Doctor discusses Bryce, state of mental health

William Evans

Dr. John Houston, commissioner of the Alabama Department of Mental Health, delivered a speech titled “Current Mental Health Issues in Alabama” to the School of Social Work in Little Hall Monday afternoon.

In his speech, Houston gave a brief overview of the department and its history.

Houston said Bryce Hospital, Alabama’s first state-supported psychiatric facility, has played an important role in the history of mental health since it treated its first patient, a Civil War soldier, in 1861.

Houston said Bryce is an integral component of the overall picture of mental health in Alabama.

“Bryce is not isolated,” Houston said. “It’s part of the overall picture, and stakeholders want to preserve its history.”

Houston said the data at Bryce indicates that recidivism for discharged patients is at a low of 1.5 percent after a period of 30 days, and the level of recidivism gets even better after a period of 80 days.

He tempered his praise for Bryce with reflection of the current sobering economic crisis.

“We will have some hard choices to make, and the two main issues that will continue to affect mental health are first, cost, and second, quality of care, and I cannot in clear conscience do anything that would cause the quality of care to suffer,” Houston said.

Because money is scarce for the department, Houston said he hopes to allocate money to mental health facilities and programs based on outcome.

“We need to know better what works and what doesn’t work so we can fund more of what works and less of what doesn’t,” Houston said.

Joanne Terrell, a social work professor who attended the speech, said the cuts in funding for Bryce would worsen an already less-than-ideal situation.

“Because Bryce is state-supported, there is an issue of money,” Terrell said. “Funding for psychiatric hospitals like Bryce comes from the general fund, which has historically been more underfunded than the economic trust fund, so psychiatric hospitals have been hit harder in this recession.”

Terrell also said the amount of community resources to aid mental health patients are sorely lacking.

In his speech, Houston discussed the tension between providing more beds in facilities and devoting more money to community resources.

In addition, Houston said he personally thinks devoting more funds to community resources tends to prevent the need for more beds.

Terrell said there are not enough community resources for group homes and other locally based programs.

“Partial hospitalizations are also critical,” he said. “Partial hospitalization requires a patient to attend a therapeutic program all day, and afterwards he or she can go back home or to their apartment for the night.”

Terrell also said that more mental health professionals need to work in jails, which have become de facto holding cells for some people who belong in the care of a psychiatric institution.

“There will always be mentally ill people who will remain hospitalized for the rest of their life,” Terrell said. “These individuals are the number one priority because if mental health facilities don’t have the beds for these people, then they will end up in jail, which has become their de facto psychiatric institution in this recession because of the lack of resources needed to treat them.”