European Stars And Stripes (Newspaper) - April 8, 1986, Darmstadt, Hesse                                Tuesday april 8, 1986 the stars and stripes Page 9 palme murder reconstructed a photos a policeman posing As the killer left stands behind two colleagues acting As swedish Premier Olof palme and his wife Lisbeth at the site of palme s assassination in Stockholm. The unidentified police woman bends Over the officer acting As palme right after the simulated shooting. Swedish police reconstructed the event As part of their investigation into the killing. In the background posters of poems and Flowers Mark the spot where the murder took place. Mental health care spotty in u.s., study Washington a Wisconsin Rhode Island and Colorado offer the Best care in the United states for the seriously mentally ill while Mississippi new Mexico and Hawaii have the worst Ralph Nader s Public citizen organization says. The Public citizen health research group in a 105-Page report on mental health care said it was surprised to find that neither per capita income nor per capita spending on mental health determine the Quality of care. In fact the study said the five highest ranking states spent no better than an aver age amount on mental health care. New York and the District of Columbia on the other hand spent Large amounts for bloated mental health bureaucracies and very mediocre services the study said. The single most important finding in this Survey is that there Are local programs in some states and a Small number of state programs providing High Quality services for the mentally ill the study said. They demonstrate conclusively that such programs Are possible and that the seriously mentally ill and their families need not accept mediocre services As a Factor life it said. The group a Liberal oriented private re search organization said it initiated the Survey because of the scope of the problem and the Lack of Progress the United states has made against it. There Are an estimated 2 million people in the United states who Are seriously men tally ill most suffering from either schizophrenia or manic depressive illness. Of those the group said an estimated 150,000 live in Public shelters or on the streets. The group admitted its evaluation of state mental health programs was Subjec Tive. The group took 12 possible sources of information including government evaluations of mental facilities obtained under the Freedom of information act reports of the joint commission on accreditation of hospitals internal surveys by state mental health departments and interviews with experts sex patient groups and family con Sumer groups. The reports were assigned numerical rankings on two Scales one for outpatient care and one for inpatients. Thus each state had a ranking of be tween two and nine. States with tie scores were ranked according to their per capita spending on mental health care with the lower spending state ranked higher on the Assumption it was More efficient. Wisconsin Rhode Island and Colorado ranked highest the group said. All received nine Points with Wisconsin ranked first be cause it spent the least Money per capita of the three. In More detailed analyses the group said Wisconsin has achieved a National reputation for excellent services primarily be cause of its programs in Madison. But it said the state As a whole has succeeded largely because of Money and authority delegated to 56 Community service boards aggressive citizen advocacy groups for the mentally ill and farsighted planning for Homes in the Community. The first three states were followed by Maine Oregon Iowa and new Hampshire All with eight Points. The Bottom three states were Hawaii new Mexico and Mississippi which received two Points each. Hawaii was slammed for its state mental Hospital described As a third class institution where one Federal Survey found in coming patients who were not Given a phys ical exam until a month after their arrival. The group said Hawaii has turned at least two federally funded mental health centers into general health centers. Outpatient cares no better the group said. Until a Large wave of indignation sweeps Over the islands the plight of the seriously mentally ill is not Likely to improve the study says. Just above the lowest three were Dela Ware Texas Montana South Carolina and West Virginia with three Points. Even within the subjective standards used by the group it conceded there were limitations to the evaluations. For example while new York rated Only 26th in the country in terms of Quality some state hospitals Are very Good but Are overshadowed by the very poor. Similarly it said California gives mental health responsibilities to its counties and the resulting Quality varies from excellent to virtually non existent. Geography also affects the ranking the group said. Rhode Island and Montana have similar populations it said but Rhode Island must provide outpatient services Over Only 1,214 Square Miles while Montana must serve 147,138 Square Miles. Montana suffers in the out patient evaluation As a result the group said. Pentagon reports on Gao study stays of civ/7/ans near same in military civilian hospitals by Clint Swift Washington Bureau Washington Hospital stays of civilian patients in military hospitals Are not significantly longer than those of civilians in civilian hospitals according to a congressional study. The Pentagon s top doctor said the finding shows that military Medicine is not much different from civilian Medicine in the states. The general accounting office an investigative Arm of Congress said an analysis of about 150,000 civilian patients in defense department hospitals in the states found no appreciable difference Between their average lengths of stay and those of comparable patients in civilian  report did not study whether patients were admitted for appropriate reasons. The study compared groups of patients with More than 100 types of illnesses. In a letter to the Gao or. William Mayer assistant defense Secretary for health affairs responded the find ing of no significant difference Between the lengths of stays for these two groups reflects the similarity Between military Medicine and the mainstream of american  about 70 percent of the patients in military hospitals Are civilians according to Dod data. The study was requested by sen. Daniel Inouye Dha Waii. The senator has been among legislators who would like to see those patients health insurance reimburse Dod for the care a staff member said. He said Blue Cross and Blue shield officials have con tended that the Quality of care and lengths of stay in the military and civilian sectors were too different. On average the lengths of stay for 149,946 Dod civil Ian patients studied was about 23 minutes longer than civilians in civilian hospitals the Gao report said. The study was based on 1983 data from the army Navy air Force and the National Center for health statistics of the department of health and human services. The year was the most recent one for which Complete defense and civilian statistics were available. The report said that 1983 and 1984 data appeared to show that lengths of stay in civilian hospitals might be declining More rapidly than in military hospitals. Stays in civilian hospitals decreased by about 5 percent Between 1983 and 1984, the study said. Between 1983 and 1984, the average stay in army and air Force hospitals decreased by less than 2 percent. Comparable figures were not available for the Navy. Mayer said the civilian sector decline probably stemmed in part from increased scrutiny of charges by medicare. The Gao analysis did not include any Active duty Mili tary patients or civilians in military hospitals overseas because the researchers did not believe fair comparisons could be made. Active duty patients for example May have to be admitted for less serious illnesses or for longer periods of time because living in Barracks precludes the kind of Home care Many civilians can receive the report said