A DISTURBING TREND IN MENTAL HEALTH AID

More crowding. More drug abuse. More stress. More noise. More pressure.
More paper work. More people.

In the past five years, Austin has gotten more of everything, right?

Wrong. The city's ability to care for serious mental illness among its
burgeoning population has shrunk. And we may pay a high price for
letting that happen.

Every once in awhile, the prevalence of mental illness gets our
attention. A deranged man stabs three people he passes in the Sixth
Street entertainment area. A middle-school student commits suicide at
school. An elderly neighbor withdraws behind closed blinds. A friend
fails to "snap out of it." The teen-ager down the street goes to rehab.
A relative's child is prescribed drugs to cope with severe behavioral
problems.

While hospitalization is a last resort, it is at times a necessary one.
Yet hospitalization options are dwindling. The number of private
psychiatric hospitals in Austin has shrunk by half over five years. The
remaining two hospitals, Seton Shoal Creek and St. David's Pavilion,
have been in merger talks for about a year. "Just one" is not the best
option, but it would surely beat "none."

The Travis County Jail awkwardly fills a yawning treatment gap. Never
meant for the role, the jail has become the county's "biggest
psychiatric hospital," according to Dr. Deborah Peel, president of the
Texas Society of Psychiatric Physicians. She views the proposed
private-hospital merger as a potential "disaster."

The 312-bed Austin State Hospital reports admissions at a 12-year high.
It stays nearly full despite increasingly brief stays by patients,
mostly the indigent and the ill who are committed by the courts. The
hospital's ability to help more patients is limited by, among other
factors, a shortage of workers. About 150 job slots are empty, according
to the clinical director, Dr. Clifford Moy.

Children's advocates say finding appropriate care for young people with
mental and behavioral problems is particularly daunting. Neither public
nor private health insurance plans adequately cover treatment needs.
Services are not well coordinated, and support for families coping with
mental illness -- such as respite care -- are often lacking. Many
children eligible for public health insurance plans don't get help
because the state discourages participation with Medicaid red tape.

Among the elderly, mental disorders such as clinical depression and
substance abuse often go undiagnosed and untreated.

"This is a critical time for our mental health system," said Dr. Moy,
who was quoted in a recent report by American-Statesman reporter Mary
Ann Roser on the proposed hospital merger. In the Jan. 29 article, "Is a
single psychiatrist hospital enough to serve Austin's patients?" Roser
found deep concern among mental health workers about a shrinking number
of psychiatric beds and options for treatment. The possibility that the
city might be left with no private psychiatrist hospital is frightening,
said Dr. James E. Kreisle Jr., president of the medical staff at St.
David's Pavilion.

Mental illness and addictive diseases are a huge, often ignored problem
for this community. Lack of treatment is costly to families, to
employers, to public service agencies and to the city's quality of life.
Citizens in all economic levels have a right to expect a basic level of
health care that never falters.

Neither oversight nor turbulence in market forces should deter the
community from making sure care is available when we need it.