Wednesday, July 30, 2008

America's Mental Health Care System in Shambles

By Art Levine, The American Prospect
Posted on July 26, 2008, Printed on July 28, 2008

may seem arcane, but the reimbursement and spending priorities of
government health agencies can literally have life and death
consequences for people with mental illness
. Just ask the family of
Carolyn Howard, who was bludgeoned to death in 2005 on her front lawn
by her adult son Keith, who suffers from paranoid schizophrenia.

tragedy unfolded after the Florida Medicaid program abruptly dropped
Zyprexa, the expensive antipsychotic medication upon which Keith Howard
had depended, from its formulary of approved drugs. As a result, Howard
was hospitalized twice in the two months before the killing, having
heard voices telling him his mother conspired with murderers like Lee
Harvey Oswald. An investigation by The Orlando Sentinel last year found
that Howard was prescribed substitute medications but that they didn't
help. Today, compelling federally funded studies question, in general,
the effectiveness of such "second generation" antipsychotic medications
as Zyprexa; these drugs, although they may work for certain individuals
like Howard, also pose health risks like diabetes while boosting
Medicaid's antipsychotic drug costs 10-fold in barely a decade. But
Florida's inflexible, ham-handed approach to cost cutting, as opposed
to more humane cost-effectiveness strategies in a few other states,
shows the devastating impact of shortsighted budgetary policies.

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