Policy Documents

Principled Mental Health System Reform

Timothy A. Kelly –
January 7, 2000

in this Backgrounder, Timothy Kelly writes that an estimated 5.6 million Americans suffer from severe mental illness. It strikes without regard to age, gender, race, education, socioeconomic status, culture, or ideology. In many cases it brings suffering not only to the individual but also family and friends. Depression, which causes many of the 30,000 suicides in America each year, especially targets the elderly. Schizophrenia tragically afflicts some of the best and brightest adolescents.

Persons with mental illness deserve compassionate support, but are often met with fear and stigma. They need effective treatment, but are too often offered ineffective care, if any at all. The economic costs of mental illness are staggering. America spends over $69 billion yearly on direct treatment costs. Virginia is a case in point: It spends over $1 billion for publicly funded psychiatric care each year; per-bed-year costs of hospitalization run between $108,000 and $175,000. Yet there are long waiting lists for community services, and many persons with severe mental illness are caught in a vicious circle. They enter a psychiatric hospital for treatment, are discharged back to their home community with no effective follow-up care, and end up homeless or back in the hospital, In addition, it is not unusual for those with private insurance to end up in public care once their limited coverage is exhausted.