In the Sunday Milwaukee Journal Sentinel the front page story asks, are health systems failing a moral test? My question is simpler, who will care for the poor? I have worked in several levels of mental health including apartment programs, the crisis resource center, the mental hospital and case management, for more than 10 years. And much has changed during that time. The most dramatic is the downsizing of the mental hospital which now sites half empty. At the same time resources have been shifted towards improving people’s access to resources in the community. There are more organizations dedicated to ensuring that people don’t need the things that inpatient care provides.
When I worked at the hospital, nursing staff morale was low because they saw where it was going. I saw former nurses at a recent listening session held by the Milwaukee Mental Health Board. It was hard not to feel some sympathy for them as they talked about the end of their careers while in their 50s and early 60s.
There are multiple sides to this story. There are tragic stories of people who died at the mental health complex. There are people who did not need to be housed in the long term care units who were assisted in transitioning into the community. There are some acutely ill people being turned away from the mental hospital because there are not enough beds and not enough staff to care for them.
The Milwaukee County Mental Health Complex has always served as the safety net for the sickest and poorest of our residents. The Milwaukee Journal Sentinel asks which of the profitable existing private hospitals will take it over and serve their patients. People who had no insurance always knew the the county was there for them. But those days are rapidly coming to a close. They asked the advocates what they hoped for but I don’t recall anyone asking the people who sometimes become too ill in the community what they would like to see. If I was a poor person looking at these choices, I would be afraid. And the nights are still cold.