For a few dollars more …

Is poverty, including housing insecurity a major factor in the hospitalization of people with mental illness? Anglicare raises this issue in its Report, Thin Ice.

The Report says:

The predominance of the illness (mental illness) is such that it is almost as if we lose the capacity to speculate how the lives of people with mental illness would be if they weren’t also chronically poor and disadvantaged in purely social and economic ways. Would the experience of schizophrenia be different if, instead of the trauma of homelessness, people who are ill had housing they could rely on, housing which was affordable, near to services, and in which they had support to stabilise their health and live a fulfilling life? Would disorganised psychotic thoughts be so overwhelming if you weren’t also under pressure to deal with Centrelink forms and the prospect of having your electricity disconnected?

This is a question that has serious implications for taxpayers. It has been estimated that a single episode of schizophrenia costs taxpayers $24,000.

If poverty was the underlying reason behind many hospital admissions then it would be more cost effective to increase Centrelink payments by some $100 per fortnight for those with serious mental illnesses in order to overcome the stressors of poverty and insecure expensive housing.

Twenty percent of Anglicare’s mentally ill respondents in their Report had to move house 5 times in 5 years. As we all know the costs of moving both in terms of stress and money are huge. Providing people with recurrent mental illness with secure Government housing is one way to reduce admissions in my view.

Paying people an additional payment to keep them out of hospital would be cost effective – some $2,500 a year to keep a person out of hospital against $24,000 for the hospital admission. It is not unusual for people with mental health problems to get very ill when poverty problems hit. The power being cut off and running out of food are very good reasons for a person to turn up in emergency as the person has no more resources and it is the only place he or she can go. I have actually seen hospital documents where this is apparently so common that the nurses gave it a special name – “turning up at the ward seeking means of sustenance” or words to that effect. This problem needs to be addressed.

Another aspect is that if poverty is 50% responsible for putting people with mental health issues in hospital (which I think it is) then people with mental illnesses could be paid directly and there could be a cut back in some of the current funding to NGOs currently servicing the sector, thus saving revenue. People who do not have stable housing really can’t benefit from many NGO services anyway as they are not stable enough to benefit from the programme offered.

About 50% of people with schizophrenia are estimated to recover. This leaves another 50% who may be too symptomatic to benefit from the many recovery programmes that are currently available. These people get no benefit from Government funding at all at present. They are among the most needy and vulnerable people in our society and if they were paid directly they would at least be able to buy better food to eat and possibly afford a taxi to get out of the house once in a while so they can take advantage of the various activities offered in the community.

I hate to sound dismissive of charities such as the new Food Bank initiative, but I fear that the food offered to the mentally ill and other disadvantaged groups from agencies like this are most likely be a hodge podge of unlikely items with high salt content that will not meet nutritional needs and certainly won’t lift self esteem. The kind of combinations you get in these food parcels are things like a packet of cellophane noodles (with no sauce to go with it) last year’s Christmas biscuits and I defy anyone to eat the tins of “Hearty Stew” that you get in these parcels. It is much better to give people the money directly so they can buy fresh food that they can use in a sensible way.

I realize here I am probably offending a whole heap of people including volunteers, but NGOs really have to consider whether their provision of services is the best thing for the people they are trying to help or would directly increasing benefits be the way to go.

People with an additional $100 a fortnight could buy their own new clothes and not have to wear dead people’s clothes. Charities should have a good think about that.

Paying people with mental illnesses directly instead of providing various services through NGOs is also cost effective because there are not the infrastructure and administration costs connected with delivery of necessities.

What is required is some researcher to do the research.

The question would be: “Are the stressors of poverty and housing insecurity major factors in the hospitalization of people with mental illnesses? If so to what extent?”

This is a very simple question but it has the potential to turn the delivery of social welfare services to people with serious mental health problems on its head. If the stress of poverty and housing insecurity are resulting in more hospital admissions then for the taxpayers’ benefit we should think of the direct payment alternative – quarantined to pay bills if necessary – as well as retaining those NGOs and agencies who provide programmes that have been proven to keep people out of hospital.

A longer article on this issue can be found HERE

Maggie Maguire is a blogger who writes mainly on Tasmanian mental health issues. A born curmudgeon, she takes an insider’s view of the little known workings of the Tasmanian mental health system and the Tasmanian social welfare system in general. Her main hope is that she can engender some understanding and respect, if not awe, for the singular and different minds that comprise the community of people with mental health issues.