In Arkansas, Mental Health Treatment Bogged Down by Uninsured

by Kate Knable  on Monday, Jan. 28, 2013 12:00 am  

“Sometimes you see a cycle of patients who, if we did have resources for them, they could avoid hospitalization and could function better,” said Barry Pipkin, CEO of The BridgeWay. (Photo by Michael Pirnique)

Concerns over mental health services have spiked nationally since last month’s school massacre in Connecticut, but mental health professionals in Arkansas say dealing with the mentally ill comes down to one thing: insurance.

At any given time, about 5 percent of Arkansas’ population struggles with mental illness that is too serious to allow them to manage their own care, according to Tom Grunden, executive director of the Little Rock Community Mental Health Center.

Those who are insured have plenty of options, the professionals say. Those who are uninsured can’t be turned away by hospitals and publicly funded community mental health centers, but their treatment options are limited and they drain resources away from even the paying patients.

Hospitals are “the safety net for society right now,” said Barry Pipkin, CEO of The BridgeWay, a private psychiatric hospital in North Little Rock.

The chronically severely mentally ill are often without health insurance or Medicaid and, in crises, seek care at hospital emergency rooms or psychiatric hospitals like his, Pipkin said.

Out of the 20-25 patients who come in daily to be assessed for treatment at The BridgeWay, two or three fit that chronic, severe category, he said.

“Many of those patients are not paid for and they have many needs. … They require a lot of our medical care, a lot of our special care,” he said. “At a small hospital such as ours, it does put a burden on our resources.”

The BridgeWay can stabilize a patient in an emergency, but the chronically mentally ill typically need much more care than that. More than half of the people The BridgeWay treats for mental illness also struggle with substance abuse, so people often leave the hospital’s acute care only to return to unhealthy lifestyle patterns outside the hospital’s walls, Pipkin said.

Other long-term needs, such as for help finding work or housing, play into the problem, he said.

“Those patients are the neediest patients, and they’re long-term care patients. Sometimes those patients, in addition to their mental illness and addictive disease, have developmental issues. … They’re a very complicated patient who requires a lot of care,” Pipkin said. “There’s outpatient services out there, but these folks need more than that. If you don’t have a job, who’s going to feed you? Who’s going to shelter you? Those go beyond outpatient needs.”

A homeless shelter isn’t equipped to deal with severe mental and physical health issues, Pipkin said.

CEO Tom Petrizzo of Ozark Guidance in Springdale said his organization seeks out grants and other ways to subsidize the care the organization provides at no cost to the uninsured. Ozark Guidance is among the state’s 13 state-contracted community mental health centers.



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