Our View: Louisiana needs mental health check

The U.S. Department of Justice has made clear that Louisiana has breached its duty to aid some of its most vulnerable citizens, by keeping them warehoused in nursing homes rather than placed in community settings where they would have a much better chance of living fulfilling lives.

The Times engaged in a deep exploration of the issue, digging deeper to get a better understanding of the issues raised in a 30-page letter sent to Gov. John Bel Edwards by the DOJ. As the resulting article indicates, there is ample reason to believe that the DOJ is not overplaying its hand, and that no bluffing is involved.

The fact is that over many years we have seen time and again that our state places mental health care for its citizens. There have been some improvements. But more are needed.

What is not needed is for people who don’t need the strictures of nursing home living to be subjected to that as the only viable option.

We don’t know – yet – how many people in this predicament are patients of nursing homes in the Bayou Region, although advocates have confirmed that at least four nursing homes in Terrebonne Parish have such patients. There is no telling how many people from this area are consigned to nursing homes elsewhere. State officials say they are compiling data in response to a Times request for facts. We are grateful that they are keeping channels of communication open. But the information should have been readily available. That it must be coaxed from state computers is an indication itself of the problem. The time between delivery of the DOJ letter and preparation of the article in today’s issue of The Times is too long. That data was not readily available gives an indication, to us, of where all of this lies in terms of state priorities.

It is no secret that the Louisiana Department of Health and Hospitals is one of the state’s agencies that has a budget susceptible to cuts, something that might be addressed better if long-needed changes were made to the state’s Constitution. But suggestions for true solutions, such as those championed by legislators like Dee Richard (No party-Thibodaux) are repeatedly ignored.

That the mentally ill people who live in Louisiana nursing homes are free to go if they wish, as the head of the Louisiana Nursing Home Association points out, is of little comfort.

It is easy to imagine nursing home employees being flummoxed when presented with a request for egress. Their default would naturally be to recommend that patients stay, particularly those with no families to help care for them.

But there is a family for them, the human family of Louisiana, and the people who work for solutions like the Start Corporation. Fortunately, there are some safety net provisions in Houma. The same isn’t true for the rest of the state.

During the administration of former Gov. Bobby Jindal we saw effective mental health assistance wither. That should come as a surprise to no one. It was Jindal, years ago, as Gov. Mike Foster’s Medicaid czar, who helped create a situation that left families in Houma and other local communities suffering. Child psychiatrists, unwilling to accept the meager pay Louisiana Medicaid allowed, went to practice elsewhere. A generation of children received less than adequate care because of this.

Now, the DOJ report sent to Gov. John Bel Edwards makes clear that adults with brain disorders are being short-changed.

And it’s not just them.

Louisiana taxpayers are footing the bill for the higher cost that nursing homes demand. Studies and practice in other states have made clear that community living for people with serious mental illnesses is the less expensive alternative.

We have no doubt that Gov.Edwards will do his best to change in this regard a reality. Advocate for the mentally ill and even state employees, who spoke with reporters on deep background, appear to agree that this administration will do what it can to see that the law is followed, and that people with mental illnesses will see some relief.

The question is how long will it take to fix a broken system that demands payment of top dollar.

Louisiana must make good on the requirements of federal laws that have been flaunted for too long, not just because failing to do so is not legal, but also because it is not right. •