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Mental health cases rise, funding falls

Advocates say, by cutting services, more people will show up in costly hospitals and jails.


© St. Petersburg Times, published February 1, 1999

CLEARWATER -- They are the people who have been "lost in charts" by the bureaucrats, Jim Eakins complains.

People like Gigi Rebecca Behar, a woman who suffers from paranoid schizophrenia who Eakins says has been forgotten by the lawmakers in Tallahassee.

Eakins admits he gets a little emotional when he talks about Behar, a woman who has lived in his Clearwater home for six years. A woman he considers his sister.

The feeling is mutual.

"I love being here," a smiling Behar, 45, said as she sat in their dining room one day last week.

Behar came to Eakins and his wife, Rosemary, through a state program that places mentally ill patients from state hospitals into private homes. The families take care of the patients and encourage them to be self-sufficient.

The Eakins have kept 10 patients in their home since the program, administered by Gulf Coast Jewish Family and Mental Health Services and funded by the state's Department of Children and Families, began in 1991.

They have watched "clients" get their driver's license and move out on their own. They have experienced the pain of seeing a man, whom everyone thought was progressing with his depression, commit suicide last August.

Through the ups and downs, the Eakins see hope. But that hope, Eakins says, has been tested by funding cuts to mental health programs in recent years that have forced agencies like Gulf Coast to limit the number of patients that can be placed in homes like the Eakins'.

"These people are somebody's mother, father, brother, sister," said Eakins, 45. "They need help."

Like Gulf Coast, agencies across Pinellas have been forced to scale back programs, lay off employees and search for new funding sources.

"What it has resulted in is doing more with less," said Tom Riggs, chief executive officer of Directions for Mental Health, a Clearwater organization that provides treatment for the mentally ill. The group recently eliminated a program that provided respite time for the parents of mentally ill children.

County commissioners have taken up the cause by making care for the mentally ill one of their top five priorities this year. Last month, public and private officials who have some contact with the mentally ill met to discuss how to improve services.

Commissioner Barbara Sheen Todd appealed to the Florida Association of Counties to put together a data base that would help state lawmakers better understand how desperately money is needed.

"There are not enough community service agency dollars to pay for them to take care of them," Todd said in an interview. "It's because we have no resources to treat them."

While there is no accurate count of the mentally ill population in Pinellas, advocates and government officials say the number of those who suffer from some form of mental illness has risen while funding has decreased.

Advocates say 20 percent of older adults suffer from mental disorders, more than one-half of those in long-term care facilities have some form of mental illness and about 15 percent of those incarcerated are taking some form of medication to combat a mental illness.

In addition, more mentally ill people are winding up on the streets of Pinellas. Advocates also say that more people are being checked into hospitals under the Baker Act, which allows police or family members to commit someone involuntarily if they are a danger to themselves or others.

The state ranks 45th in the country in per capita expenditures for behavioral health care, according to the National Association of State Mental Health Program Directors.

Last year, the state Legislature provided additional funding to the Department of Children and Families to help people who get mental health counseling or substance abuse treatment get off the welfare rolls. But funding was cut in other areas such as a new vocational program for those suffering from schizophrenia and other disorders.

Cuts were also made to DCF's residential programs, and subsidies to help those in assisted-living facilities remain there or continue to get their medication were cut in half.

"Our concern was by cutting some of these services, that these individuals end up in hospitals," said Diane Wallace, who oversees mentally ill programs for the DCF.

Mental health program advocates acknowledge that they are competing with equally worthy programs that need funding.

And County Commission Chairman Sallie Parks suggests that money alone won't solve the problem. Enhanced community treatment, common sense policies and better data collection would help.

"We don't have our act together," she said.

Still, program operators warn that without additional funding, mental health could reach the crisis level.

"I think we're looking at the jail population increasing, the psychiatric hospitals increasing. We're looking at more people needing to go to the state hospitals," Wallace said.

County commissioners are worried about the same thing and want to get more money from the Legislature for prevention programs that advocates say are less expensive than institutionalization.

For example, it costs about $70,000 to keep one patient in a state hospital for a year while the cost to keep someone in the Gulf Coast sponsored program, called the Alternative Family Program, costs about $12,000 per person each year, according to the program's team leader, Margie Shanley.

The program is the only such initiative in this part of the state. Ninety-two percent of those who have gone through the program have not been readmitted to a state hospital, Shanley said.

Shanley said budget cuts in 1996 forced them to cut back on the number of people they could take from institutions into their program from 40 to 33. There are currently 17 people on the waiting list, some who have been waiting for placement as long as two years.

"There are a lot of people we are turning away," Shanley said.

Wallace said it is one of the programs she will try to make sure has additional funding for the next fiscal year.

"It's just a matter of providing for people who society has just forgotten and shoved under a rug," Eakins said.

Since Behar's arrival into their household six years ago, Eakins said he has seen positive changes in Behar, who likes to be called Gigi.

When she moved in, Eakins said she wouldn't look him in the eye and hid her face behind her long, graying hair. Now she smiles often, is more independent and plans to take computer courses so she can become an airline ticket agent and move into her own apartment.

Behar has relatives in Arizona, but she doesn't want to move in with them because she doesn't want to be a burden.

That's just the way Behar is, Eakins said.

She often gives part of her salary from McDonald's, where she has worked on weekends for nearly three years, to Gulf Coast to help pay for the program that serves her.

"I love them," she said.

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