The quality of care...

When we talk about providing treatment for the mentally ill, which includes those struggling with addiction; it's important to talk about the quality of services.  Here is the article that I am basing this discussion on:  http://bit.ly/1aYkjoZ  As you will see in this article, not all treatment is actually helpful.  Providing treatment can simply become a way to make money.  Without actually providing quality treatment. Or without providing any treatment at all.  Spending money for rehab is already such a difficult topic for people, the waste involved in some programs is something that will hurt all of the mentally ill over the long-term.  So, what is the answer to this?  First of all, I believe social service programs and medical facilities require significant oversight.  If there are no efforts to hold treatment providers accountable, they won’t behave in ways that are ethical.  Sorry I have such a negative view of social service providers, but I have some practical experience.  I worked in the system.  

I believe that oversight is important to maintaining a system that actually works.  Now, I have to be honest, I am not sure what kinds of oversight are built into the system in New York.  But I can assume that there isn’t adequate oversight because of the kinds of issues that are outlined in that article.  If people are selling drugs to the patients going to a clinic before they even get to groups, how is that an indicator of adequate supervision?  What kinds of policies and procedures does this clinic have in place?  Do they actually enforce them?  (For example, do they actually do drug tests to make sure that patients are coming to groups clean and sober?  How do they deal with the situation when patients are not maintaining sobriety?) 

Of course, there is another factor here.  Many social service agencies are so overwhelmed with clients/patients that they are unable to function in efficient and productive ways.  High case loads?  That’s pretty common for case managers, therapists, and counselors.  And it is simply logical that if you have huge caseloads, you cannot give adequate attention to your clients.  This means things are bound to be overlooked.  People don’t get the support they need.  For someone who is serious about getting help, that is obviously a problem.  This is basically the issue with the underfunding that exists in our system.  When there isn’t enough money to treat people, they don’t get treatment.  If they don’t get treatment, there is almost no chance of recovery.  As we have discussed before, we have paid for our lack of attention to treatment.  We pay with vulnerable families, the chance for crime and violence, increased costs for incarceration, homelessness, and high suicide rates.   We pay because we have an inhumane and inefficient system. We simply allow too many people to fall through the cracks.  It really is time to take a thoughtful look at the cost of an inadequate system and the cost of providing the care that is needed.  It is my opinion that the money we spend on providing adequate diagnosis and care will pay off in a healthier society and lower costs in a variety of areas:  The costs of prison, homelessness, and crime/violence for a start.

What do you think about this article?  Would you want your loved one attending a program like that?  What do you think about spending our tax dollars on programs that aren’t working?  It’s time to re-think our system.  Do you agree?