health services.
4. Remind state legislators that the system didn’t break until they tried to fix it.
5. Learn all you can about health care statistics and health care financing, because those are what the termites misuse to devour our professional house.
6. Persuade state legislators that they will save more tax money and get more votes if they stop listening to termites and start listening to homeowners.
7. Remind legislators that without psychiatric treatment, patients will be in the streets, the emergency rooms, the jails and the morgue. This will eventually cost more than psychiatric care and will also discourage businesses from locating in Maryland, thereby reducing tax revenues.
If you haven’t been affected by these problems yet and think you’re safe, remember Cousin May. She thought she was safe until the moment she fell through the floor.
Dr. Klee has frequently written in TMP about how State health regulators use false and misleading statistics to justify reductions in funding for psychiatric services.