Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, April 1, 1990                   TAG: 9004020202
SECTION: EDITORIAL                    PAGE: F2   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

PICKING POCKETS OF THE MENTALLY ILL

A wonderful idea. The only problem, as a nation now knows, is that back home, community care has largely been missing. One evidence of that is the increasing number of homeless on the streets of big cities. Another is how often the mentally ill are in and out of hospitals. It is a sad tale of neglect.

Sadder yet is neglect in the very places where the ill should have found care. A House subcommittee says that from 1963 to 1980, hospitals around the United States took federal money they were supposed to spend on mental-health facilities and put it to other uses. Up to $100 million may have been diverted, some of it spent on swimming pools, volleyball courts and maids.

Rep. Ted Weiss, chairman of the House Human Resources subcommittee, said that officials of the National Institute of Mental Health knew of these problems for years. NIMH's own auditors uncovered these and other violations. But partly for bureaucratic reasons, there seems to have been little corrective action.

The federal Community Mental Health Centers Act provided 482 grants totaling $295 million to hospitals to build new community mental-health centers. The hospitals were to provide services to all comers, including those unable to pay, for 20 years. Weiss' subcommittee report says that NIMH auditors visited 138 such centers and found that more than half did not follow the law; one-fourth had violations "of major dimensions."

Major indeed. The Orlando (Fla.) Regional Medical Center used federal funds, intended for the mentally ill, to build a pool and tennis and volleyball courts. In some instances, centers financed with federal money were converted into office space or other non-psychiatric uses that illegally helped the hospitals make a profit. In other instances, hospitals failed to provide some or all of the services they had contracted to give. Some stopped providing services to the poor or reduced the number they did serve.

One obvious remedy is for Uncle Sam to ask the providers to shape up or pay back the money with interest. Instead, NIMH has granted scores of waivers allowing violations to continue. Public Citizen, a consumer-advocacy group, and the National Alliance for the Mentally Ill contend that only $3.7 million has been recovered from the $100 million said to have been misused.

Why? NIMH's deputy director, Dr. Alan I. Leshner, told The New York Times that until last year, the agency's attitude was: "If you push for recovery of the money immediately, [the provider] will stop providing services. . . . If the money was recovered it would go back to the treasury, not into mental-health services. The belief was that any services were better than none." Put another way, the government, along with thousands of luckless mental cases, was being held hostage by those who were supposed to treat the mentally ill.

Leshner says the agency is cracking down now. It will spend $300,000 on monitoring the mental-health centers; all 575 will be visited, 105 of them by the end of this fiscal year Sept. 30. There will be "a tougher approach."

Tougher, one hopes, on the providers. The system's been tough enough already on the patients. As a group, the mentally ill are better off than a generation ago; the "snake pits" have been cleaned up. But these people, sick through no fault of their own, remain outcasts: feared, friendless and ignored by most of society. It is a crowning cruelty when, in effect, some who claim to serve the ill pick their pockets instead.