Louisiana’s mental health crisis

Louisiana’s mental health crisis

Louisiana spends less on mental health care, per capita, than 43 other states. In the absence of state investment, police are often the first responders for people facing a mental health crisis. But while police are increasingly tasked with providing mental health crisis intervention services, department training, policies and resources often fail to match this reality. New reporting from Nola.com | The Times-Picayune’s Jonathan Bullington tells the story of Preston Thornton, a U.S. Army veteran whose call to the Department of Veterans Affairs Crisis Line ended in his death and a deputy’s injury. Thornton’s story illustrates the costs of placing law enforcement officers in the role of mental health crisis responders without providing them with training or resources adequate to the task:

As Preston paced about the house, (his mother) Natalie called her daughter, Sydneye Thornton, 30 miles away in Natchitoches. It was usually Sydneye who could talk her older brother back to reality. “Settle down Preston,” Sydneye told him on the phone. “It’s gonna be alright. Go to sleep.” “They’re out there, Bam!” he replied, using the nickname he gave her. “I’ve seen them!” Realizing she couldn’t calm her brother, Sydneye made a decision she has come to regret in the 16 months since that day: She called the U.S. Department of Veterans Affairs crisis line. The family thought paramedics would come take Preston to the VA hospital in Shreveport. Instead, two Red River Parish sheriff’s deputies were dispatched to 1218 Banks St. that morning. Seven minutes after the first deputy knocked on the side door, Preston was dead, cut down in a brief but ferocious exchange of gunfire that wounded one of the deputies.

While many law enforcement agencies in the state have introduced policies and training programs that aim to address the increased frequency with which they are tasked with filling this role, the majority still appear not to have such policies on the books.

NOLA.com | The Times-Picayune sought records from all 378 law enforcement agencies in Louisiana to see if they have adopted policies and training to guide officers responding to calls involving someone with a mental illness. Out of 146 agencies that responded as of early December, 84 – or 58 percent – did not have such a policy. Many agencies still do not take advantage of that additional training, putting officers and the community in danger, advocates say. “We are creating a system where we are putting people who are fragile in the hands of people who do not know how to handle them,” said the Rev. Alexis Anderson, a mental-health advocate in Baton Rouge.


Landry’s ACA win is a loss for Louisiana, even on appeal
A lawsuit to invalidate the Affordable Care Act, backed by Attorney General Jeff Landry, may have prevailed in a Texas federal court last Friday – imperiling the health care of hundreds of thousands of Louisiana residents. But it still faces a long path through federal courts of appeal. In the meantime, health care protections under the ACA remain in effect. But just because the worst consequences of the ruling haven’t yet arrived doesn’t mean that bad consequences aren’t already here. The Advocate’s Stephanie Grace explains:

It’s bad for business, specifically the insurance and medical industries, which cannot plan for the future amid extreme uncertainty. It’s bad for patients who rely upon these protections, obviously. That includes people with pre-existing conditions who now buy their own insurance or might need to in the future, young adults kids who can now stay on their parents’ policies until they’re 26, people who use essential benefits such as mental health and pregnancy coverage, and anyone on Medicaid expansion, a program so popular that voters in three conservative states just approved referenda to opt in. And ironically, it’s terrible for the politics of the people who supported the suit in the first place — even if they’re the last to realize that the tide has turned, that the fear they long sowed has subsided, and that Americans in red states, as well as blue, have come to rely upon the law’s consumer protections.

Gov. John Bel Edwards told The AP’s Melinda Deslatte that he will seek legislation in the 2019 session to enshrine some of the ACA’s federal protections into state law, such as banning insurance company discrimination against people with pre-existing medical conditions.


Reducing school fees – and raising education funding – helps low-income students
With schools facing stagnant state funding, many have turned to student fees to help offset budget shortfalls. But in a state where 2 of every 3 public school students classify as economically disadvantaged, these fees can place a substantial burden on families. Now, The Advocate’s Will Sentell reports, a state task force has recommended that district policies show how low-income families can be exempted from burdensome fees:

About a dozen school districts and schools imposed fees totaling nearly $3 million in 2016, state officials said. Fees are charged for school supplies, registration, locker, parking, ID badges, coursework and extracurricular activities. Charges range from $10 to $300 per student, according to a state survey. “We are recommending that school fees come down,” said Tommy Byler, principal of North Vermilion High School in Maurice, and a member of the task force. While officials in 56 percent of school districts told the state they had formal policies in place, barely 1 in 10 said the rules were on websites or other platforms easily available for students and families. Few said they had hardship waivers in place for students unable to pay, according to the survey by the state Department of Education. The panel, called The Task Force on Student Fees, said waivers are especially vital because of Louisiana’s high poverty rate.

As LBP’s Neva Butkus reported earlier this year, school funding in Louisiana has been frozen since 2008. Because of inflation this funding freeze is effectively a funding cut:

Starting in 2009, the state stopped giving school districts the resources to keep up with rising costs – a trend that has now continued for nearly a whole decade. This policy shift has significantly changed how public schools are funded, putting new financial pressure on local governments while eroding the state’s investments in students, teachers and school support workers. The failure to continue cost-of-living adjustments has reduced equitable school funding by $6.8 billion over the past decade. Louisiana’s base per pupil spending of $3,961 would need to be $700 higher today just to keep up with inflation since 2008. The erosion of state support has forced almost every local school district to increase their contribution to education to make up the difference.


Labor market concentration and employer power
Income gains over the last several decades have skewed toward the wealthy – high-income earners have taken home increasingly larger shares of the wealth workers produce than those at the lower end of the wage scale. New research from the Economic Policy Institute points out that this shift in compensation is not just the result of impersonal market forces, but of specific policy decisions that have given employers more power and workers less. The Washington Post’s Christopher Ingraham explains their findings:

Bivens and Shierholz say that poor wage growth is less a function of increasing employer power and more a product of deliberate efforts to undermine worker power. Policymakers, for instance, have been reluctant to raise minimum wages, which would directly benefit workers at the bottom of the income distribution. They’ve taken steps to make it harder for workers to secure bargaining power, eroding union membership in the process. And Bivens and Shierholz maintain that the Federal Reserve has contributed to the problem by prioritizing low inflation over high employment. Many of these policies were put in place with good intentions — to boost productivity and the health of the economy as a whole. But the data show that productivity has actually slowed since the 1970s. “Between 1973 and 2017,” Bivens and Shierholz write, “net productivity grew half as fast as it had from 1948 to 1973.” Bivens and Shierholz conclude that if policymakers are interested in boosting wages, they should work to increase the power of workers relative to employers by prioritizing strong unions, high minimum wages and full employment. “In short, the policy movement to disempower workers not only led to less equal growth, but was also associated with significantly slower growth,” they write.

The study’s authors point out that policy actions to level the playing field between workers and employers are necessary because of a fundamental asymmetry in the labor market: in the absence of corrective policies, employers enjoy considerable leverage over employees. Essentially, the absence of policy supports for low-wage workers is a policy choice to favor employers.


Number of the Day
$6,800,000,000 – Funding lost to Louisiana public schools since the state’s suspended an annual 2.75% inflationary increase in per-student spending, in 2008. (Source: Louisiana Budget Project)