
Florida cut $100M from its mental hospitals – chaos followed - paulpauper
http://www.tampabay.com/projects/2015/investigations/florida-mental-health-hospitals/
======
will_brown
I am not sure the answer is framing this as a Left/Right issue like a lot of
the thread is doing.

The underlying reason for cuts in Mental Health is the same reason 1,000 State
jobs got eliminated this year or $1.2B was cut from FL education the
Governor's first year...it is a finite budget problem.

Take the Zika virus, a current South Florida news story gaining national
attention. I haven't seen a single news spot/article mention how Zika is
linked to the budget cuts (State and local) that gutted mosquito controlling
programs. There is no mention how before Zika, in 2009 under former Governor
Crist the budget cuts for mosquito control lead to a Dengue outbreak (~4,000
cases). Yet about $5.5M in mosquito control cuts lead to a $5.5B (10%) loss in
FL tourism in 2009, these are not calculated political decision of the Right,
but difficult budget decision that had horrendous consequences.

To really put it in perspective, Crist later ran for Senate as an Independent
and then re-ran for Governor as a Democrat with full support of Obama...party
affiliation would not have changed the decisions he made as a Republican
Governor. Further take the $1.2B education cut the first year of the new
Governor, since then he has fully restored that amount and then some, why? Not
because as a member of the Right he changed his political ideology towards
education, but the reality is FL is $200B in debt; however, we are no longer
running a $3.5B deficit, in fact not only is the budget balanced this year FL
is projected to have a surplus and that has allowed the Governor to restore
education funding.

~~~
astrodust
"Most of the state will be part of the ocean within fifty years, but don't
worry people, we've slashed services so the budget's balanced and your taxes
won't go up."

Sometimes you need to spend money to protect against a future where the costs
are even higher. The mosquito control initiative could have paid for itself
with the sales taxes on that $5.5B in revenue that never happened.

~~~
will_brown
Agreed, but sometimes there is no money to spend, and that's my point...it is
purely a budget issue not a political one. When your State budget goes from
say $70B down to $60B (including a stimulus package from the federal
government) and the state is already $200B in debt where does the money come
from?

Had the republican (turned independent, turned democrat) governor Crist known
saving $5.5M would cost $5.5B he wouldn't have done it, but he didn't and
instead maybe he saved 100 state jobs.

It's easy to know the right decision after the facts, but these budget issues
cut both ways. For example, during the housing crisis to keep Florida
operating I believe Crist liquidated like 1/3 to 2/3 of FL pension trusts. So,
yes it's great that FL didn't shut down, but what happens when FL can't pay
retirees pensions?

So if you want $100M for mental Health funding who do you take it from?

~~~
astrodust
Where do you get that money? I bet you could shake $100M out of the prison
system if you looked for cases of people being locked up for ridiculously
trivial offenses. Given how prisoners often cost $40-60K per year, wouldn't
take that many.

I don't expect people to be psychic, but common sense must apply here. When
you "save money" by slashing budgets on road repairs, and ten years later your
roads are so awful you have to replace them all at great expense, is that
really savings?

A bridge that's deteriorating is expensive to fix. A bridge that's collapsed
from lack of maintenance is _crazy_ expensive to replace.

The so-called fiscal conservatives are always looking at saving money now,
they don't seem to care about what happens tomorrow.

~~~
paulddraper
Florida has somewhat of a...reputation...for the caliber of its criminals.

~~~
astrodust
It's got a spectrum of those incarcerated that's perhaps skewed a bit more to
one extreme than other states like Connecticut but that doesn't mean there
aren't a lot of people locked away for petty crimes.

The worst is those who are otherwise good citizens but got busted for simple
possession and are doing years of time. That costs the state hundreds of
thousands of dollars, and after they're branded a felon, they'll probably "re-
offend" given they have limited job opportunities.

If you wanted to design a system to generate prisoners they're doing a great
job, which given the for-profit prison system, is probably the idea.

------
MaxfordAndSons
I was about to wonder aloud why there can't be more private, for-profit mental
health facilities instead of private prisons, as huge swathes of the
incarcerated population are very mentally unwell and probably do need to be in
custody but would likely benefit tremendously from a less oppressive setting.
Surely there could be some profit to be extracted by privatization there.

Then I realized it's because they couldn't make mental health patients do
slave labor, and why leave all that money on the table when the facilities
they'd be building are basically the same, as are the people they'll be
housing, once they and their political allies have successfully choked out the
public mental health system. Ah the glory of the free market.

~~~
newman314
Health should not be for-profit. Such a system puts the needy at a tremendous
disadvantage. Needing a heart transplant etc. does not put one in a situation
to shop around.

