CARES Commission Accountable if Realignment Plans Are Flawed

Posted on February 2, 2004

NAMI’s concern grows over the Veterans Administration’s Capital Asset Realignment for Enhanced Services (CARES) commission’s decisions to close inpatient psychiatric care beds, such as the currently planned closure of Waco Veterans Affairs Psychiatric Hospital in Waco, TX.

Unintended consequences may show up in over-crowded emergency rooms, non-person misdemeanor arrests, and homelessness—even when accurate data and careful planning are implemented. However, the CARES data and planning appears flawed. "We do not have enough information to address the long-term care of psychiatric patients," said Undersecretary for Health Robert Roswell, August 23, in St. Louis, MO. "There is no policy."

A recent report to the VA undersecretary from the committee on the Care of Severely Chronically Mentally Ill veterans (SCMI) states further concerns: "VHA has been alarmingly inconsistent in building and providing an adequate continuum of care for veterans who are seriously mentally ill."

"Closing these hospital beds, particularly without funding community mental health services and supports like transitional housing in their place, is nothing less than abandoning our veterans to the streets," said Joel Miller, NAMI senior policy advisor. "NAMI believes the VA must assure the same full range of integrated services within the hospital and upon discharge to the community that are received by other people living with mental illnesses."

The VA decisions, with or without planning, will affect nearly half a million veterans with a service-connected disability due to mental illness and their families. President Bush’s New Freedom Commission on Mental Health recently called America to unprecedented accountability for people with mental disorders who live in the shadows of failed mental health services and rejection from the jobs and housing needed for life in the community. Predictable results measured in human suffering, frequent relapse, incarceration and/or homelessness for veterans will be the outcome of decisions driven by any lesser measure than the law (P.L. 107-135).  The law mandates provision of the full spectrum of care for veterans with severe mental illnesses—from access to inpatient hospitalizations to community services, treatments and supports.

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As The Nation’s Voice on Mental Illness, NAMI leads a national grassroots effort to transform America’s mental health care system, combat stigma, support research, and attain adequate health insurance, housing, rehabilitation, jobs and family support for millions of Americans living with mental illnesses. NAMI’s one thousand affiliates are dedicated to public education, advocacy and support and receive generous donations from tens of thousands of individuals as well as grants from government, foundations and corporations. NAMI’s greatest asset, however, is its volunteers—who donate an estimated $135 million worth of their time each year.