When the Food and Drug Administration approved the first antipsychotic, Thorazine, in 1954, mental health service providers hoped this drug would revolutionize mental health care. Finally, scientists had created a pharmaceutical that would cure the mentally ill.
But as researchers have studied psychosis, they have learned that antipsychotics do not address the root causes of mental illness. They only alleviate symptoms.
Likewise, our ailing mental health care system in Texas treats the symptoms of its illness rather than its causes. We often wait until the mentally ill are in crisis and react by throwing them in jail or treating them in an emergency room. In doing so, we’ve reduced some of the most vulnerable people in society to problems that need to be fixed.
We try to fix these problems by throwing money at programs that we think will help them. But the problems remain, in part because the programs do not acknowledge the strengths and abilities of the people they serve.
Texas should adopt a person-centered, recovery-oriented system of care that empowers people with mental illness to move toward self-sufficiency. The current system, by contrast, practically necessitates dependence on government services.
The Department of State Health Services is the primary point of entry into mental health services in Texas. The agency is supposed to serve as a safety net for the poor, and uses a closed provider network that limits patient choice and hinders nonprofit and private sector participation in the delivery of mental health care.
Within this system many decisions about recovery are predetermined for patients. The constraints imposed by limited service options create a system that cannot account for the complexity of the challenges each person with a mental illness experiences. More importantly, this system ignores the potential of each patient.
Within the bounds of our current system, research shows that about a third of those diagnosed with a serious mental illness will recover from the disorder over time, a third will significantly improve and recover high levels of functioning, 25 percent will chronically suffer from their disability, and 10 percent will commit suicide.
What if we could create a system that would help more people with mental illness move into recovery? Consumer-directed care is a step in the right direction. In this model, patients choose how to pursue their recovery and are given more provider choices through greater nonprofit and private sector participation in mental health care delivery.
With the assistance of a facilitator, patients would have a budget to pursue personal recovery goals rather than the goals government programs set for them. Incorporating more individual choice into mental health care would allow people in our now rigid mental health care system to break out and pursue treatment most likely to work for them.
It also would allow those with mental illness to seek services from any entity in their community. Each individual can work toward reaching their potential and living free, independent lives supported by their loved ones and their community.
If we’re going to get to the root of the dysfunction in our mental health care system, we have to stop treating symptoms and start treating the whole person.
Murphy is a mental health fellow at the Texas Public Policy Foundation.