10.17.2009

TPC: New Orleans Has A Mental Health Care Problem. Bobby Jindal Made It Worse.

The latest from guest blogger GottaLaff (originally posted at the The Political Carnival on October 15, 2009):


TPC EXCLUSIVE: New Orleans has mental health care problem. Bobby Jindal made it worse.

Yes, Bobby Jindal made the mental health care problem worse, alright... simply by his mere presence. But that's another story. Here's the real one that needs to get out there, and it's all about the New Orleans Adolescent Hospital (NOAH), health care, and politics:

CBS





State Representative Neil Abramson (D) New Orleans

Mrs. Neil Abramson wrote to me first:
My husband is State Representative Neil Abramson (D) New Orleans; he was a partner in a worldwide law firm but became so frustrated after the events of Hurricane Katrina, he ran for office. He has truly carried the banner for New Orleans and its recovery, even butting heads with Governor Jindal on a few key issues. One of the is the closing of the ONLY public mental health facility in New Orleans.

When Jindal first wanted to close NOAH citing budgetary concerns, the New Orleans delegation, led by my husband, fought and found the funds to keep it open. Jindal vetoed the funds.

Since that time, Jindal has closed NOAH. What is devastating is that NOAH wasn't even up to it's full capacity from before Katrina - and with all the increase in PTSD here, it really should have been expanded 4x because there is so much need.

Jindal's plan was to transport patients, many in emergency crisis situations, an hour away by ambulance (over Lake Ponchartrain) to Southeast Hospital in Mandeville, LA. Besides the fact that that is absurd, now that hospital is slated to close! SO WHERE IS ANYONE TO BE TREATED?! It's a travesty.

Currently another hospital has stepped up with 13 mental health beds, though the need in in the hundreds...

Our fears are that Jindal wants to sell both NOAH and Southeast (gorgeous buildings on prime property) to his cronies under "privatization".

Our latest battle has been that NOAH used to be the Marine dorms (it's in Uptown New Orleans on the River) and was sold by the US to the State of Louisiana WITH THE UNDERSTANDING IT WOULD BE USED AS A HOSPITAL UNTIL 2011!

If it isn't, ownership reverts back to the US Gov't. Obviously that is preferable to a "fire sale" of the property by Jindal. We are trying to use that as an incentive to let another State owned hospital run the facility to combat the need here.
Then State Rep. Neil Abramson sent me an exclusive e-mail:
We have a severe mental health crisis in New Orleans. We have a growing number of people with mental health needs while our mental health services are significantly lower since Katrina. The closure of the New Orleans Adolescent Hospital (NOAH), the only state run mental health facility in the New Orleans area, only exacerbates that problem.

In the legislature, we funded NOAH to keep it open. Governor Jindal "line-item" vetoed that appropriation. Instead, his plan is to send all mental health patients 60 miles away, across a 24 mile bridge over Lake Ponchartrain, to receive critical mental health hospital services. [...]

Closing NOAH and having no mental health hospital services in New Orleans flies in the face of the entire reason NOAH was established in the first place. And, there is more of a mental health need now than ever before. Quite simply, it makes absolutely no sense.

The non-sensical nature of NOAH's closing is even more disheartening because it wasn't about the money. Louisiana, just like many other parts of the country, is facing economic issues and we had to cut spending in places. In the legislature, we were able to allocate funding to keep NOAH open by still operating within our existing budget. As public spending was cut across the board 15% or so, we reduced NOAH by the same amount as other facilities. Yet, we kept it open to provide the vital resources it does.

What is sometimes lost in the discussion is that NOAH services low-income, medicaid patients, and it was established to treat adolescents, although adults were treated or evaluated there after Katrina because of lack of other facilities. These kids need to be close to their families, and the entire families need to be part of the counseling in order for the treatment to be productive. Most of these kids and families do not have the ability or the means to travel to 60 miles, across a long bridge. They can easily get to NOAH using public city transportation. Therefore, moving the services to the Northshore is like throwing all of the money away because the services need to be in New Orleans to be worthwhile. [...]

It is already being reported that our Parish Jail is now becoming the new mental health hospital. [By this, Rep. Abramson means that "those who should be in NOAH are doing things they shouldn't, and end up in jail instead."]
Unacceptable. Why is it that mental health is like the poor stepchild when it comes to care? If someone broke a limb, it would be tended to immediately and professionally.... well, with the proper insurance... and hospitals... and medical personnel.

But emotional/mental issues? Ignored, shunned, punted.

Our entire health care system is in desperate need of repair, just as New Orleans is. But for now, let's stick to NOAH.

I called Rep. Abramson just now for further comment. Here is some of what he told me, starting with his main points. All are direct quotes, some are paraphrased just a little, because I had to write so fast as he talked:
We have to be problem-solvers, not bean counters... no matter whose idea it is. We can't have tunnel vision.

The real problem, unfortunately, is this became an issue of politics: Who has the idea and whether or not we need to be problem solvers, not bean counters.

Jindal decided to save money, to consolidate two state mental hospitals into one. It became obvious to me that you can save all the money you want, but the facility HAD to be in New Orleans to address the needs of the patients.

They wanted to save money, of course. But I went to the administration and said [the facility, NOAH] has to be in New Orleans. If it's too inefficent, give me an alternative, an economically viable one that puts services in New Orleans. It can be NOAH, or it can be someone else, but it must be here.

They got bogged down in "this is my concept", so I got money to keep NOAH open. We weren't asking to raise taxes, but to operate within the same existing structure as everyone else. But no thought was given to this. We need a better system.

I was trying to solve the problem. But it came down to "my way or the highway." Jindal vetoed the funding.

I just want the best idea, no matter whose idea it is.
I asked Rep. Abramson if some people think that Bobby Jindal is anti-low income, anti-minority. Jindal didn't carry New Orleans, so politically, they are not a priority. Rep. Abramson thinks it's more about "the governor being in campaign mode" than anything.

What do you think?

Here are a few excerpts from a Washington Times piece that the Abramsons pointed me to:

A mental health crisis that has swamped this city's care facilities as surely as Hurricane Katrina's floodwaters washed over the Lower 9th Ward is about to become even worse, care providers say.

New Orleans already is struggling with fewer than half of the inpatient beds for the mentally ill that it had before the 2005 hurricane - even as suicide rates and the number of people with mental health problems have doubled. [...]

"What we have is PTSD on steroids," the doctor said. [...]

State Rep. Neal Abramson, whose district includes New Orleans, mounted a last-ditch effort to keep the hospital open. [Laffy Note: They misspelled his name]

"For people who need the facility, they are looking at over an hour of travel, and most people don't have the means to get there," said Mr. Abramson.

For those who don't have cars, he said, the hospital might as well be moving to Arkansas. [...]

"I've told people for so long, just don't come back [to New Orleans] right now," said Cecile Tebo, administrator of the New Orleans Police Department Crisis Unit that responds to 911 calls involving the mentally ill.

"Don't come back if you have any kind of special needs; this is not the place to be if you have elderly that are really sick, if you have children with special needs or people in the family with mental illness or mental retardation; this is just not a good place to be right now," said Mrs. Tebo, whose own staff of volunteers is just a little more than half the size it was before Katrina.

Tomorrow, President Obama is going to New Orleans. This story will get a whole lot bigger in the next 24 hours.
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