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Budget proposal worries advocates for mentally ill

As the House and Senate hammer out a budget compromise, psychiatrists and advocates for people with mental illness say a Senate proposal could have potentially harmful consequences.

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By
Bruce Mildwurf
RALEIGH, N.C. — As the House and Senate hammer out a budget compromise, psychiatrists and advocates for people with mental illness say a Senate proposal could have potentially harmful consequences.

The proposal would require physicians to obtain prior authorization from the state's Medicaid managed care system to prescribe medication for any kind of mental illness.

"I know their intentions are good, but they are not well-informed, and doing this is bad for the state, bad for the economy and bad for the patient," said Dr. Assad Meymandi, a Raleigh psychiatrist and neurologist.

Meymandi and other experts say the proper medication is critical in treating mental illness, and what works for one patient may not work for another. Giving patients cheaper drugs doesn't always pay off, he said.

"The incidence of suicide goes sky high. The incidence of recurrence, psychosis and readmission, recidivism goes sky high," he said.

Meymandi said a managed care system for physical ailments can save money, but not for diseases such as schizophrenia. One hospitalization or visit to an emergency room wipes out all the savings, he said, so it could wind up costing more money.

Marc Jacques, who was diagnosed 30 years ago with paranoid schizophrenia, said the pre-authorization proposal would be a dangerous pill to swallow if it makes it info the final budget.

"It's dangerous to the people who take the meds and dangerous to the community where these folks live because, in the absence of the right medication, the symptoms take over," Jacques said.

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