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February 28, 2008


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Alison Hymes

I think the authors of the abstract are over-simplifying a complex problem. For instance in my state in the U.S., we actually spend much, much more on state hospitals than we do no community mental health services and our public mental health system's outpatient capacity has actually decreased in the last decade as the state hospitals continue to eat up @70% of the MH budget.

One of the problems I see in my state is the zero tolerance approach to even minor crime and the elimination of parole and "good time" etc. leading to many more people in general being imprisoned. I think more people with mental illness are in jail and prison in Virginia because more people in general are in jail and prison in Virginia, in fact we have a higher percentage of our population imprisoned than any other state last I read.

I also notice that we don't have trauma informed care in our state hospitals nor in our civil commitment process nor in the majority of our community mental health centers, I think that would be the place to start. A person with PTSD or DID dependent on the public mental health system in Virginia would be SOOL, there just are no long term therapy services and no therapists qualified to treat trauma disorders.

I am very grateful to be able to afford a private psychologist through paying 200 dollars a month for Medigap with my Medicare but most people under 65 in Virginia don't even have the option of buying Medigap to pay the 50% co-pay Medicare charges discriminatorily for mental health services because it isn't sold in Virginia, I got mine in Pennsylvania many years ago. Lucky me, but unlucky most folks.

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