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Every day, hundreds of sick and injured patients walk into free and charitable clinics around the Tampa Bay area in need of a doctor.Many are suffering from chronic conditions, such as diabetes or high blood pressure. Some patients were referred to the clinics by staff at hospitals where they landed after years of neglecting to care for treatable conditions.The clinics allow the patients to pay what they can, or nothing at all. They are staffed by doctors and nurses who volunteer their time. They survive off donations and small grants.Many of the patients have jobs but they are living paycheck to paycheck. None have health insurance, either because they do not qualify for Medicaid or can’t afford private coverage. For these patients, the clinics are often their only option for primary care.

A Conversation About Florida’s Troubled Mental Hospitals: “Insane. Invisible. In Danger.”

Florida legislators have cut $100 million from the state’s mental health budget since 2009—and now an investigative series, “Insane. Invisible. In Danger.” by two Florida newspapers details how those cuts have put patients and staff in harm’s way.

Health News Florida spoke with the Tampa Bay Times’ Leonora LaPeter Anton, one of the reporters who spent more than a year looking into Florida’s mental hospitals. You can hear the conversation about what this has meant for patients in these facilities here:

Anton also talked about the responses from staff and other stakeholders in Florida’s troubled mental hospitals:

What have you heard from employees of these facilities about what they need?

A lot of them told us they were afraid to do their jobs. In fact, in the wake of the series we've heard from tons of employees who have said, wow, you guys got it right—this is how it is inside these facilities and we're afraid.

We heard also from others who say they're not afraid. It's not every single ward, every single patient. It’s not completely horrible every single day of the week.

It’s just that there’s just not enough employees on duty, they said.

They often have to work double shifts, they're tired, they’re not paid well. And what you find is the people who are working with the patients, they're not educated in the area of mental health often. They’re people who maybe worked in McDonald's or Burger King and they maybe have a high school education. They get some training when they start out, but a lot of them said it wasn’t enough.

The other thing we saw was that each hospital has a staffing ratio. But it’s not a standard ratio. It’s by hospital. There doesn’t seem to be any ramifications if it’s not followed. So one thing that has been talked a lot about is coming up with a statewide standard for how many patients each staffer should take care of.

The Department of Children and Families responded with a list of disputesto your article. They say they only experienced about $50 million in budget cuts. How’d they come up with such different numbers?

The state reports its expenditures on a state fiscal portal—that's what it reports to the public. And this is what we used.

They’re saying that part of that money is a fee for administration—a fee for DCF’s administration in Tallahassee.

We’re saying, well, these are the figures you report to the public. And so we think that those are the proper figures to use.

And also a lot of the disputes they had with our facts are not really disputes. Our facts are our facts. We do not feel anything is inaccurate. We feel everything is accurate.

What happens next?

We hope the state looks at the information we’ve provided and comes up with some sort of answers, some sort of solution. Whether it’s statewide standards, more money, better patient-to-staff ratios, more protection for patients, better training—we think it’s important.

We think we’ve raised an issue that needs to be addressed and we hope that the state does.

--Sammy Mack is a reporter with WLRN in Miami. WLRN is a partner with Health News Florida, which receives support from the Corporation for Public Broadcasting.