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County Pays For Lack Of Proper Care For Mentally Ill Man

Posted by Chris Liebenthal on December 23, 2010

From Milwaukee County First:

Last week, the Milwaukee Journal Sentinel reported that the Milwaukee County Board of Supervisors had approved of paying out $25,000 to settle a lawsuit stemming from the poor treatment given to a man who had been a patient at the mental health complex.

The man, Larry Ellis, had been diagnosed with schizophrenia and was a frequent patient at the mental health complex.  Three weeks after being discharged, he had a psychotic episode.  Police were forced to shoot and kill Mr. Ellis when he charged them with a knife:

Larry Ellis was charging at a police officer while wielding a knife when he was shot to death on Oct. 26, 2006, in what’s been called “suicide by cop.” The 25-year-old Ellis, who was diagnosed as schizophrenic, had been released from the complex about three weeks earlier. He also had previous stays at the county’s psychiatric hospital and prior suicide threats.

Ellis’ mother and sister – Beryldene Williams and Jameila Ellis – sued the city and county in federal court, claiming a civil rights violation over the shooting and the quality of care Larry Ellis had at the complex.

The claim against the city and the officer who shot Ellis was dismissed last year.

There is no explanation on why Mr. Ellis’ family chose to sue the County, but it does not take much to come up with the probable story.

By 2006, Scott Walker had already downsized the mental health complex considerably.  Psychiatric beds were a precious commodity and many times the staff at the complex were forced into making decisions on who to accept and who to discharged based on the severity of the mental illness and the level of danger the patient presented.  Often, decisions were made to discharge a patient deemed as less severe to make room for another patient who was seen as being more at risk.

Likewise, Walker has been unwilling to provide adequate outpatient care for these same patients.  He did this despite the proven success of such programs in reducing hospitalizations and/or police costs.

Two supervisors, Patricia Jursik and Joe Sanfelippo, expressed doubt about making this payment, even though they eventually joined the other 17 supervisors in voting to approve it.

Jursik’s issue involved her concern about the thin line the county was traveling down.  She correctly points out that state law requires patients to receive care in the least restrictive setting possible, but this puts them at risk for consequences of inappropriate discharges.

Sanfelippo’s concern was much more base.  He was worried that this might encourage others to sue the county because “they were unhappy with their treatment at the Mental Health Complex.”

This position is alarming.  A young man lost his life, a tragic event that might have been avoided if there were sufficient psychiatric beds or if he had follow up care after his discharge.  But due to cynical budget cuts, cuts that Sanfelippo supported, Mr. Ellis didn’t just get poor service, he didn’t get enough treatment and support.

If Supervisor Sanfelippo or anyone else would complain that tax payers simply cannot afford to provide adequate care, I would point out this report, which shows that we cannot afford not to provide that care (emphasis ours):

Serious mental illnesses (SMIs), which afflict about 6% of American adults, cost society $193.2 billion in lost earnings per year, according to findings published in this month’s American Journal of Psychiatry. Surveying data from nearly 5,000 participants, researchers determined that people suffering from a SMI — defined as a range of mood and anxiety disorders, including suicidal tendencies, that significantly impaired a person’s ability to function for at least 30 days over the past year — earned at least 40% less than people in good mental health. “The results of this study confirm the belief that mental disorders contribute to enormous losses of human productivity,” says Ronald Kessler, a Harvard professor of health care policy and lead author of the study, funded by the National Institute of Mental Health.

Researchers arrived at that figure using data from the 2002 National Comorbidity Survey Replication, a nationally representative study designed to gauge the overall mental health of Americans, and extrapolated it to the general population. Kessler and his colleagues determined that a person suffering from SMI had earned $23,000 on average in the previous year. Those respondents without SMI averaged nearly $40,000. The researchers attributed 75% of that difference to the person’s mental illness. The other 25% was attributed to a greater likelihood that a mentally ill person would not have worked at all, thus earning nothing — Kessler says, for example, that very few participants with autism, schizophrenia or other chronic illnesses were included in the $193 billion figure.

Though these figures may seem high, Kessler and his colleagues caution that they are likely too conservative. For one thing, the study’s conclusions are based on data from 2002; today, Kessler says, the rate of mental illness is likely higher due to a variety of causes, including the Iraq war starting in 2003. But, more importantly, lost earning potential is only one of the many indirect costs of mental illness in American society. Social Security payments, homelessness and incarceration add to that economic burden, as well as direct costs such as medications and physicians’ care. “The actual costs are probably higher that what we have estimated,” Kessler says.

What’s more, Kessler’s report considers only severe mental illness in its calculations. Yet more than one in four American adults suffers from shorter-term, but clinically diagnosable mental disorders in a given year — including depression or an eating disorder — and such disorders are the leading cause of disability among U.S. workers under age 45. In 2005, research by Kessler showed that 60% of Americans with a mental disorder got no treatment for their ailment at all.

Finally, do not make the mistake in believing that Mr. Ellis’ case was an isolated incident.  There are many stories in the news, such as the the person who shot two Milwaukee Police Department officers two years ago, of people that were receiving inadequate care and cost society much, much more than the cost of providing adequate care.

But to say that we cannot afford proper treatment for these vulnerable citizens is just an example of being penny-wise and dollar-foolish.


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