Blind worship of a free market can lead to some pretty obscene outcomes.

~~~
forgetsusername
> _Health should not be for-profit._

Yeah, it should be public like Canada, where I've been on a waiting list for 2
years just to get a family doctor...

I think there's some middle ground there. The market _does_ solve certain
problems.

~~~
brandon272
I am a Canadian and don't have a family doctor and am unclear on the benefits
of having one. When I had one years ago I didn't feel like I was getting any
extra special attention beyond what I get now by walking into a walk-in clinic
and seeing any random doctor.

Perhaps the benefits are clearer if you have ongoing medical issues? Or
perhaps my old family doctor wasn't doing things a family doctor is supposed
to do in terms of ongoing care?

~~~
nameless912
I'm an American with kickass insurance who doesn't have a "family doctor". I
go to a local practice that has 5 or so doctors and a couple of CNP's. I don't
always see the same person, but I see someone within 2 or 3 days for routine
stuff and same day for urgent stuff. I think that the moderate trade off
between "personalization" and availability is totally worth it, especially
since it saves me money (my insurance is apparently billed less for an
appointment at a group practice, which means eventually my premiums are
lower).

~~~
ehnto
For another data point, I live in Australia and can see a doctor, same day or
night, for around 20 USD. It is very convenient and I am glad that part of the
system runs well enough.

There can be waiting lists for public surgeons however, and private health
insurance can help solve that to an extent.

I think we have a good balance here but I am not familiar enough with the
nuances of health care to know.

------
happyslobro
Stuff like this has happened in recent history in Canada too. At the federal
level, and the BC provincial level. All in the name of fiscal responsibility,
as if people existed for the sake of money, and not the other way around.

It's too bad that the people who founded the country didn't lay down some sort
of law against a (then colonial) government sabotaging itself. We even have a
vestigial British governor general who could enforce it for us. The word
"treason" comes to mind.

~~~
nibs
Same thing happened in Toronto as the former mental hospital near Allen
Gardens in the East End by Cabbagetown was essentially disbanded. A lot of
people stayed in the area and can still be found there to this day (it was at
least a decade ago, trying to find a media link...)

------
_nullandnull_
This is just sad. Didn't something similar happen with Ronald Reagan in the
1980s?

[http://www.nytimes.com/1984/10/30/science/how-release-of-
men...](http://www.nytimes.com/1984/10/30/science/how-release-of-mental-
patients-began.html?pagewanted=all)

[http://www.motherjones.com/politics/2013/04/timeline-
mental-...](http://www.motherjones.com/politics/2013/04/timeline-mental-
health-america)

~~~
refurb
Please don't reference Mother Jones. It's incredibly biased.

Just like every other political issue, mental health, is complicated and there
isn't one reason or person for the way things are.

Blaming Reagan ignores the dact that new antipsychotics were developed that
allowed patients that were previous confinded to institutions to be released
to the community.

Also, the ACLU along with the supreme court changed the laws and made it much
tougher to confine people for mental health issues. One of the biggest
challenges in treating mental health is compliance. Having a mental illness
often takes away the ability to see what's best for yourself. Ask a mental
patient if they want to go to the hospital, they'll often say no. And based on
current laws, there isn't anything we can do about it.

~~~
dalke
It would be nice to know what that bias might be. For example, "bias towards
truth" is different than "bias towards restoring the US to British monarchy."

Mother Jones is of course a politically progressive magazine, so there's a
bias in the topics they cover. But that sort of bias says nothing about the
quality of the coverage. The Economist is also 'incredibly biased' in what it
cover, and they do good job of it as well.

Similarly, Mother Jones wins awards, like the National Magazine Awards.

Quoting its co-editor Clara Jeffery [http://www.wnyc.org/story/what-its-when-
redditors-ban-your-w...](http://www.wnyc.org/story/what-its-when-redditors-
ban-your-website/) :

> We report from all side of an issue. We do investigations into things that
> people on the left or the Democrats wish we wouldn’t. And all of our
> journalism is fact-checked, sourced, and linked through. Facts are what we
> do, and statistical data analysis journalism is a big part of what we do. So
> I don’t see that part either. And we don’t really lace our reporting with
> opinion. It’s more, we’re a shop that cares about the little guy and
> inequality. So that informs some, but by no means all, of our story
> selection.

~~~
reality_czech
I have never, ever, seen Mother Jones do "an investigation into things that
people on the left or the Democrats wish we wouldn't." Maybe there was a time
that they were more extremist than the Democrats, and that's what they are
referring to. They are basically Fox News, but on the left. Both Fox and MJ
make you less informed than before because they leave out facts and stories
that don't fit their preconceived viewpoint. They seldom straight-up lie, but
the way they frame the stories and what they leave out gives you a distorted
picture.

