COLUMN: State has had enough time to fix mental-health mess
by PIERRE NOTH, Columnist
Sep 02, 2012 | 851 views | 0 0 comments | 12 12 recommendations | email to a friend | print
SHOWING some leniency where none was deserved, U.S. District Judge Charles Pannell, who is charged with overseeing the federally imposed consent decree regarding improved community-based treatment for mental-health patients, gave Georgia officials another year to straighten up their act regarding promises made but not kept. However, he did warn:

“I’m going to give them just as much rope as I think they need and then we’re going to have a hanging party if they don’t comply.”

Frankly, after two and a half years of failure the state has had enough rope. Pannell should have just thrown a noose over the nearest tree branch and strung up the entire Department of Behavioral Health and Developmental Disabilities created for precisely and only the purpose of making this happen. For good measure, Pannell should have ordered the public flogging of top state elected officials from the governor down through the General Assembly for failing to make sure what they agreed to actually happened.

By the way, for those unaware of what “capital punishment” would be in this matter it likely involves the federal government taking over the entire operation, spending whatever it takes to fix the situation and handing state taxpayers the entire bill even if it is 100 times the amount Georgia has been spending.

Apparently Pannell did not drop the hammer because of what may be one of the oldest political cosmetic tricks in the book to cover up ugly governance scars: The old “give the new kid a chance to do better” trick.

At the same time, the jurist plainly knew what was afoot, turning aside a state request to put a court-appointed monitor in charge. Pannell, a former juvenile and Superior Court judge, noting the state had amassed an utterly abysmal record regarding protecting the vulnerable in society — the mentally ill, the disabled, foster children. He made it plain he didn’t want any more scapegoats or lightning rods. “I want the state to live up to its promise in the agreement,” he said. “I don’t want to let the state off the hook.”

OBVIOUSLY THIS mid-point court evaluation in what is supposed to be a process successfully completed in five years under the deal was not a surprise. The state knew what was coming and probably fell back on political guile — about the only thing it seems to be good at.

As almost nobody in the general public knows, the department got a new commissioner about three weeks ago, Frank Berry, after the old one, Frank Shelp, left under a dark cloud while muttering about having done his job and setting everything up for success. The department cranked out the mandatory press releases about the new boy in charge ... with a Google news search finding not a single print/electronic media report being passed on. The same with, right before Pannell’s promise of a future hanging party, another release announcing an entirely new batch of top department bureaucrats to oversee a revived effort.

Ah, yes. Throwing yourself on the mercy of the court. Somebody else messed this up, and we are mending our ways. Please give us time to reform. We really want to stop our evil ways.

By the way, the state really missed an image-polishing chance on this one. It did not highlight that in 2005 Berry, then working for juvenile justice, was forced to resign for refusing to destroy a memo he had written critical of mental-health inadequacies in a private company poised to take over the youth prison at Augusta. Time will tell, but he may be just what this new department needs.

In recent days this newspaper has reported on a topic directly related to all this — and caused by the state’s abysmal failure in helping those most helpless, to use the judge’s description although it also matches that of this writer going back a couple of decades. Seriously … that long. That’s why, in our view, the necktie party should have already begun.

The problems with a growing mental-health patient population at the Floyd County Jail, and others across the state, are the direct cause of this state failure. Those whom the state has failed to assist as ordered are winding up in cells, which is not necessarily better than the sometimes dangerous state hospitals they now appear to be replacing.

IT IS ALSO distressing to learn, because court proceedings are not secret, that a state so fond of churning out feel-good and personnel press releases in this realm has failed to keep the public informed of what amounts to a colossal failure in just one tiny piece of a gigantic problem on which the taxpayers foot the bill without being informed of the result.

In Pannell’s courtroom, it came out that the state had been expected to have its new Assertive Community Treatment (ACT) teams running by July 1 with the task of making certain some 2,000 of the most-seriously mentally ill patients were taking their medications, not homeless and staying out of hospitals — and jails. There were, by the way, an estimated 9,000 such patients in the state when the consent decree was reached so even that likely was not enough but merely considered a start.

Each team — made up of 10 case workers, nurses and other specialties — was to handle 100 patients at a cost of $700,000 a year per team. It appears that they have been failures and some 13 of the 20 teams disbanded with the other 7 evaluated as not being up to snuff. That would, over two years, mean approximately 28 million tax dollars were expended without a positive result.

Well, that sure explains the jail problem does it not? And the homeless-shelter needs, and the “street people,” and occasionally encountering strange behavior when out in public.

Most such persons now largely missing the help they once had are more a danger to themselves than others. The ones in jail tend to be off their meds — in the hospitals somebody watched them put the pill in their mouth and swallow — and likely not so much engaged in “criminal” behavior than in violations of social niceties. This is not meant to defend the horrors that occurred at the state hospitals although those were, just as the current situation appears to be, a failure of administrative oversight and competence.

HOWEVER, at the same time and rather amazing in light of mental-health issues that “make the news” instead of being ignored, there are scary exceptions that also may be falling between the chasms of a state preventative and protection system that actually does not exist. For example, the suspect in the Colorado movie theater massacre was in known and extreme mental difficulty to which authorities were alerted without taking any action.

Equally or even more frightening, in a point this column has often made since this “deal” was set in motion, the adult mental-health patients are but one component. The profoundly developmentally disabled — unable to even speak for themselves and outside even the oversight of jailers — are now supposedly being taken care of by the same state agency. However, where this population once was routinely visited by compassionate and concerned community members — even brought Christmas presents! — they are now in small group homes, or perhaps nursing homes, where their fate and care is even harder to monitor than ever before … if at all.

If the ACT teams have been such an abject failure it might behoove the federal court to get a lot more details about how the state is doing in this regard. Frankly, confidence should be low. Not only, as the judge pointed out, has the state a miserable track record on foster children, the disabled and mental patients, it also has a miserable track record in handling more visible items such as education, transportation, water supply and so forth. The media can help the public and courts keep an eye on things that are on the record but, when it comes to patients or minors there is a privacy shield behind which many bad things can be concealed.

Judge Pannell is quite correct in not wanting his court to appoint a monitor to run the mental-health operation that the state should be handling. For one thing, when the courts yield oversight it then becomes pretty risky to assume the state can magically start doing an acceptable job.

THE COURTS might well wish to consider a different sort of monitoring entirely. Why not appoint a team of investigators, with subpoena powers, to poke around at the level of actual service provision wherever it might occur be it in public agencies, private ones or non-profits? So long as public dollars are funding this operation, which they are, there needs to be outside policing/oversight. Such investigators could then report back to the court, which the judge can make public records as the need arises so that the public and its media can learn what is really going on.

That would be way, way better than waiting for the court-ordered evaluation dates. It only takes a single unobserved day … or hour, or minute … for bad or illegal or unethical things to happen.

Somebody needs to be watching … and it sure should not be a state with a long, long history of being run by well-paid people who don’t want to get blamed for anything they do.
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