One patient, a man in his late 50s, had never had mental health problems before. But the combination of a job transfer to Florida, being away from his family and other pressures pushed him into a nervous breakdown. Then he got fired and his insurance ran out.
He could have gone to a state mental hospital. Instead, he wound up at a small community-based, residential treatment program for older people _ the Florida Mental Health Institute (FMHI) in Tampa. After a dozen weeks, he is recovering nicely and about to go home.
Now, the program that saved him is about to close _ a victim of state budget cuts at the mental health institute and its parent, the University of South Florida.
Max Dertke, dean of the institute, said Wednesday that he regretted having to close the program, which has 20 beds and about two dozen employees.
But faced with an order to cut spending by nearly $1-million dollars _ about 10 percent of the institute's budget _ Dertke said he was left with little choice but to drop a program that is more social service than part of the main educational job of the university.
Helen West, the faculty member who oversees the program, doesn't quite see it that way. While treating 323 patients over the past three years, the program also has trained 77 undergraduate, graduate and postgraduate professional students in geriatric mental health _ an increasingly important field, she said. The program also provides a laboratory for significant research, she said.
But a state task force, appointed by the Legislature, recommended two years ago that programs like this be shifted to the state Department of Health and Rehabilitative Services (HRS), Dertke said.
HRS hasn't had the money to take them on either, he said.
Dertke and his boss, USF Provost Gerry Meisels, said they had been waiting on HRS so that USF's money could be shifted toward research and training activities.
With continuing budget cuts of its own, USF can no longer afford to wait, Meisels said. "USF . . . cannot continue to pay for what HRS should, but is unable to support," he wrote Dertke in a recent letter.
So where will the patients in this particular program go?
That wasn't clear Wednesday. Neither HRS spokesman Tom Jones nor officials with HRS' aging and mental health divisions could be reached for comment.
Helen West said she is hoping to find a way to let the 14 or 15 current patients finish their normal treatments, which generally last 12 to 14 weeks, instead of closing down abruptly on June 30, when the money runs out. She doesn't know yet whether her request will be approved.
After that, she said, older people with mental problems who would normally come to the institute will either remain at home and try to get help elsewhere, or be forced to go to the state mental hospital in Arcadia, which is under its own pressures to reduce its patient load.
In any case, older people with treatable mental health problems will not be served as efficiently or as well, she said. The institute's program, which serves patients from all over west-central Florida, is the only one like it in Hillsborough County, she said.
Michael Bernstein, executive director of Gulf Coast Jewish Family Services, agreed. His private, non-profit agency in Pinellas County operates a similar program, with 111 beds, but there is always a waiting list, he said.
"There's a tremendous shortage of mental health support for the elderly," Bernstein said. Older people are more likely to successfully commit suicide than any other age group, and the Tampa Bay area has one of the highest suicide rates in the country, he added.
Dertke said the most needy cases will be absorbed somewhere else in the mental health system, but less serious ones may well go without treatment.
"It's part of the shameful phenomenon of our society," he said, lamenting the lack of government resources, despite increasing human needs. "Where do you think the people sitting on park benches come from?"