LISTEN LIVE: This American Life
LISTEN LIVE: This American Life


"Budget Cuts Come Down Hard on Mentally Ill"

This article is more than 13 years old.

It’s a tiny sliver of the billion dollars in budget cuts that Governor Deval Patrick has had to make recently. But the nearly four million dollars being eliminated from programs for the chronically mentally ill have a huge impact on the people who benefit from them.

FRED THYS: The people affected by these particular budget cuts suffer from severe and persistent mental illness: schizophrenia, bipolar disorder, deep depression. Among them, and among the people who help them, there is disbelief that programs that seem to work so well are being eliminated. What’s being cut are those programs that help people with severe and persistent mental illness rejoin the world and stay in it: support groups and job training. Toby Fisher is the Massachusetts policy director of the National Alliance on Mental Illness.

TOBY FISHER: I truly fear without them, you’re going to see more people going into the emergency room, more people going into the in-patient hospitalization, and potentially hurting themselves, because they have really learned how to live in the community with these supports, not live in the community without these supports, so I think it’s pretty scary.

THYS: Providers say about 2600 people are affected by the cuts. In a state of more than six million people, it’s not a huge number, but they expect to feel the cuts deeply. Bill Santoro suffers from severe depression and anxiety. Every day, he goes to a day care treatment center in Somerville.

BILL SANTORO: These people go there to stay off the street and they can talk to one another because they have the same illnesses.

THYS: The center has support groups for people who are afraid of relapsing, a yoga group to foster relaxation, and on Fridays people make lunch together. The center closes next week, and Santoro is scared.

SANTORO: I’m a recovering alcoholic, and without these programs, I’d go back into deep depression and try to commit suicide.

THYS: Santoro says he’s a nervous wreck. He says he hopes he won’t go back to drinking. He doesn’t want to be back in the hospital, worrying about how he’s going to pay his bills. He predicts that he and others will be walking the streets, panhandling.

Work Inc., is a nonprofit in Quincy that provides vocational rehabilitation and recovery: they help chronically mentally ill people find the job they want to do, assess their skills to make sure they’re ready to that job, and support them once they get the job to make sure they’re successful. Geralyn Hughes, who sorts nails for a company in Taunton, is among them.

GERALYN HUGHES: Gonna go home and not do anything, and I’m not too happy about it, ‘cause I’ve been here for four years, and I’ve made a lot of friends, and I’m not used to being at home. Used to be out making money. It’s going to be boring being at home not doing anything.

THYS: The vocational services here cost the state $12 a day, and the people who benefit pay taxes. Without work, many could wind up at clinics, where outpatient services cost the state $80 day.

One of the workers, Charles McGuire, helps organize activities at a health center in Weymouth. He makes coffee and serves muffins, plays cards and catch and provides therapy to Alzheimer’s patients.

CHARLES McGUIRE: I like what I do, and it can be challenging at times.

THYS: McGuire has been working with a counselor who helps him do his job.

McGUIRE: Kevin does resumes, tells me how to speak and dress for interviews. He guides me and a lot of times he’ll come with me and stay out in the waiting room, and I fill out the application and give out the resume. If I have trouble, I talk to Kevin.

THYS: McGuire and 160 other people who get counseling from Work Inc. are about to lose their services. Jim Cassetta, the CEO of Work Inc., says they will fall through the cracks.

JIM CASSETTA: And if history repeats itself, they’ll end up on the streets, homeless, incarcerated, in psychiatric emergency rooms, in homeless shelters.


THYS: Cassetta says for these 160 people, work is their only hope for recovery.

CASSETTA: These people are vulnerable. They can’t speak out like other constituencies, and I think someone said somewhere: “Who’s going to yell the softest?” And unfortunately, people with mental illness have been targeted yet again.

THYS: The Commissioner of Mental Health, Barbara Leidholm, says she had to cut seven per cent of her budget, and she chose to save psychiatric care, as well as housing for the chronically mentally ill. Even though she was able to tap into a state trust fund to minimize the cuts, Leidholm says something had to go.

BARBARA LEIDHOLM: There was no program we wanted to cut, but we had to cut something, and rather than bleed every program a little bit, we felt we needed to actually look at specific programs, and those are the ones that we selected. It was a very difficult decision, and so the question for us was how to minimize the impact.

THYS: The impact is about to be felt at the Cambridge-Somerville Social Club. The place is open weekdays from 3 to 7:45 PM. People come for meals, to socialize, meditate, use the computers, make art, and play music. Susan Geronimus, the director, worries about how the people who use the club will deal with their loneliness when it closes at the end of next month.

SUSAN GERONIMUS: My concern is that folks will need to go to emergency rooms a lot more. There’ll be more hospitalizations because they won’t have the structure. They won’t have the purpose. They’ll be really, really isolated.

THYS: We’ve agreed not to use the names of the people who come to the club in order to protect their confidentiality. One woman says she’s been coming here for twenty years.

We have all the counselors here and everything. If you’re having a bad day, you come in and sit down with a counselor, work it through, sit down for a hot meal, just camaraderie with your friends here and everything. You usually go home feeling pretty good and your problems are resolved.

THYS: Two people at the Cambridge Somerville Social Club hand me notes. One of them says: “We now have a stronghold, a sanctuary, a place of fairness, a decent place where we at last belong.” The sanctuary closes New Year’s Eve.

This program aired on November 19, 2008. The audio for this program is not available.

Martha Bebinger Twitter Reporter
Martha Bebinger covers health care and other general assignments for WBUR.