State Budget Considerations Become Agonizingly Real When the Subject Is Mental Health

The case of the late Stephanie Moulton stands as a rebuke to anyone who believes the state's mental health budget can be cut further than it already has been over the past few years.

A woman of compassion and uncompromising ideals, Stephanie went to work as a counselor at a group home for mental patients in Revere and was brutally murdered by one of her clients on January 20, 2011.

Small of stature and only 25 years old, Stephanie was working alone that day at the home when she was attacked for no reason by a schizophrenic male resident with a history of violence. Her attacker was much bigger and stronger than Stephanie; she didn't have a prayer when he went into a murderous rage.

How Stephanie came to be alone in that house with a severely disturbed 27-year-old man was not an accident, nor was it a quirk of scheduling or staffing. Rather, it was the direct result of a state policy to reduce beds at in-patient facilities for the mentally ill and to restrict funding for out-patient care to the point that the lowest-paid workers are frequently the sole care-givers.

The New York Times recently published an expose on this situation, "A Schizophrenic, a Slain Worker, Troubling Questions," (6/16/11), which may be found at: http://www.nytimes.com/2011/06/17/us/17MENTAL.html?_r=2&pagewanted=print

Vicker V. DiGravio, III, chief executive of the Association for Behavioral Healthcare, was quoted as saying, "The outpatient treatment system in Massachusetts is dying on the vine."

The Times amplified that as follows:

"Providers have trouble finding psychiatrists and other clinicians who are willing to work in the community; they depend on recent social work graduates, who usually move on quickly to better-paying jobs at hospitals or in private practice. They also have difficulty recruiting and retaining quality workers for group homes, and many hired do not even have the college degree that Ms. Moulton possessed."

According to Mr. DiGravio, "The end result is a system where the folks with the least experience are serving the clients with the most intensive needs -- because the Department of Mental Health serves only those people with the most severe mental illness."

Last week there came a report that state tax collections during the first half of this month were 9.3% higher than the comparable period in 2010, news that prompted some at the Massachusetts State House to start talking about tax cuts.

"...it makes it much harder to argue that we should increase what are already unacceptably high tax rates when you have a significant increase in revenue," said one state senator.

I don't know if Stephanie Moulton's mother, Kimberly Flynn, will be at the State House when the legislature next debates tax cuts. But I hope she will be there, speaking up for the people like her daughter who do not hesitate to serve on the front lines of our mental health care system, to fight the good fight for the rest of us.

In the meantime, perhaps it would be good if the following words of Mrs. Flynn were copied and pasted into a few computer files at the State House. This was Mrs. Flynn's final lament to the reporter who wrote that excellent New York Times article, Deborah Sontag:

"Stephanie should be here now, planning her wedding and rolling her eyes at me like she always does. It was totally unnecessary for her to get killed and murdered on the job when all she was trying to do was help people."