Lack of long-term mental health care for people who are experiencing homelessness can lead to individuals ending up in emergency rooms and, in some cases, prisons.
A panel of 17 community members who work in mental health, prisons and community housing programs discussed homelessness, mental health and the criminal justice system on July 11 to a group of about 50 people at the Columbia Public Library.
“ER costs are astronomical, especially when it comes to mental health,” said John Cummins, chief resident of psychiatry at MU Health Care.
Emergency rooms tend to be the first and only provider of care for people without long-term support, and it costs the individual, and if the individual can’t pay, the system, Cummins said.
People with mental health concerns used to be put in psychiatric institutions, but a movement to de-institutionalize people started in the mid-twentieth century.
Community health centers were built to help people coming out of institutions, but there wasn’t a lot of funding for these centers, said Tim Harlan, a lawyer practicing in Columbia.
This encouraged a phenomenon called trans-institutionalization, which is moving people from one institution, like a hospital, to another such as a prison. In the 1990s, jails started to experience overcrowding, partially due to deinsitutionalization.
This phenomenon is still an issue, and the panelists discussed ways to deal with the problem.
Some initiatives include Crisis Intervention Training, or CIT, for police officers, and the Emergency Room Enhancement Program.
CIT helps officers learn how to de-escalate crises and potentially keep people who need mental health help out of prison. The ERE program helps frequent visitors at the emergency department get in touch with long-term care opportunities.