Wednesday, May 11, 2005

The illusion of help

In a move that I'm not too enthused by, a southern suburb of Chicago has implemented a new mental health policy in an attempt to help the most severely mentally ill people get on their feet.

Problem #1. In a population of 155,000 mentally ill people, the .08% who will actually be "helped" by this program most likely represent those who are unlikely to ever become productive members of society. The craziest of the crazy need a helluva lot more help than meeting with a psychiatrist with an insurmountable case load.

Problem #2. How is it that a psychiatrist gets paid $70,000/year to meet with 40 patients a week, and a bilingual social worker gets paid $58,000/year to meet with 30 clients per week. WHAT!?! Why the CRAP are you paying your social worker that much money? Not to belittle the difficulty of the job, but seriously, that should be a position with a MAXIMUM salary of $40,000 that you might get after working for 30 years.

This is part of the reason that I can't deal with the government up here. In Maricopa County (in AZ), the desperately mentally ill are put through a state program for several months. The program mandates that they see a doctor, a counselor and attend what basically amounts to school to learn basic life skills. By the time they are put out into the world, these folks have a stable medication regimen and experience with learning how to balance a budget, stay out of dangerous relationships and most importantly, apply for work. The genius of the AZ system is that the state will hire some of the new graduates to train other mentally ill patients going through the system. So, under supervision, some of these folk will be empowered by helping others like them. Great experience.

Most amazing about the AZ program, however, is the fact that the government will provide low cost drugs to graduates for a generous period of time, during which the mentally ill folk should have been able to find a job, start working and get health benefits.

And you know, that system work pretty damn well. You can't change a person and if people stop taking their meds, nothing good can come of it, but at least you've given people a structured chance for a better life.

Somehow, the Chicago formula feels like a way to justify the creation a couple of cushy jobs. That pisses me off because there are people out there who desperately need help.

My opinion? Better than nothing. Barely.