Suppose you or someone you know had a serious disease or illness that required a long course of intensive treatment.

Say they needed therapy such as radiation or chemotherapy for cancer, a transplant for a failing kidney, liver or heart, or an expensive course of drugs for tuberculosis or Hodgkin’s disease?

Would your advice to them be to go to the emergency room to wait in line for treatment from someone who was not a specialist in their condition?

Perhaps, but only as a last resort if their situation, left untreated, was immediately life-threatening. And even that would only be the entry point for acquiring the services of specialists that could give them the long-term treatment they needed to be cured.

However, what happens to patients with mental illness who don’t have insurance to cover appropriate treatment has often taken precisely that course.

Driven by a crisis to seek care, they show up in ERs and enter a system that is not geared to provide the long-term treatments they need.

They also find the attention they can get comes at a very high cost, either to them or the institution that provides it.

Now, however, a nonprofit mental health agency in Portland has received a grant for $100,000 that it plans to use to provide a month’s worth of outpatient or community-based care to people whose lack of insurance or other resources leaves them with few or no options for effective treatment. Some whose suffering goes untreated have even considered or attempted suicide.

Youth Alternatives Ingraham, armed with a two-year grant from the JTG Foundation, founded by the late John T. “Tom” Gorman, plans to spend the money getting more effective treatment for those with mental illness who would otherwise fall through the cracks of the state’s health care system.

State officials are quick to say that, while the grant may help some people in a limited geographic area, it falls far short of replacing the cutbacks for such care in state funding, which has dropped more than $4 million since 2008, a 15 percent decline.

And in truth, while a month-long course of treatment may stabilize a person, such conditions often require care for much longer periods of time.

Prospects for that are even slimmer as long as funding shortfalls continue.


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