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Beyond The Politics of Hospital ClosuresAn Opinion by Michael B. Friedman, CSW
The Governor’s Budget Request this year includes a proposal to establish a bi-partisan Commission for the Closure of State Psychiatric Centers. It’s the right thing to do. For the past few years progress in community mental health in New York State has been stymied by the politics of hospital closures. The Governor has proposed closing state psychiatric hospital centers in The Executive Budget Request. Local communities, which would take an economic hit and lose services, have reacted with outrage. Unions that represent state workers have fought to retain jobs. Family members who have come to rely on these particular state facilities have reacted with fear about what will happen to their loved ones. Some mental health advocacy organizations have opposed the closures because of concerns about loss of vital services without a clear plan to replace them. And in response to all this agitation, the Legislation has recoiled in political horror and refused to go along with the Governor. Savings Should Be Reinvested in Community ServicesGiven the lack of public planning for hospital closures, the Legislature’s response is understandable. But in fact it makes good economic sense to close more psychiatric centers. The same number of beds can be provided in fewer hospitals. Why spend money to renovate and maintain inpatient facilities if (and this is a big if) the same services can be provided elsewhere? So much is needed to provide a comprehensive community-based mental health system that every effort should be made to take the savings that are possible without loss of necessary services and to reinvest them in community services. The Commission the Governor has proposed can help the state move past the politics of closure. But to do so it will need to address some very tough questions. In general it will have to determine what the impact of particular closures is on patients and their families, on local mental health systems, on the education of mental health professionals, on state workers, on the mental health system, and on the economy of the community. The Commission will also have to determine how much will be saved, what assurance there is that the savings will be reinvested in community-based services, and whether these gains counterbalance the unquestionable pain that will be caused in economic losses and in increased difficulty of access to services for some people. Questions That Must Be Answered About Hospitals Considered for ClosureHere are some critical questions the Commission must be able to answer about each hospital considered for closure. Impact on Service
Impact on the Local System of Care
Costs and Savings
Impact on Education of Mental Health Professionals
Impact on Employees
Impact on the Economy of the Local Community
Tough Questions Must Be Answered PubliclyThese are tough questions, but they need to be answered, and answered publicly, because too many people are affected by hospital closures to take them lightly. The bi-partisan Commission proposed by the Governor is the right way to take on the issues. Let’s hope that it can be done with a minimum of political posturing and that decisions can be made which will make it possible for New York State to regain momentum towards the development of a high quality, comprehensive, community mental health system. (Michael B. Friedman, CSW is The Director of The Center for Policy and Advocacy of The Mental Health Associations of New York City and Westchester. The opinions in this article are his own and do not necessarily reflect the positions of The Mental Health Associations.) Return to the top of the page.
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