You have TONS of more reputable news sources to choose from like the Atlantic,
New Yorker, NYT, Economist, etc. With MJ you're just reading straight-up
propaganda and it's very distasteful.

In the case of mental health, a lot of things would have to happen before we
could get those mentally ill people off the streets. And Mother Jones would
oppose many of those things. For example, we would have to be able to commit
more people to institutions against their will. We would have to make it
harder to sue mental health professionals or else the government would be
bankrupted. To really get a lot of them back to work, we'd have to lower the
minimum wage to the point that businesses were actually willing to pay for
their time rather than use a robot or an outsourced Indian. But that's a lot
more complex than hurr hurr Regan was teh Satan, so you won't find that
discussed by MJ.

~~~
dalke
I am confused by your positioning Mother Jones as no more extremist than the
Democrats while also saying "They are basically Fox News, but on the left".

I can't tell from that if you mean that the Democratic party is an extremist
party, or if you mean that that Fox News is as moderate towards the right as
the Democrats are towards the left, or both.

I thought 'Democracy Now' was more like the left-extreme version of right-
extreme Fox News, only much less influential. In any cases, shouldn't your
comparison be more to one of the conservative _print_ sources? Is Mother Jones
more like the National Review or The American Conservative for the left?

From what you wrote, it's hard for me to tell if your statement that the
Mother Jones writing "gives you a distorted picture" is because you also have
a distorted partisan view.

About the only times I read an article from Mother Jones is when it was
submitted here on HN, which occurs a few times each week according to an HN
search.

I looked now at several of their investigation pieces, at
[http://www.motherjones.com/topics/investigations?page=1](http://www.motherjones.com/topics/investigations?page=1)
, I do not get the same feeling of being "less informed" that you described.
To the contrary, pieces like "They Had Created This Remarkable System for
Taking Every Last Dime From Their Customers" and "The World Bank Is Supposed
to Help the Poor. So Why Is it Bankrolling Oligarchs?" seem like informative,
well-written pieces that I would expect from those reputable sources you
mentioned. They also link to primary resources, including SEC filings and
court documents. That's not something I see from Fox News reports.

The web site lists only a small number of investigations, I can't find an
investigation that the Democrats wish hadn't been reported. I instead looked
for other long-form pieces.

Five years ago they ran "Why the Democratic Party Has Abandoned the Middle
Class in Favor of the Rich",
[http://www.alternet.org/story/151108/why_the_democratic_part...](http://www.alternet.org/story/151108/why_the_democratic_party_has_abandoned_the_middle_class_in_favor_of_the_rich)
(first appeared in Mother Jones, but doesn't appear to be online) and "Why
Screwing Unions Screws the Entire Middle Class" at
[http://www.motherjones.com/politics/2011/02/income-
inequalit...](http://www.motherjones.com/politics/2011/02/income-inequality-
labor-union-decline?page=3) , which contains among other things the line "The
Democratic Party has largely abandoned the working class".

The author of those piece is Keven Drum, who has continued with more recent
articles like "Democrats Have Done Virtually Nothing for the Middle Class in
30 Years".

These do not appear to be something the Democratic Party would wish published.

My examination is only cursory, so while I don't see how you reached your
conclusion, you have the longer experience with Mother Jones to be a better
judge.

~~~
reality_czech
I believe that Mother Jones is to the left of the traditional Democrat party
platform. I also believe that Fox News is to the right of the traditional
Republican party platform. In that way, I think the two publications are
similar.

Basically, I don't consider either publication a useful source of news. In
general, both of them leave out the context that would be needed to understand
what is going on in the world. For example, that Mother Jones article about
"Why is [the world bank] Bankrolling Oligarchs" leaves out the context of what
has been going on in Myanmar in the last few years. Myanmar has gone from
being a completely military-run state, to allowing a limited democratic
opposition to exist. The World Bank is making investments there partly as a
kind of reward for that. If the World Bank left, other countries like China
would step in and try to buy influence there with their own equivalent of the
IMF (China Development Bank). It invests in bigger companies because it has
to, because the managerial overhead of investing in tiny ones would be way too
high.

All the same issues exist in our government's aid programs to poor countries.
The money does indeed often get siphoned off to the rich and well-connected.
But of course Mother Jones doesn't comment on this, becuase the narrative is
government = good, World Bank = bad. If facts or context have to be left out
to fit the narrative, they always will.

I could go on, but you get the idea. By leaving out facts and, most
especially, context, biased news sources like these leave you less informed
after you read them than before.

------
leekh
Why cut these services?!

Is Florida going to add more police, social workers, ER doctors and etc deal
with the consequences?

~~~
pbarnes_1
Who do you think cut these services?

This is GOP 101.

Never elect a Republican governor. See MI, ME, FL, etc, etc.

