The cost of stigmatizing mental disorders

I saw an internist friend today and asked him to share a pet peeve about the health care system. Here’s what he told me:

An uninsured patient was seen at MGH. He was psychotic and was referred to a well-known mental hospital for treatment. After 9 days he was released -with no discharge plan. He wasn’t cured or even stabilized, but 9 days of costs was all the hospital would or could absorb.

No psychiatrist his family could find would treat him, and he eventually found his way to my friend the internist’s office via a personal connection. My friend isn’t equipped to treat a psychotic patient and only by spending considerable time and calling in a big favor was he able to find a psychiatrist to treat the patient.

My friend’s sense is that the state’s unwillingness to pay for mental health care is a bad ethical and financial policy. Maybe the voices in the patient’s head will start telling him to do bad things. It won’t be good for anyone when the case is transferred to the prison system.

July 4, 2005

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