Recent news about reviving the New Orleans Police Department Crisis Unit and training police officers to be sensitive to people in crisis is necessary and laudable, but what mental health services and facilities are available for officers to connect people with — outside of Orleans Parish Prison — in the event that there is an incident?
Post-Katrina, with the intentional shutdown of Charity Hospital, the city lost 128 psychiatric beds. Some of those beds were moved to the New Orleans Adolescent Hospital [NOAH], until Gov. Bobby Jindal shut it down. Since then, there are a dangerously low number of long-term inpatient psychiatric facilities to care for people experiencing a mental health crisis.
While there is federal funding for outpatient services and/or primary care clinics for people in New Orleans who are able to find and gain entry to such programs, there is little for those suffering with severe mental illness. They need to be stabilized in long-term care facilities and might ultimately find sanctuary in supportive housing situations. They are the population NOPD officers are most likely to encounter.
In 1980, the "deinstitutionalization freak-out," brought about as a reaction to the horrific sanatoriums of old, incentivized President Ronald Reagan to kill the Mental Healthcare Act — the law that enabled federal funding for state psychiatric hospitals. But the deinstitutionalization experiment has failed. Instead of warehousing people in hospitals, now we warehouse them in jails — a phenomenon known as trans-institutionalization.
A familiar refrain from families in crisis is that they tried, but couldn't, find help for their loved ones before a tragedy involving suicide, murder or assault. There are a myriad of reasons, but many of us have struggled with being unable to keep a friend or family member in a hospital for needed mental health care because of legal interference.
U.S. House Resolution 3717, proposed by Rep. Tim Murphy, R-Pa., earlier this year, would restore federal funding for assisted outpatient treatment and allow judges to order a small group of the most seriously ill to stay in six months of mandated and monitored treatment. Congress, however, failed to advance the bill. Advanced outpatient treatment is one part of the bill's comprehensive overhaul of the highly fractured mental health care system. It remains to be seen whether HR 3717, also known as "The Helping Families in Mental Crisis Act," passes in Congress next year. Meanwhile, various localities, including New Orleans, are left to find our own solutions.
Inpatient care and outpatient care should not be viewed as mutually exclusive. What is needed is a middle path. And there is a million-square-foot solution located right under our noses. Charity Hospital — in context with the medical corridor — is the perfect facility to combine a long-term mental health restoration center with transitional housing. Located in the BioDistrict, this new mission of Charity Hospital could act as an exclusive mental health/neurological research facility while encompassing creative workspaces for organizations that deal with systemic problems of mental illness, homelessness, workforce challenges and stigma.
The multi-complex would form a matrix that acts as an incubator dedicated to progressive and enlightened approaches to mental health care. People released from the restoration center who have nowhere to go would be transferred or transitioned into outside supportive communities with medical professionals living on site.
The new University Medical Center and Veterans Affairs Medical Center will offer only 80 inpatient psychiatric beds combined, half of what was available pre-Katrina. The Charity proposal recognizes the critical need for additional long-term beds as well as building upon Charity Hospital's cultural importance. The costs of the project would surely be far less than the long-term societal costs and consequences of increased violence such as: incarceration, 911 calls, police resources, ER visits. It also would ease the problem of families unable to find long-term coping strategies for their loved ones who are in jails and prisons or who are prematurely released from hospitals and dangerously vulnerable.
There is also the problem of the cost of how the rest of the world sees our state, given that Louisiana is the incarceration capital of the world. Our jails are filled, not only with those who are a real and present danger to society, but also with homeless people and people who have minor drug offenses or unpaid traffic fines — including many afflicted with mental illness.
Janet Hays is a member of the Orleans Parish Prison Reform Coalition and Health Justice Advocacy Director for SaveCharityHospital.com