Commentary: Providers of Illinois mental health services might consider using Cuba Gooding Jr.
This article first appeared in the St. Louis Beacon, April 25, 2010 - Providers of mental health services throughout Illinois might consider enlisting Cuba Gooding Jr. as their spokesperson. Who better could deliver the line that won him an Academy Award in the mid-'90s?
"Show me the money."
Wide receiver Rod Tidwell, as portrayed by Gooding, laid the demand on his prospective agent Jerry Maguire. Service providers, reeling from state budget cuts and payment delays, fully deserve to ask the same from state government - especially now.
In recent weeks, the Quinn administration and lawmakers have pledged to move thousands of people with mental illness from nursing homes to community settings. That should allow them to receive the intensive counseling and treatment needed to lead more independent, productive, fulfilling lives near their families and others who care about them. It also should reduce dramatically, if not eliminate, violence against elderly nursing home patients by younger residents with profound mental health issues.
The commitment to sweeping reform took shape in two venues.
It emerged among key recommendations of a task force created by the governor and steered by senior aides in response to a Chicago Tribune series documenting the combustibility of ill-conceived patient mixes in nursing homes.
Meanwhile, the administration agreed to settle a federal court lawsuit brought by the American Civil Liberties Union and others on behalf of mentally ill people who were inappropriately housed in nursing homes instead of less restrictive settings.
All this actually constitutes a recycled commitment that should summon skepticism as well as hope.
More than 30 years ago, our leaders declared we would no longer warehouse tens of thousands of Illinois citizens. They closed state hospitals despite the understandable angst of those employed within them and the cities that valued the jobs. They encouraged and nurtured community services that would civilize Illinois' response to mental illness and facilitate the early and comprehensive interventions so crucial in addressing it. However, they and their successors failed to establish and fully fund the infrastructure needed to accurately evaluate, properly place and effectively treat those battling the most serious disabilities.
The cost in human misery and taxpayer dollars has been staggering. Many of those tens of thousands swelled the ranks of the homeless. Cook County jail became the state's largest psychiatric facility. More than 11,000 inmates in our prisons have been diagnosed as having mental disorders. Thousands are confined in nursing homes.
In the early '80s, our chief policymakers resolved to de-institutionalize; however, in several respects, Illinois has trans-institutionalized. Indeed, the threats to a viable service network have exponentially magnified even as this governor vows anew to undertake reforms that will make us more reliant upon expansive community-based operations.
Providers face a cut of more than $90 million after a year in which many of them have downsized and reluctantly curtailed caseloads because the state, in the words of a seasoned observer, has paid "low and slow." Even with some short-term relief from a state government adrift in a red-ink sea, they cannot come close to meeting the expectations raised by a truly deinstitutionalized mental health system that, ironically, could save tax dollars if implemented properly.
Decade after decade, promise after promise, governors and lawmakers have not delivered. They should do so before a federal judge orders it, citing the Quinn administration's settlement in the ACLU lawsuit.
As figments of filmdom, Rod Tidwell and Jerry Maguire entertain us. As one of the rudest realities in a disintegrating Illinois, the plight of community-based mental health organizations and their constituents shames us and especially those we have elected.
Show them the money.
Mike Lawrence, former director of the Paul Simon Public Policy Institute at Southern Illinois University, writes a twice-monthly column.