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EDITORIAL: Monroe's mental health crisis

Pocono Record (Stroudsburg, PA) - 4/19/2014

April 18--A new mental health services center in Mount Pocono is seeking approval from state officials to accept insurance plans. If it's approved, the Rose Resiliency Center would offer a welcome expansion of available therapists to serve as many as 100 clients weekly.

Yet even Rose Resiliency Center won't put much of a dent in the problem of seriously mentally ill people who require psychiatric evaluation and care. Take the case earlier this month of a passenger who repeatedly punched a Monroe County Transit Authority bus driver who refused his request to halt the bus between stops. The man police accuse in the attack is sitting in jail, facing trial in Monroe County Court for two counts each of simple assault and disorderly conduct, and other charges.

The 35-year-old inmate is mentally ill, diagnosed with bipolar disorder and schizophrenia but refusing to admit his problems or to take medication for them. He and many other mentally ill men and women all too often end up in jail, probably the last place that will do them any good.

Yet jailing the mentally ill is a common phenomenon. All too often, there's no other place to put them. And even those who aren't violent, and who don't have brushes with the law, face an uphill battle for treatment. Long waits to see a psychiatrist are routine: According to the Carbon-Monroe-Pike Mental Health and Developmental Services agency, it can take two weeks even for an emergency appointment, partly because fewer doctors are going into psychiatry to treat seriously mentally ill people. Psychiatrists' schooling takes many years, and practitioners often come out with crushing debt. Yet the pay isn't good, and the reimbursement system is poor as well. The dearth of psychiatrists presents a challenge when patients who can become violent, those who are suicidal and other seriously ill people need treatment.

Changing the regulations that govern reimbursements to make them more favorable would help. Another way to ameliorate the problem is telepsychiatry, which C-M-PMHDS now uses in all three counties. The agency contracts to have a psychiatrist on call and available by teleconference. This somewhat relieves the access issue while providing service that an agency spokeswoman said gave high satisfaction in a client survey.

C-M-PMHDS has written a letter of support for Rose Resiliency Center's quest for approval to begin accepting clients' insurance plans, knowing that the center will add needed therapists and options for scores of area residents. But caring for the acutely mentally ill remains a serious challenge. Jailing such struggling individuals should be the last resort.

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