Utah has a critical need for a long-term residential facility for those who are low-functioning, says the administrator of the Utah Alliance for the Mentally Ill.

Jan Harding said that facilities like the State Hospital offer short-term help to the mentally ill. "But a lot of long-term low-functioning folks end up in University Hospital and at Provo because there's nowhere else to go. Nothing is set up for long-term care."Utah continually shortchanges programs and services for the mentally ill, she said.

Low-functioning, she explained, means people who don't respond to medication or have a hard time stabilizing on medication. "If they have support, supervision, someone to help with their food, they can be handled in the community," she said. "Most will be in and out of hospitals all of their lives, though."

A long-term facility would allow the chronically mentally ill to stay in the community at a lower cost to both taxpayers and families. Ironically, though, federal funds will not pay for such a facility. "Policy sometimes has the effect of forcing the mentally ill to become critically ill before they can receive any help," Harding said.

Harding said research has shown that the facilities in other states that have been the most helpful in dealing with the chronically mentally ill are not even available in Utah - particularly crisis centers. Many programs that could benefit both patients and families don't exist here. Utah doesn't even have a forensic director, an official charged with making sure the rights of the mentally ill are protected in the criminal justice system. And she said a law enforcement official told her that "30-40 percent of our mentally ill are in our jails."

The problem with using jails to house the mentally ill, Harding said, is people who commit crimes because they are sick don't get treatment. And treatment can be completely effective, which means that the person probably wouldn't need to be in jail at all. It's a Catch-22 situation.

Schizophrenics make up a large portion of the chronically mentally ill population, and misconceptions about the disease have hampered providing adequate care.

A fact sheet put out by the National Alliance for the Mentally Ill explains that schizophrenia is "a brain disease, now definitely known to be such. It is a real scientific and biological entity as clearly as diabetes, multiple sclerosis and cancer are." The symptoms, it says, are those of a brain disease, including thinking impairment, delusions, hallucinations and change in emotions and behavior. It is not split personality, and it cannot be corrected through psychoanalysis.

"Schizophrenia is pretty common," Harding said. "But it is so misunderstood and there's so much stigma attached that no one wants to help these people. If you think doctors like to take care of them, you're wrong, because you can't cure them and treatment is time-consuming. And when it comes to handing out money for programs and research, these people are the victims of serious discrimination. It's not even being researched much."

The disease usually affects people between ages 17 and 25. Occurrence after age 30 is rare. "And these are often beautiful, bright children," Harding said. "But it doesn't take away the intelligence. It just takes away the ability to think logically."