~~~
emehrkay
Rick Scott's administration passed a law that said welfare recipients must be
drug tested in order to receive benefits. Rick Scott's family has a lot
(~68/200 million) invested in some of those facilities.

~~~
shepardrtc
And here is the initial result of all that:
[http://www.tampabay.com/news/courts/florida-didnt-save-
money...](http://www.tampabay.com/news/courts/florida-didnt-save-money-by-
drug-testing-welfare-recipients-data-shows/1225721)

Followed by the end of it: [http://www.cbsnews.com/news/florida-declines-to-
appeal-furth...](http://www.cbsnews.com/news/florida-declines-to-appeal-
further-in-case-of-welfare-drug-testing/)

------
elgabogringo
The real issue is a legal, not financial one. The ACLU fought a long time ago
to make it very hard to commit anyone, very hard to give them treatment while
committed, very hard to keep them there, etc.

No matter how much city/states spend, they can't fill up the hospitals and
treat patients, which is why most of the hospitals were closed.

If you are interested, there's a very thorough book on the subject that I'd
recommend:

[https://www.amazon.com/My-Brother-Ron-Personal-
Deinstitution...](https://www.amazon.com/My-Brother-Ron-Personal-
Deinstitutionalization-ebook/dp/B008E0LRQE)

~~~
electricEmu
This conclusion does cut both ways. It should be acknowledged that treatment
at mental institutions then was horrific. Current treatment is not much
better.

------
jandrese
Maybe they were worried about a downtick in "Florida Man" stories? This is one
sure way to keep your state in the "News of the Weird" segment every week.

~~~
JumpCrisscross
The Florida Man phenomenon is mainly a result of the state's stringent public-
records laws [1]:

"Since 1909, Florida has had a proud tradition that all government business is
public business and therefore should be available to the public. That means
all records, including photos and videos, produced by a public agency are
easily accessible with a few narrow and obvious exceptions. Public officials
are also required to open all of their meetings — even unofficial ones — to
the public."

[1] [http://www.miaminewtimes.com/news/how-floridas-proud-open-
go...](http://www.miaminewtimes.com/news/how-floridas-proud-open-government-
laws-lead-to-the-shame-of-florida-man-news-stories-7608595)

------
rhizome
This story is way too lengthy (and important) to have glitzy scroll tricks
getting in the way. [Insert your favorite Creative Director joke here]

~~~
chefandy
Agreed

------
chefandy
Shit. That's bad. Those CC camera clips make it look more like the time I
spent as a bouncer than someplace where people are safely receiving treatment
for their mental conditions.

~~~
kbenson
Well, I'm only partially joking when I point out that wherever you were a
bouncer at was likely a place quite a few people voluntarily went to treat
their mental conditions.

------
tn13
$100M is just a cut. So how much is Florida actually spending on mental
hospitals ? Sounds like a ridiculously high cost to me.

~~~
jmcgough
When mental health services are cut, the burden doesn't go away but gets
picked up by police and hospitals, who aren't properly equipped to handle
those challenges. The SFPD and ambulances spend massive amounts of time
responding to emergencies involving mentally ill homeless, which limits their
ability to respond to other problems.

~~~
tn13
My question was what is the total cost of Florida's mental hospitals and if
that is worth it. Assuming that $100M cut was a 10% cut it means that the
total expenditure could be $1B. Which looks ridiculously high for merely 20M
population of Florida.

Of course there is a whole point of whether government ought to spend some
money now to avoid spending on basic services later whether there are proper
studies done and if people agree to it and if the mental hospitals are free
for everyone. But that was not my question here.

~~~
zd4akaq85a
Florida's GDP is $748B. Suppose 1 in 300 people in the state are mentally ill
enough at a given time to warrant living in a mental hospital. If that costs
$1B, about half as much of the economy would be spent on them (per capita),
compared to the general population. Seems very reasonable to me, without any
more specific numbers to go on.

To throw out another number for comparison, medicare and medicaid together
cost about $50B / year in the state.

~~~
tn13
Assuming your numbers government spends $15k for every 1 of those 300 people.
That number seems pretty high.

The Tampa Bay investigation's violence refers to violence in the hospitals
itself and not the general violence in society. For 13.5K per year you might
reduce the hospital staff by 10% but that is unlikely to result into chaos
that the report seems to suggest.

~~~
zd4akaq85a
How cheap do you think room, board, and medical care should be?

By the way, for comparison, Medicare spends $10k/year per beneficiary in
Florida.

------
threepipeproblm
Ensued. You're supposed to say "ensued".

------
nameless912
Let's all say it together:

 _No_.

 _Fucking_.

 _Way_.

How could anyone have seen this coming!?

