Cart reported as being ahead of the horse

How often have we heard about "putting the cart before the horse?"

How many times have we laughed, pointed fingers and gave the expressions of a fool? (well, I have).

What do you do when it was you who made the mistake? Learn from it, finger point, hope no one thinks it could be you since you are Ms. Perfect? How is it possible to be perfect when nothing can be exactly perfect.

Here is my point:

Seventy years ago we had 600,000 inpatient psychiatric beds in our country. Today, we only have 40,000. Five hundred and sixty thousand beds have been lost, plus the 47 we lost last month in OKC.

This didn't happen by accident. Oh wait, yes it did.

The focus to reduce hundreds of thousands of inpatient psych beds came about by using an alternative by switching those living with a serious mental illness in a hospital setting to living back in their communities. Psychotropic medications had drastic improvements, treatment, in general, had improved where, in theory, most people could receive out-patient services in their hometowns. It was a great idea.

Medicaid was so excited it created the Institutions For Mental Disease Exclusion. States loved it. Hospitals started shutting down. The responsibility would be that of local communities within a given county, within a given state.

Oh, wait. The local community mental health centers were not built. Model practices had yet to be established. The community services were not ready for the transition.

Did this stop the hospital closings? No.

Did Medicaid get a little 'trigger happy' with the exclusion of payment policies, meaning if you kept the majority of Medicaid patients you would not be paid for professional and institutional services? Yes.

Was anyone able to raise the red flag and stay STOP the transition? No.

Did the left hand know what the right hand was doing? No

Were patients being discharged with no where to go? Yes

Were patients getting their medications? No

Did patients, homeless and off medications, get in to trouble with the law? Yes

Did those patients go in to the correctional system? Yes

What was the plan when a new crisis occurred? What do you mean by crisis

The questions could go on and on.

Does anyone know what it means to put the cart in front of the horse? Most Certainly

Does anyone of authority know the mental illness system has the cart in front of the Horse? Oh, really?

Were people working within the system able to change their belief system to learn not to give a damn? Yes

Did people become so overwhelmed that they did not know what to do? Yes

Has the Federal Government thrown money at the system to patch it to make it work? Yes

Has State Government thrown money at the system to patch it to make it work? Yes

Is there anyone who can say stop, I can fix the problem, I can get the horse to the front of the cart?

ANYONE?

Does anyone believe in Murphy's law?