The Mental Healthcare Crisis

A graphic of Michelle Cusseaux, a mental health patient whose conditions led to a deadly encounter with Phoenix police officers (Photo: Gawker)

by Lydia Marie Hanna/Love and Rage

It’s hard to get help if you’ve never done it before. There’s an art to it, to obtaining the support you need from a medical establishment that is poorly designed to help those living with mental illness. There is an infinite list of practical obstacles to getting help,  – the cost of therapy, haggling with insurance companies, transportation – but what is particularly challenging is the way the healthcare system is structured.  

It has been my experience that a formal diagnosis will give you far more credibility with some doctors, and consequently better care. Unfortunately, it can take a large investment of time and money into your own mental health before things start to improve. In a lot of cases, talk therapy and medication is simply not enough, and individuals wind up in a crisis. When people are afraid of themselves, they generally call a hotline or go to the emergency room. We’ve been consistently taught that this is what should be done, and that these resources will help us. And they can — sometimes. But not always.

I, more than once, have been turned away by emergency room doctors because my psychiatric symptoms were deemed not severe enough to merit treatment. Mental health crises like suicidal ideation, self-harm and psychosis are supposed to grant one admittance to a place where their symptoms can be treated. However, the system simply does not have the resources to care for everybody who needs it. There are simply too few beds, and too few psychiatric hospitals in existence today.

Before the deinstitutionalization of the mental health system, a hospital stay would last months or years, and far more facilities existed, allowing for far more patients to be admitted and receive care. Today, psychiatric hospitals are few and far between, and an emergency stay is often less than a week, certainly not enough time for any real healing.

Longer-term residential care does exist at some private hospitals, but it is almost prohibitively expensive and patients are often discharged by insurance companies rather than by their doctors. McLean Hospital in Boston is known for its high-quality and comprehensive mental healthcare, but most programs do not accept insurance and can cost hundreds of dollars per day.

Crisis units, where patients are usually funnelled from emergency rooms, are often underfunded, understaffed, and can be violent. In 2006, a teenager died at Westwood Lodge in Massachusetts, after the understaffed facility failed to give her proper care for a brain  tumor. Syracuse, NY’s Comprehensive Psychiatric Emergency Program (CPEP)  is being sued along with Syracuse University for improperly locking up and medicating Kaitlyn Taylor, a student who visited the university’s health center for flu symptoms, and CPEP is located at the same hospital where a doctor accused of sexually harrassing patients has been reinstated. Cases like this are rampant nationwide, highlighing the fact that often, there is simply nowhere for a person in crisis to go that will not cause further problems.

The medical community has come up with some creative solutions to this problem. There is partial hospitalization, or intensive daytime care that has all the makings of traditional hospitalization but does not require patients to spend the night. There is dialectical behavioral therapy, a type of outpatient cognitive behaviors therapy that is extremely effective.  The internet has been instrumental in improving life for those living with mental illnesses, allowing for information about symptoms, medications, hospital and doctor reviews, and crisis resources to be readily accessed. There are support groups, online communities, and many therapists who are willing to go the extra mile for their patients. There is a lot of compassion in the mental healthcare system.

Yet, all of these medical professionals are still working within the restrictions of a financially drained, insurance controlled system that frequently places profits above patient care. As a result,  thousands of people slip through the cracks each year. Suicide was the tenth leading cause of death in the United States in 2013. Self-harm is just as common. But these are merely the visible signs of the mental illness epidemic — there is no way to measure the profusion of emotional suffering that is taking place.

The overwhelmed medical system has been forced to scale back its efforts and focus only on patients that are at risk for suicide or a danger to others. While these are of course serious concerns,  this all-or-nothing approach to mental healthcare has a profoundly negative effect on patients. The system effectively ignores the multitudes of people who are suffering from anxiety, bipolar disorder, depression, obsessive compulsive disorder, schizophrenia, eating disorders and a host of other problems, unless there is a direct safety threat. Anyone who has sought help knows that there are dozens of hoops to jump through -many of them financial-  before any real progress can be made, and that it is a very long and expensive process.

There is no one solution, but what groups like the National Alliance on Mental Illness and the International OCD Foundation have proven is that education can make a massive difference in how people with mental illness are treated, both medically and in their daily lives. Both of these groups, together with many others, host awareness events and serve to bring together those living with mental illness so that they can organize and lobby for better mental healthcare legislation. Ordinary citizens should also make an effort to become aware of the problems facing the mentally ill, and stand up for them by becoming involved in letter writing and awareness campaigns. There is still a pervasive trend of viewing mental illness as a personal flaw, rather than a medical condition, and this stigma can lead to all manner of harmful misconceptions. Debunking myths and reducing stigma will gradually shift society’s views toward framing mental illness as a legitimate medical concern that demands attention, rather than a taboo subject.  

The issue of mental health needs much more attention in congress. Insurance companies and legislators must both be active in reducing the high pricetag of mental healthcare, as the result of the current state of affairs leaves many without the ability to afford prescriptions, hospital time, and therapy. Hospitals must expand the range of psychiatric services they offer, and these services must be overseen carefully to reduce the high rate of patient abuse in the United States. Finally, everyone must make an effort to understand the unfortunate reality that a healthcare system that does not adequately treat diseases of the mind is not an adequate healthcare system at all.


Lydia Marie Hanna is from Holland Patent, NY and attended Syracuse University where she studied Literature with an emphasis on Post-Colonial Theory and Marxism. While at SU, Lydia also worked for the New York Public Interest Research Group (NYPIRG) and was involved in student activism — especiall in relation to mental health issues and access.

 

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