10/31/2005 – Delaware Co. Daily Times

Editorial: Funding cuts threaten mental-health care 

Halloween is a time of spooky celebration, a time for children and many adults to play at being ghosts and goblins in the name of "trick or treat."

But for some people, life seems like a daily horror show because of the demons wrought by mental illness. It isn't fun and it isn't funny. It is a challenge to live with for both patients and their loved ones. On rare occasions, it has fatal consequences.

The most notorious case is that of Sylvia Seegrist who, on Oct. 30, 1985, dressed in Army fatigues, entered Springfield Mall brandishing a semi-automatic rifle.

Because it was the afternoon before Mischief Night, some shoppers and mall workers initially thought the 25-year-old woman was part of a Halloween prank.

They did not know that she was a paranoid schizophrenic with a history of violence who had been hospitalized 13 times in 10 years and who refused to stay on medication long enough to be stabilized.

No sooner did Seegrist hit the mall entrance than she opened fire, killing three people and seriously injuring six others. In June 1986 she was found guilty but mentally ill and is now serving three consecutive life sentences at Muncy State Correctional Institution in Lycoming County.

It was devastating not only for her victims and their families, but for her parents who had been frustrated in their attempts to keep her on medication by the Pennsylvania Mental Health Procedures Act. It was written in 1976 and amended in 1978 with an eye towards respecting patients' civil rights.

The Springfield Mall tragedy spawned scrutiny of the mental-health system in Pennsylvania and brought awareness of the need for more targeted case management.

Twenty years later, mental-health services in Delaware County have, on one hand, improved with the help of new medications, psychiatric rehabilitation programs and community residences.

On the other hand, they have been hampered by inadequate state and federal funds to support the influx of patients into the community that resulted from the closing of Haverford State Hospital in 1998.

And how to handle mentally ill patients who are violent seems as much of a dilemma today as it was 20 years ago. That realization was brought home once again to Delaware County residents in July when Michael Rafferty stabbed to death his parents and one of their neighbors and seriously injured the neighbor's wife.

Like Seegrist, the 29-year-old Upper Darby resident had a history of violence, mental illness and non-compliance with taking medication. In August he died of head and neck injuries when he jumped from his bunk into a wall at Delaware County's prison.

The pros and cons of state Senate Bill 213, which would force potentially violent mental-health patients to be compliant with medication and other treatment, need to be seriously considered by lawmakers. Whether such a law would have prevented patients like Seegrist and Rafferty from committing violent acts, is difficult to say and requires further investigation.

In a week-long series that began Sunday in the Daily Times, law enforcement officials, district justices, mental health care providers, mental health consumers and their loved ones talk about the successes and failures of the mental health system.

It is clear that those working in the field are doing the best they can with the resources they have.

However Republican lawmakers' proposed $10 billion in federal cutbacks to Medicaid and Medicare pose a serious threat to the already struggling mental health services.

"All of our services are going to be severely hampered. If this goes through, shame on us," said mental-health consumer and advocate Ronald L. Berman of Ridley Township.

Indeed, if the progress made in mental-health services in the last 20 years is to continue, it must not be crippled by inadequate federal and state funding. That includes sufficient funding for community residences, medication and mental health care workers.

The consequences of short-changing mental-health services go beyond just the consumer. Mental illness that is not properly managed has repercussions for the patients' loved ones and for society in general.

Just as in physical illness, when a productive member of society is disabled by mental illness, all taxpayers pay the price.

That price goes beyond dollars when mental illness moves a person to violence.