Hooked on treatment: Marylanders pay clinic millions, but diagnoses questionable
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( Karl Merton Ferron, The Baltimore Sun / July 2, 2010 ) Kevin Brown knew he was hooked on crack cocaine. That was obvious each time he set off on another smoking binge. But Brown says he never imagined that he also suffered from a mental illness until he walked into Baltimore Behavioral Health Inc.A day or so after he went to the private, nonprofit Southwest Baltimore clinic in 2007 hoping to kick his drug habit, a psychiatrist diagnosed him with major depression. Soon, he was living in one of BBH's houses, taking antidepressants and spending hours each day in group therapy, half of it focused on mental illness. The treatment lasted months and cost taxpayers thousands of dollars. But Brown, 46, doubted that he had a psychiatric illness or needed medication. And for good reason, says Amy Jackson, a University of Maryland mental health social worker who counseled him over a recent six-month stretch after he'd relapsed: He never was clinically depressed. "Once he was no longer using the substance, he was no longer showing signs of the depression," Jackson said. In other words, he suffers from a chemical addiction, and when that is under control, his mind is not burdened by mental illness. Brown, an addict diagnosed with a psychiatric illness that some outside health providers do not think he has, illustrates a recurring theme at BBH. Addicts who step into BBH from the city's drug-racked streets are three times more likely to be deemed mentally ill than are addicts treated at other centers across Maryland, state records show. And BBH has long funneled patients into the costliest outpatient treatment programs available to poor Marylanders - programs they would not qualify for without a diagnosis that they have a psychiatric illness. In some years, state data show, the West Pratt Street center has swallowed up 85 percent of the taxpayer funds spent on intensive outpatient mental health care across Maryland. From modest beginnings in 1997, Baltimore Behavioral Health grew by last year into a $17 million-per-year operation, with more than 250 staff members tending hundreds of patients a day, making it one of the region's largest providers of drug treatment. It has diagnosed and treated thousands of the city's most broken and desperate, offering many a bed in its network of area rental homes, then busing them daily to the center for state-funded treatment. |
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