My husband recently died from a combination of a weak heart, massive amounts of prescription drugs in his system, and severe depression, which in
spite of years of psychotherapy and medication was not yielding to treatment. Regardless of his very supportive family and my best efforts, we were
not able to save him. The official diagnosis was heart failure, but we all know it was essentially a suicide.
My husband had been in the local hospital's emergency room for overdoses several times in the past six months. Each time they strongly recommended he
go into their drug addiction/psych unit for treatment and each time he refused. In despair, his family and I went to the magistrate and got an order
for an involuntary commitment. However, when he was given his evaluation he assured the examiner that he was neither homicidal nor suicidal, so they
did not have any legal grounds to keep him against his will. In fact he was totally suicidal, but he knew exactly what to say and aced the
examination. He had had enough experience with the mental health system to know how to do that. The hospital sent him right back home. He died that
evening. He was 53 years old.
My second aim in this post is to add something to the discussion of mental health resources in this country. When I first moved down here, there was
an excellent, state-funded, community mental health facility which offered a range of services, from psychiatrist to psychiatric medication to
psychotherapy to nursing to case management to social workers who looked into the patient's living situation and helped them apply for every benefit
they were entitled to. I know this from personal experience with them, as I have also been diagnosed with a mental illness. The health center also
provided some free drugs for those who could not pay for them. The fees were assessed on a sliding scale according to one's income, which for many
people was zero or close to it. They were treated free of charge. People in shelters or a homeless person could just walk in off the street and be
Then there was a change in the state government. They decided, in their wisdom, that this community mental health system and others like it were
costing too much. The responsible political party shall remain nameless but everybody probably can figure that out. Anyway, the community center and
others across the state were dismantled in favor of privatization. In other words, whatever mental health services we have left now are run for
profit. Those services now cherry-pick those types of treatment which are money-makers. For example, treating the indigent has pretty much fallen by
the wayside. Instead of the large state-funded mental health facility we have one or two smaller ones that provide counseling for those who are not
considered seriously ill, and they have one or two nurse-practitioners, who are supposed to be working under the supervision of a psychiatrist but in
fact are not. These nurse-practitioners are, of course, much cheaper than actual doctors. The staff at these private providers are typically
overworked and underpaid.
Whereas this state used to have five or six hospitals for the mentally ill, it now has one. The prevailing philosophy is called "community-based
integration and support." Sounds pretty good, huh? It has connotations of the mentally ill being embraced and cared or by their own communities.
What it actually amounts to is they send them home for their families to take care of as best they can. The homeless mentally ill can now sleep on
the streets of their own hometowns. In fact, there are one or two profit-making group homes here for the mentally ill but the residents are not
integrated into their communities in any meaningful way. The severely ill, especially, just aren't readily accepted by those who consider themselves
completely sane. In addition, the funding for this "community support" is very limited, based on the assumption that people will need crisis
intervention for a brief period of time, then be "cured." There are no real provisions for the long-term or seriously ill.
The places of last resort now are prisons. Society just doesn't have any other alternatives for them. They get caught up in a cycle of offend (often
because they are mentally ill), incarcerate, release, at which time they will offend again, etc etc. for as long as they manage to survive, which for
many is not long.
Unless there is a great protest by the citizenry every state will probably eventually have a system as poor as ours.
edit on 20-1-2011
by Sestias because: (no reason given)