The case for mental health reform: Part 2, hospitals and emergency care

So, I finally got my first two letters done! Whew, it took more time to complete than I thought! I decided to start with emergency care, and so I addressed my letters to the President and CEO of each of the largest hospital systems in my area. I’ve had experience being a guest at both. Here are some of the highlights of the letters I sent. 

When it gets to the point of going to the hospital or using emergency services, this is when control of one’s mental health has usually gotten out of control. Yet, when mental health patients seek out emergency care there are few effective resources available to the patient, except of course in the instance where one is violent, suicidal or considered some other kind of imminent threat to society or themselves.

What happens though when a person is not suicidal, homicidal or completely out of control but is still in acute mental pain? From my own experience, the current standard emergency room practice is to treat physical ailments and then provide the patient with a list of resources to contact in order to treat any psychological concerns. In a nut shell, no pun intended, what this tells the patients is: we don’t want to hear about your mental problems here.

Funny, when this was happening to me I knew it was wrong, yet it didn’t truly hit me how wrong it was until I read so many painful stories from other people. I recently wrote a post about the strong coorelation between mental pain and physical pain called, “It’s not all in your mind.” Even I was shocked, upon doing a little research, at how closely these two work together towards whole health, which makes me wonder: Why is there such a monsterous gap between treating a patient’s physical symptoms and treating their mental symptoms?

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So, what are my own suggestions for improving this situation? Is it really such an outrageous request to have people on staff who can properly address mental health issues? I’m not naïve enough to think that there will be an ideal protocol for every situation. Mental health disorders can vary greatly in type and level of severity. The ability and the willingness to consider and accept help is also crucial.

At the very least, there should be someone who can sit with a patient, listen to their concerns, explain things to them, etc–someone who has the same level of care and compassion in mind as any other doctor, nurse or attendant on staff? I don’t think this is something that would cause too much of a hiccup for hospitals.

Having a dedicated team would be even better. I’m not talking about a “behavior” wing. I’ve had experience with that too, where I’ve been treated more like a prisoner or criminal than a patin.

In writing my letters I also suggested that hospital-funded programs could be established in order to address mental health issues, much like they might have a similar program for heart and lung patients…. maybe a walk-in mental health clinic?

Considering the unprecedented number of people who are reporting mental health concerns these days, along with soaring rates of things like suicide and random acts of violence, none of this seems unreasonable.

I say if even one suicide or mass shooting has the chance to be prevented it would be well worth it. If it was your loved one involved, either as a perpetrator or a victim, would you not want everything under the sun to be done in order to prevent such an occurrence from happening? Beyond these two extremes though, is it not simply the right thing to do when so many people seem to be living in pain?

I would like to encourage anyone who has had a similar experience to write a thoughful letter to your local hospital leadership or adminstrative team asking them to please consider revising their protocol when it comes to how they treat mental health patients.

My ultimate goal is to help establish programs and improve the effectiveness of mental health treatments in most aspects of life including schools, universities, educational programs and professional organizations. Too many people are needlessly living in pain and anguish because of a broken system. It’s no exaggeration to say that it’s becoming an epidemic that continues to grow in intensity.

A century ago mental health care was just beginning to come out of its infancy. Now we must do the work to bring it out of its adolescence.

Read my first post here: The case for mental health reform: Part 1, failure is not an option

Also check out this mental health series: Memo at Midnight

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37 comments

  1. A dear friend of mine, who lives in a major city, has been struggling with this. During times when she recognizes she needs to be hospitalized, she has to get herself to the hospital with the mental health ward (she doesn’t drive) and go to the emergency room. She then has to stay there until a bed in the mental health ward opens up. She’s sometimes spent 3 days or more in emergency, waiting to be checked in.

    With all the stress she has to deal with, just to get checked in, and the things she has to deal with while there (all types of mental illness are in the same ward, so someone who is lucid and rational, but mentally in pain, like herself, shares the small ward with people who have had psychotic breaks and are detached from reality), I sometimes wonder if being there is actually helping her at all. 😦

    No doubt, that mental illness is not taken as seriously as physical illness, but even the different types of mental illnesses are just lumped together.

    Liked by 3 people

    • Wow, I’m really sorry to hear that. And yes it’s very true that everyone who has a mental condition is often lumped together and treated the same whether the person is severely depressed or full-blown psychotic. Good point. Different conditions require very different treatments. Well hopefully things will get better. I encourage anyone who has had an experience like this to consider writing a letter to the hospital administration. The more the better! 🙂

      Liked by 2 people

  2. Doubtless, just like the entry you penned, it was a thoughtful letter, reasoned in its approach. You took the frustration you clearly feel and transformed that emotion to purpose.

    Healthcare professionals, from nurses all the way “up” to administrators, respond to visual cues, from physical trauma to vituperative mental distress. Anything beyond that often doesn’t register, particularly when the professionals are charged with marshalling limited resources, be they money, time, whatever.

    Your approach, JoAnn, as well as encouraging others to do the same, should help to move things in the right direction.

