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Penny Smart, Pound Foolish: Stopping funding for Mental Illness Medication November 28, 2010

Posted by Crazy Mermaid in Health Insurance and Mental Illness, Healthcare, Medication, mental illness.
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Today I went to the pharmacy to pick up my 30 day supply of prescriptions for my mental illness.  My prescriptions consists of Geodon, Lamictal and a few other drugs. My total bill for 30 days of medication was $1057 per month. Multiplying that out by the number of months in a year, I spend $12,684 for a year’s supply of medication.

Then there’s the psychiatrist visit. If – and this is a big if- I don’t have any major emergencies like hearing voices, I can get by with seeing him about every 4 weeks or so.  That’s about $250 a month.  Then there’s my therapist.  She runs $125 an hour. I see her twice a month. $250 (it used to be weekly until the bill got too expensive).   Between my therapist and my psychiatrist, I spend another $500 a month for their services.  Don’t get me wrong: they’re worth their weight in gold.

The grand total for a year of care is $18,684.  With a price tag like this, it’s easy to see why medication for mental illness is an easy target for a Legislature turning over every rock trying to find ways to cut their budget. But doing so would be penny-wise and pound-foolish.

People who are used to having their prescription drugs paid for by Medicaid, will no longer be eligible for those drugs if these budget cuts go into effect. So what will the net result of this change be?

A significant portion of people with severe mental illness are on disability. Surviving on less than $12,000 per month, they will no longer be able to afford their medications or therapy. Heck, they would have to spend more than what they make in a year on medication if their subsidies went away. Impossible.  They will have to go without.

What does that mean for society as a whole?  It means that we will have a significant percentage of the severely mentally ill off their medications.  Although having the State pay for drugs for the mentally ill appears to be for the benefit of the person with the mental illness, in fact this is a matter of public safety.

Unlike someone who needs medication to thin their blood, a person with a severe mental illness won’t die if the drug coverage is discontinued. They won’t bleed to death or go into a coma without the drugs. So it’s attractive to the cash-strapped Legislature to cut out prescription drug coverage for the mentally ill from their budget. At a cost of thousands of dollars per person, it seems a logical way to save money.

But I hope the Legislature wakes up to this fact before it’s too late: mentally ill people need their medication for public safety reasons. If they’re disabled, they won’t be able to afford their medication without subsidies from the Government. They’re essentially unemployable because of their debilitating illness. They have no reserve of funds, living on the edge of poverty because of their disability.  Without Government interference, there’s simply no room in their meager budget for medication.

The Legislature needs to understand that the medication for the mentally ill is needed as much as or perhaps even more than someone who takes drugs to thin their blood.  If the guy needing blood thinners goes off his medication, there’s a good chance that he will suffer severe symptoms, including the possibility of his death. That isn’t the public’s and the Legislature’s perception of drugs for mental illnesses.

In fact, the un-medicated mentally ill are going to be much more expensive than the medicated mentally ill. Take me, for example. Without my medication, I would be in my own world, disconnected from my family and friends, lost in my own mind. I would once again be that mermaid, disrobing in public.  Trees would talk to me. I would once again believe I had ESP. But the main problem is that without my medication I would become a danger to society.  Believing that zombies are after me, or that I’m being held hostage or numerous violent scenarios will cause me to strike out at whoever tries to subdue me.

Imagine what the world would be like if suddenly all the people with severe mental illnesses- bad enough to be on disability- went off their medication at the same time.  What if the people on antipsychotics stopped taking them after their “free” supply ran out?  All of those psychotic people concentrated in Washington State won’t go quietly off their meds. They need those drugs to prevent their return to a psychotic state.

Washington State has the fewest hospital beds per capita in the Nation, so it’s not like we’ll have any room for the mentally ill in the mental hospitals. If they can get in, mental hospitals cost around $3,000 per day. But  before they go there, they’ll pass through the doors of a “real” hospital- likely the understaffed, overcrowded, cash-strapped emergency room. Think of it: a person in a psychotic state in a room full of sick people.

If they commit a crime, which many are likely to do, they will swamp the legal system and the jails. Police taking on the task of dealing with this situation will short-change other areas of their responsibility.  If you think medication is expensive, think about how expensive incarceration is. The last figure I remember reading is about $50,000 per year.

And what about the mentally ill people who injure others? A paranoid schizophrenic without medication will not be a pretty sight. Won’t those injured “sane” people and their loved ones appreciate what a good job the Legislature did by saving all that money?

I hope that the legislature comes to its senses before cutting those drug benefits.  I hope they recognize it for what it would be: a public health crisis.

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Comments»

1. Jennifer - December 7, 2010

I think, besides the likelihood that people will end up in jail if they’re not on their medication, it’s also very true that many will end up homeless, or dead by suicide. I know that I never set out to harm anyone while I was psycohtic, but I certainly had serious suicide attempts and was homeless numerous times. These are other things society should keep in mind, if this is a society that cares about its citizens, which I’m not so sure it is. I live in Florida, and I recently heard from an expert at a NAMI conference (national alliance on mental illness) that 75% of the women in prison or jail here have been diagnosed with a mental illness. Most of the time they’re in jail for petty crimes, such as sleeping on the sidewalk or having an open container of alcohol in public. And the government is willing to spend many thousands of dollars to lock these people up in jail, but not to provide them with the treatment that would prevent them from ending up in jail in the first place.

Also, as you mentioned, medications are extremely expensive. I am on disability, and the amount of money I get to live on from that is less than $700 dollars a month. If I didn’t have a part time job, I couldn’t eat on that amount of money. If I was more sick than I am right now, I couldn’t work a part time job. It’s a great merry-go-round because I get Medicare which pays for my prescriptions since I am on disability, but if I want to try and work a regular full time job, I will have to go off disability which means I will lose the Medicare, which means I will no longer have the money for my prescriptions, and will not be able to function at all.

2. Clay - December 11, 2010

The system isn’t set up to benefit the people, but the corporations.


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