Waiting List for Indigent Mental Health Patients
Mental health has always been a long ignored and overlooked topic in our health delivery system. Recently, I was given the opportunity to visit with the El Paso Mental Health and Mental Retardation (EPMHMR) Agency. Though this is somewhat of a digression from my formal duties at my internship, I felt it was important to observe different areas of health services to acquire a more wholesome understanding of the system.
I was in for a big surprise. I first had lunch with Rene Hurtado, the External Affairs Officer at the EPMHMR. I quickly learned about the pending mental health crisis about to inundate the El Paso county - effective September 1st of this year, MHMR will need to close its doors to any new indigent patients requesting mental health services. Unless patients are protected by alternate sources of funding or able to pay out-of-pocket, they will be placed on a waiting list with no telling of how long before they receive necessary treatment. I didn’t realize the severity of this consequence until I was later invited to a community stakeholder’s meeting resulting from this decision.
During lunch, Rene gave me a brief overview of the mental health situation in El Paso. In fact, unlike other states, Texas does not have a state mental health office. The absence of a governmental authority over such a critical area of overall wellbeing should indicate the little priority given to mental health in the state. The state, however, has traditionally delivered funds for mental health. The money is transferred to EPMHMR, the umbrella, community based institution that contracts with smaller mental health clinics across the county. The EPMHMR is not a governmental agency.
The mental health crisis is exacerbated by the state’s refusal to increase funding despite the snowballing demand for mental health in El Paso. According to Rene, the chronic stigmatization of mental health has been the basis for the lack of political clout for mental health advocacy. What many politicians fail to recognize is that mental health is characteristic to any population. Rene himself along with other prominent mental health advocates have persistently lobbied during the legislative session in Washington D.C. on behalf of El Paso, but these efforts have not resulted in legislative actions to increase funding.
My visit with the EPMHMR ultimately culminated into a community stakeholder’s meeting at the El Paso Chamber of Commerce. Different interest groups within the mental health community, including representatives from local homeless shelters, law enforcement agencies, public defenders office, businesses, and the health commission were present to officially receive news about the institution’s decision to institute a waiting list for uninsured mental health patients. After the CEO of the EPMHMR concluded his presentation and debate was initiated, the conference room was occupied with frustration, outrage and tension. It was by far one of the most interesting meetings I’ve attended in my experience here thus far.
Witnessing the disgruntlement felt by community leaders made me realized that the eventual ramifications of MHMR’s service halt are not isolated. EPMHMR estimates that immediately following the waiting list execution, over 1,500 El Pasoans may have to be turned away for treatment. Routinely, law enforcement officers have dropped off people exhibiting risky behavior at EPMHMR to seek help, but the institution will have no choice but to turn indigent patients away. I learned that the nearest mental health facility is 5 hours away, meaning police officers will be reluctant to transport patients to alternate facilities.
The denial of mental health services for the most vulnerable populations, mainly the uninsured and poor, will inevitably penetrate the prison systems, shelters, emergency rooms, court systems, rape and crisis centers. Rates of homelessness, domestic violence, homicides, suicides, substance abuse, and overall crime are expected to soar. Ultimately, negligence of mental health will only mean that problems end up on someone else’s lap.
I’m wondering why there isn’t more outrage and resistance demonstrated by the community. There was only one article written by the local newspaper pertaining to the decision, and I have yet to see continued media attention directed at the pending crisis. I almost feel somewhat discombobulated because while the EPMHMR and community stakeholders recognize the severity of the problem, they appear to have accepted the situation for what it is. Isn’t there anything that can be done?
Related article by the El Paso Times: http://www.elpasotimes.com/newupdated/ci_12615739