    After all, not to diminish what those with dire issues to overcome, everyone is “broken” to some degree. A cliché, certainly, but nobody is 100% sane. A cliché becomes such for a reason.

    Liked by 3 people

    • Good points. Trained professionals in the system try to improve it, but it is an uphill battle with limited funds and “managed care” accountants and MBAs with NO clinical training imposing constraints based on assumptions that do not reflect the realities of patients and their needs. Contrary to what some believe, “single payer” might not stop the problem and might make it worse. Single payer systems also have to allocate resources, and the wait times are notoriously long. People in crisis lose out when wait times are long. And in the current system they lose out by being turned away. What solution might work remains an open question. We might need something new (or very old): unpaid volunteers who can fill in the gaps or maybe more profound change. Let’s face it: regardless of their rhetoric and manifestos, shooters and suicide bombers are all, or almost all, identifiably mentally ill.

      Liked by 1 person

      • Education and understanding is always the key—in a perfect world of course. 🤗
        Stopping all suicides and mass shootings is impossible but I would have to think that, particularly for the under 23 shooters, that perhaps the right help would have made the difference. A child’s brain isn’t considered fully matured until around age 23 so it’s reasonable to expect that if a teenage shooter was just a few years older they might not make the same choice to pick up a gun to solve their problems.

        Liked by 1 person

      • One thing we are missing is the numbers and stats on how many suicides / shooters are stopped by the system as it is. Without baseline data, we don’t really know if we are making progress. AND we might be doing better than we realize.

        Liked by 1 person

    • It’s true everyone is broken. You would think that knowledge would serve to unite us rather than divide us. Alas we are all flawed beings though… fear, misunderstanding, jealousy, selfishness and a host of other things get in the way… and to a certain extent we are all guilty of those things.

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  3. This was very helpful and hope that more hospitals take this under consideration – I have been in crisis mode but didn’t feel bad enough to go to a hospital or suicidal to call the suicide hotline, but when calling my local mental health clinic where my psychiatrist is only there 3 (1/2 days) a week because he works at the mental health hospital they don’t refer me to someone who can help me but take my number and say they will leave him a message – I have since seen a nurse practitioner at the clinic who said she or my doctor will be there during business hours so if it’s a day my Dr isn’t there I leave a message for her to call me – but I still have to wait – hey I’m in crisis people can I please talk to someone now!!!

    Liked by 3 people

    • Yes, in an ideal world there would be 24-hour emergency services for all people, including those suffering mental health issues. Hopefully something will change for the better in this regard. 🙂

      Liked by 1 person

  4. More power to you, JoAnn. I think our entire medical system needs to be reformed, and among the reasons why some medical professionals don’t want to deal with so-called mental issues is because they feel ill-trained and little qualified, and they are worried that it might take extra time, in a scenario where nobody ever has enough time. Also, procedures get remunerated, and talking doesn’t.

    Liked by 3 people

    • Yes, money is always a factor and many mental health patients unfortunately tend to fall into a lower financial demographic. Big part of the problem I’m sure.
      Catching mental health issues as early as possible would seem to increase the likelihood of successful treatment… I think that’s been starting to happen but of course needs much improvement also.

      Liked by 2 people

    • Good points. And some medically trained professionals who have little mental health training simply do not want to work with patients with mental health issues. Forced labor of any kind (i.e. slavery) is a bad idea, so other approaches are necessary. Sometimes support groups (like face to face AA meetings or online resources like “InTheRooms.com”) can help, but they do not address all needs. (For example, community based support groups for those with chronic, long term schizophrenia have yet to be successful. The paranoid delusions kick in and… …you can imagine the rest.)

      Liked by 2 people

  5. Yes, we are all broken to varying degrees and no one is perfect. This includes mental health professionals themselves. They do not have an easy job whatsoever. Better training and more effective treatment techniques need to be established, no doubt. 🍃🌷

    Liked by 1 person

  6. Fantastic, I’m glad you’re advocating for change. I was a “guest” at our local inpatient behavioral health center and I definitely could see alllll the need for reform while I was there. I’ve been looking for ways to advocate and help – so nice to come across another blogger doing the same. Keep it up!

    Oh and if you have time/energy I’d love to see a template of the letters so I can do the same with my behavioral health system 🙂

    And I love the idea of walk in mental health clinics, that would be amazing!

    Liked by 2 people

  7. Energy I have but there never seems to be enough time does there? Oh, how I wish I could quit my day job and devote myself full-time to this cause. Maybe one of these days!
    “Guest” yes. I’ve used that word too and then had a good laugh.
    I can provide you with a copy of the letter I sent… perhaps I will make up a template that people can use to write their own letters. That’s a great idea. How can I send the letter to you? If you want you can email me at joann@midnightharmony.com and then I will reply.

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  8. Too many people are intent on “fixing” the solution, so the patients feelings throughout are almost lost to the idea that they’ll get better. Getting through my own depression massively helped just because my best friend listened every single day. She didn’t offer solutions or ways to fix me, just listened. And now that I am of a better mental state I’ve managed to get her through the same! We need more of this in institutions

    Liked by 2 people

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