Recently, the Illinois Medicaid program limited prescription drug coverage for several medications because of the high expense of the drugs in a move to control spending in mental health care. This policy change allows most of those already receiving Medicaid prescription assistance to be grandfathered in, and consumers prescribed the drugs not on the state's preferred list may still receive those medications with authorization.
Many mental health advocates have cried foul, but their concern for people with mental illness misses a key point. Until now, the State allowed physicians to prescribe any psychotropic medication regardless of the cost. Taxpayers should appreciate that allowing a physician to prescribe every expensive psychotropic medication does not readily translate into helping those with a mental illness. The perfect drug does not always hit the bulls eye. Research has shown that for those with severe and persistent mental illness, recovery comes not solely by finding a well-tolerated, effective drug. Persons with mental illness must be part of a system of care designed to meet their needs for housing, employment and reintegration into the community.
Many mental health advocates have cried foul, but their concern for people with mental illness misses a key point. Until now, the State allowed physicians to prescribe any psychotropic medication regardless of the cost. Taxpayers should appreciate that allowing a physician to prescribe every expensive psychotropic medication does not readily translate into helping those with a mental illness. The perfect drug does not always hit the bulls eye. Research has shown that for those with severe and persistent mental illness, recovery comes not solely by finding a well-tolerated, effective drug. Persons with mental illness must be part of a system of care designed to meet their needs for housing, employment and reintegration into the community.
Proponents of the cost-cutting correctly say it will help the state manage fiscal responsibility in health care, forcing providers to find lower-cost and equally effective options for those with mental illness. Still, a larger issue remains for persons coping with mental illness. The state, while cutting spending for certain drugs, must prioritize the "wrap-around" services that community behavioral healthcare can provide. These services include supports for housing, therapeutic and outreach services, physical healthcare, and employment services. Good treatment means inspiring people to make important and rewarding contributions to society.
With this in mind, the state should continue to prioritize a holistic and cost-effective approach to addressing mental illness that doesn't simply throw money towards pharmaceutical companies promising the next big thing in mental health treatment. However, without proper therapeutic care such as community support and physical healthcare, along with housing assistance to prevent homelessness and employment services to help those with mental illness find and keep a meaningful job, even the most expensive, innovative and trustworthy drugs will have less overall effect to prevent the negative outcomes of long-term mental illness.
-- Steve Weinstein, M.D., Chicago
With this in mind, the state should continue to prioritize a holistic and cost-effective approach to addressing mental illness that doesn't simply throw money towards pharmaceutical companies promising the next big thing in mental health treatment. However, without proper therapeutic care such as community support and physical healthcare, along with housing assistance to prevent homelessness and employment services to help those with mental illness find and keep a meaningful job, even the most expensive, innovative and trustworthy drugs will have less overall effect to prevent the negative outcomes of long-term mental illness.
-- Steve Weinstein, M.D., Chicago
Chicago Tribune September 12, 2011
