How President Trump is Supporting Those with Mental Health Issues
Mental health issues aren’t as taboo as they once were, as it’s a topic that is discussed more openly these days, both by advocates as well as those suffering from various ailments. While this is great progress, there are still some aspects that require immediate attention, like the current mental health situation involving the United States prison system.
There are several hundred thousand inmates sitting in American jails and prisons on a daily basis that suffer from mental health issues, yet they are not receiving the medical and psychiatric care and attention they so desperately require.
There are less than forty-thousands of these individuals in hospitals receiving adequate mental care. The Institutions for Mental Disease Exclusion, a federal policy that dates back almost sixty years, essentially gives hospitals financial incentives to remove mentally ill patients from hospitals.
When there is a financial gain to be made, what do you think most hospitals are going to do? They are going to exploit it and take full advantage of the incentive, even if it’s not in the best interest of its patients.
This doesn’t sit well with the new administration, led by President Donald Trump, and the removal of this exclusion is at the top of the White House’s budget proposal. From the outside looking in, one wonders why, especially with so much new information regarding mental health, would this incentive still be in existence.
The news of Trump’s support of the initiative to fix this problem is great, but it’s important to understand why we aren’t providing help to those in the prison system with much-needed help.
The Institutions for Mental Disease Exclusion came to existence as part of the law that created Medicaid, back in 1965. It’s an obviously outdated piece of legislation, which prevents the program from providing financial care to mentally ill adult patients in facilities and hospitals that have more than sixteen beds.
Why? Well, it all comes down to money, sadly. The federal government didn’t want to be on the hook, financially, for these patients, and this law essentially made them the responsibility of the state in which they reside.
If care was provided on a federal level, that would result in more medication and drugs being developed and large-scale mental health facilities and rehabilitation centers popping up. This all sounds great, right? This would help cure the mental health problem, or at the very least help reduce it significantly.
Again, it comes down to money. Many so-called experts believed that this would remove the need for institutions, and if they didn’t exist, neither would the revenue they generate. The White House’s new budget proposal is a great sign, and many mental health advocates are praising President Trump’s actions.
The entire scenario has been a mess from day one, and it’s quite shocking that nothing has changed over the years when the problem is obvious. No other administration since its inception has addressed the need to make a change, until now.
Prior to 1965 and Medicaid, each state was responsible for covering the cost of hospitalization due to psychiatric related incidents. The funding was available and utilized as intended. It helped many people receive the medical treatment they required. It worked according to plan and did exactly what it was designed to do.
Then states found a loophole, that when exploited, provided them with significant financial upside. If they forced these patients out of their facilities, Medicaid would automatically enter the picture and cover 50 percent of the cost.
This snowballed, causing a significant decrease in the number of hospital beds allocated for mentally ill patients. To date, nearly a half-million hospital beds have been lost, and while the majority of that decline came in the law’s early stage, the past fifteen years saw 12,000 beds lost.
Now, President Trump isn’t alone in his support to get rid of the Institutions for Mental Disease Exclusion, with a former psychiatric nurse, Eddie Bernice Johnson, a leading supporter. Johnson is a Democratic representative for the state of Texas, and he has brought forth several bills that are designed to eliminate the Institutions for Mental Disease Exclusion.
There is more Democratic party support for this movement, with Peter Buttigieg and Amy Klobuchar, both Democratic candidates, being highly involved in the abolishment support. With so much support, why has progress stalled in Congress?
There are many ill-informed civil liberals that believe — without evidence or supporting research — that those suffering from mental illness can be healed through wellness and emotional support. Sadly, that is not the case at all. These groups continue to argue their case, yet never provide any supporting case studies or any other form of proof that their radical beliefs hold any merit whatsoever.
Even crazier is the fact that Bernie Sanders, who is very vocal about his plans to provide free health care to everyone, is against eliminating the Institutions for Mental Disease Exclusion. It’s a case of not putting the needs of those suffering from mental illness ahead of profit.
The cost to cover the treatment of patients is a major concern, and rightfully so, but at some point, you have to look at the big picture and realize that change is needed. We are no longer living in the 1960s. Back then, mental health was not a topic that was openly discussed. If someone had a problem they were not vocal about it and they did not seek out help.
Today, the stigma has changed radically, and people are actively seeking help for issues related to depression, anxiety, suicidal thoughts, etc. So, why should we limit the number of options because of a loophole in the system? In all honesty, that “hole” should have been patched decades ago.
When you look at the big picture it’s clear that the current plan hasn’t worked. There are still the same numbers of mentally ill people in prisons and jail today than there was in the early 1960s. The only difference is the majority of those people were in hospitals back then.
This is the point President Trump and the supporters of the abolishment of the Institutions for Mental Disease Exclusion are trying to make. It hasn’t worked — plain and simple.
Without change, it will continue to burden the families and loved ones that care for mentally ill adults, both emotionally and financially. Costs are sky-high, as private facilities are not cheap. There is also a gray area when it comes to what is covered by insurance.
If the Institutions for Mental Disease Exclusion is abolished, and patients are allowed to seek treatment and help in hospitals, it will make help and treatment more affordable across the board.
Police, corrections officers and prison staff are now being forced to deal with individuals that need professional psychiatric evaluation and treatment. It’s not fair to them, nor is it fair for those needing help. With President Trump’s continued support, hopefully, Congress will finally do the right thing.
Another thing to consider is that the entire medical industry has transformed tremendously since the 1960s. Technology has helped, and when you combine that with the funds that Medicaid could roll into the hospitals, you would create a program that would do exactly what it was intended to do — treat those in need.
Without abolishing the Institutions for Mental Disease Exclusion, many Americans suffering from mental illness will not receive the proper treatment. Providing them with proper treatment has a trickle-down effect, benefiting them, as well as others around them.
With President Trump’s ongoing support of this initiative, hopefully, change is on the horizon.
Dr. Vikram Tarugu, M.D, is the CEO of Detox of South Florida, Inc and medical professional focused on addiction. A veteran in the medical field with over 25 years of professional experience. He is a consultant for many South Florida Rehab centers. Patients travel from allover the US to seek his help with addiction and Hepatitis C treatment.
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