Defenders Investigation: The cost of troubled minds

How one woman's mental health struggle cost Austin taxpayers almost $1 million in health care services at area hospitals and jails.

ANDY PIERROTTI / KVUE NEWS and PHOTOJOURNALIST DEREK RASOR , KVUE

Her name is Joann Kennedy.

She's part of an alarming number of mentally ill patients in Austin burdening hospitals and jails because they are uninsured. Texas has more of them than any other state.

The 51-year-old has battled schizophrenia and bipolar disorder homeless and alone for more than 20 years on Austin streets.

"It was sad. It was crazy. Everyone wanted to offer me drugs," Kennedy said, sitting outside a temporary housing facility she recently moved into in East Austin.

"She was gorgeous, just gorgeous. I envied her for her beautiful smile, and her hair was always together," Kennedy's sister Deborah Carr said.

Before her mental illness, Kennedy was married with three children. Carr said her family's efforts to help her were met with dead ends.

"It was hard for us, because you know, she's our sister, and we wanted to help her, but we just couldn't find the resources to help her," Carr said.

When Kennedy did get help, it came from the Travis County Jail. The KVUE Defenders found Austin police arrested Kennedy at least 38 times over the past several years for minor crimes. She's spent 1,344 days behind bars. It cost the jail $189,441.40 to provide her medicine, counseling and security over a 20-year period.

From 2007 to 2013, inmates with chronic mental illnesses, like Kennedy, increased 78 percent in Travis County.

Kennedy said there are times she felt glad she got arrested, "because they gave me good medicine, but I don't want to go back there," she said.

The totals do not include money doctors billed for their services or court costs. Some health professionals and law enforcements officials told KVUE her costs would far exceed $1 million if it did.

Kennedy's sister is shocked at the cost.

"Wow. But wouldn't it be so much better if she had a primary care physician, somebody who knew her history every time she got sick? She can't afford to," Carr said.

Dr. Christopher Ziebell is the director of emer

"At any given time, I might have 15 of my beds at Brackenridge filled up with psych patients who had nowhere else to go," said Ziebell.gency services at University Medical Center Brackenridge. Over the past three years, hospitals in Austin reported a 77 percent increase in mental health patients.

That means longer waiting times in the emergency room and delays in diagnoses for other patients. To help manage the increase, Brackenridge opened an emergency room specifically to treat mental health patients earlier this month.

"Most of these folks are unfunded, uninsured, which means the prices for everything we do goes up. So to balance that out, your health insurance premiums go up," Ziebell said.

According to a recent study by the American Health Counselors Association, Texas leads the nation in the number of people who suffer from severe mental illness and have no insurance.

The study found 652,000 mentally ill Texans could be covered, but last year Texas lawmakers rejected the federal Medicaid expansion, which provides states money to insure the poor.

Joel Miller is president of the association and helped author the study.

"When you're talking about those kinds of numbers who have no health insurance coverage, no regular source of care, no preventive or wellness services, I would have to categorize that as a major crisis in that state," Miller said.

In April 2013, Texas Gov. Rick Perry announced he would not accept Medicaid expansion. He said he doesn't believe the federal funding is secure, and it would become an expensive unfunded mandate for the state.

"Medicaid expansion is, simply put, a misguided and ultimately doomed attempt to mask shortcomings of Obamacare," Perry said in a press conference.
Click here for more of Perry's response on Medicaid expansion.

"That's the position our current leadership has taken, and it's foolish, and it's giving our money away to other states in the nation," Ziebell said.

Central Health said the governor's decision means the burden to pay for the uninsured mentally ill falls on the local tax base. While Austin has many services available for the mentally ill, rural communities do ont.

Last year, lawmakers increased mental health funding by more than $200 million. That still puts Texas near the bottom in total mental health spending compared to other states. There were more beds available at state psychiatric hospitals in 1994 than there are today.

What do candidates for Texas governor think about Medicaid expansion?

Attorney General Greg Abbott's campaign said, "Greg Abbott favors expanding access to mental health clinics, which offer the most supportive and cost-effective approach to mental healthcare. He applauds the legislature for significantly increasing funding for mental healthcare to help eliminate the waiting lists for individuals seeking services. Greg Abbott also supports the legislature's decision to opt out of the Medicaid expansion provision of Obamacare. The U.S. Supreme Court ruling makes it clear that states participating in Medicaid expansion will be unable to opt out in the future, and the additional cost to the state down the line would jeopardize our ability to provide essential services like education, transportation and security. He believes that Texas can continue to expand access to mental health services for our citizens in need, without expanding Obamacare, by adopting proposals like the recently passed legislation."

State Sen. Wendy Davis' campaign responded, "By rejecting the expansion, Greg Abbott is letting Texans pay for the health care of Californians and New Yorkers. We need a Texas solution."

If you or a loved one need mental health assistance, visit the links below for more information on how to get help.