(Guest commentary in Asheville Citizen-Times promoting taxpayer savings by fully funding mental health services.)
It’s a shame it takes a catastrophe like the closing of New Vistas/Mountain Laurel to spark public interest in mental illness. If only the public knew of the countless individuals and families trapped in incredibly dark and desperate lives day after day, year after year because of a chaotic and under-funded mental health system. Perhaps then there would be enough sustained interest to make a difference.
Even if you don’t care about mental health because it’s the right thing to do, you should care about it because it’s the fiscally responsible thing to do. Care about it because it will save you money.
Simply put, it costs far fewer tax dollars to treat mental illness than to leave it untreated. According to the World Health Organization, mental illness is second only to cardiovascular disease worldwide in its “burden of disease,” a term used to define the societal costs of an illness through lost productivity, disability claims, increased costs of treating co-occurring medical conditions, court costs, incarceration costs, and the costs of homelessness and unemployment, among others.
You don’t need a global perspective, however, to realize the cost of inadequate or non-existent treatment to you as a taxpayer. The addition to the Buncombe County Detention Facility is costing $24.5 million. The largest new item in this year’s county budget is $4 million-plus in additional funds to open and operate the facility, which will increase jail capacity by about 70 percent.
And according to an August 13 Citizen-Times article, it may only take 12-18 months for the new addition to fill to capacity.
Now consider this. From July to December 2005, an informal survey of inmates at the Detention Facility found 35-40% with schizophrenia. That doesn’t even include other illnesses such as bipolar disorder and depression. If you think those figures sound high, think again. A report released this month by the U.S. Department of Justice’s Bureau of Justice Statistics estimates 64% of local jail inmates have a mental illness.
Do the math. What if the jail could be 64% smaller? Would an addition have been needed? Would another addition be contemplated? Sure, let’s lock up the bad people, but let’s treat those who are sick. And mental illness is just that, an illness, different in many ways, especially in the stigma attached to it, but essentially a biological condition like any other illness.
Ohio is trying to do something about the dilemma of mental health spending through their “A New Day” program. Simply put, Ohio, whose prison system was featured in the PBS Documentary “The New Asylums,” is looking at how it can invest more in the treatment of mental illness to save tax dollars, not just in jail costs but across the spectrum of public funding.
In its business case for A New Day, the state points out that appropriate treatment and support to people with mental illness will:
The Ohio plan also notes that treatment for mental illness is as effective as treatment for other medical conditions – 80% effective for bipolar disorder, 70 percent effective for major depression, 60% effective for schizophrenia, vs. 70-80 percent for diabetes and 41-52% for cardiovascular disease.
At some point, taxpayers simply must ask how many millions are going to be spent to build capacity before millions are spent to reduce the need for that capacity, in the process not only saving tax dollars but transforming lives.
Is it better and cheaper to have someone in jail or to have them employed and paying income taxes? Is it better and cheaper to have someone homeless or buying a home and paying property taxes? Is it better and cheaper to have someone healthy or unhealthy? Is it ever better to have someone in need?
For the past couple of months, I’ve thought a lot about the concepts of justice and injustice and how easy, once you strip away the bureaucratic maze of impediments, it is to turn an injustice into justice. If people are hungry, feed them. If people are ill, heal them. It is not only the right thing to do, it’s the smart thing to do.