Amidst recent cuts in mental healthcare expenditures on the state level and within New Orleans area hospitals, those who work with the mentally ill in St. Charles Parish say there is a definite local effect.
Marilyn Frazier, Director of the Behavioral Health Unit at St. Charles Parish Hospital, said her 20-bed unit is routinely filled to 100 percent capacity and that many of those patients come from New Orleans due to the city losing hundreds of in-patient beds after Hurricane Katrina.
"By closing beds we are just pushing the problem in a different direction," Frazier said. "It does not eliminate it."
Frazier said they are obligated to take in mental health patients from all over the state because those patients receive orders to be held in hospitals until their mental health issues are resolved.
When a patient shows up in an emergency room and a doctor designates them as an emergency certificate case they are obligated to find an in-patient bed somewhere in the state. She says that every hospital is called until a bed is located, which means that in-patient beds in St. Charles Parish Hospital are often taken up by people from outside the community.
Stays in Frazierís unit average about 12 days and the patientís issues range from severe chronic mental illness to temporary issues and substance abuse. She does tend to see the same faces show up time after time.
"Recidivism in psychiatry is expected because the illness is a lifelong illness for most," Frazier said. "Those diagnoses that are long-term chronic illnesses you do see the patients return. They can go long, long periods–years without needing hospitalization–with the right support and backup to be there for them. But thatís not to say they can go hospital free."
Frazier said unfortunately the resources for mental health continue to be cut and it is less likely people will receive the community support they need.
"We donít have the resources. The state is not providing the resources. The clinic appointments are far and in between," Frazier said. "There are very few outpatient clinics that can help. When you look at the volume of patients that need it, we need more facilities to take care of them that are outpatient."
Judge Lauren Lemmon agrees with Frazierís assessment.
Lemmon said she has recently been handling the case of an Iraq war veteran who is suffering from post-traumatic stress disorder and has been in and out of trouble with local law enforcement.
"Our governor has cut mental health significantly because it is not politically correct," Lemmon said. "But having this guy sit in jail is not helping him. Itís not helping the jail. Itís costing us more money and heís not getting the services he needs. The jail doesnít have the services to provide, but he really canít go back into our community. I donít know the answer to that, but weíre working on it. But I know the answer is not to cut the mental hospitalsí budgets, but that is what we are doing both locally and nationally."
Lemmon said she tried to get the mentally disturbed war veteran placed in the St. Charles Parish Hospital after he was arrested following a standoff with police, but due to a shortage of beds it was a few days until they were able to place him in the Veteranís Administration Hospital in New Orleans. Ten days later Lemmon said he is back on the street with very little oversight.
"Heís a danger to himself and heís a danger to our community," Lemmon said. "If heís on his medicine he is stable, but if or when he stops taking them–which he will–heís going to either kill himself or hurt someone else."
Lemmon said she expects to see more cases of war veterans returning home from Iraq and Afghanistan who are suffering from mental illness, but do not receive enough community support.
"This is scary stuff and itís only going to get more difficult and more challenging because weíre going to have more of these people coming home from war and not having the services," Lemmon said. "We pray for these people and put signs up in our yard. We all support our troops, but when they come back we donít have the services to support our people."
St. Charles Parish Hospital is currently the only facility in the parish that deals with acute mental health issues. When the new emergency room opens in early June the hospital will be adding five more beds solely to deal with mental health issues.
St. Charles Parish Hospital Marketing Director Quinn Landry said although St. Charles is bucking a trend by offering more options for mental health rather than fewer it is still not enough.
"Itís tough on the patients because we donít have the facilities," Landry said.
Landry said the hospital also offers outreach programs such as Alcoholics Anonymous meetings that meet at the hospital every Monday night at 7 p.m.
Lemmon said such outreach programs go a long way to help and that she instituted a substance abuse treatment option for those who end up in the criminal justice system who she finds have serious addiction issues.
"Substance abuse is a mental illness and itís been recognized as one by the courts, but it has not been recognized in the community as such," Lemmon said. "Again itís something thatís not politically correct."
Lemmon also said those who suffer from mental illnesses often try to self-medicate with drugs and alcohol, which have a tendency to make the problem worse.
"I have put it into my budget as a budget request and the parish has been generous enough to give us some money so that we pay for some of the mental health services here, such as substance abuse assessments when they canít afford it," Lemmon said. "Thatís going to run out one day too. We are being very proactive about helping because when you boil it down in our courts a very large percentage of what you see involves mental health issues–criminal, family, custody, protective orders, domestic violence, juvenile–itís a huge juvenile issue."
Lemmon said she brought up the issue of lack of community support for the mentally ill earlier this month in her meetings with the parishís other judges and that she hopes to further communication and collaboration amongst parish officials with a goal aimed at improving mental healthcare on the local level.
"Weíre in a terrible crisis that nobody knows about it or few people know about," Lemmon said. "Itís like a war in our own community."