The state of mental health care in the US is atrocious. Not as bad as when it was thought the ill were possessed by demons, and people were kept chained and naked in dank cells. It hasn’t improved enough. People still treat mental illness as a personality flaw, something we could change if we only tried. It is something many medical doctors, and ER staff do not recognize.
Most public hospitals prior to 1900 were operated by religious orders, and evolved from Almshouses. As so many other things, hospitals were often as squalid as the Almshouse. With time, hospitals became less of a place where paupers died and more of a place of improving one’s condition. As more of those with funds chose to go to hospital, more changes were made. Eventually public hospitals were cleaned up and money for improvements and new buildings became available. Now, the people who would like to donate don’t have the money, and those with money don’t care.
When psychoactive drugs were introduced in the US in 1955, their use lead to increased discharges from mental hospitals. Over the next 50 years there was a dramatic decline in hospital beds from 560,000 in 315 hospitals to 53,000 beds in 230 hospitals. Certainly doesn’t sound like much. Currently, according to the Mental Health America, the prevalence of untreated adults with mental illness ranges from 43.1% in Vermont to 67.5% in Nevada. That’s awful! Mental illness can be as deadly as cancer. Those with AMI (A Mental Illness) deserve better.
I discovered that the largest mental health facility in the country is in Los Angeles and is part of the county jail. The article: Inside The Nation’s Largest Mental Institution (heard on Morning Edition, on NPR August 13, 20083:09 PM ET, by Renee Montagne) wrote, in part:
The largest mental institution in the country is actually a wing of a county jail. Known as Twin Towers, because of the design, the facility houses 1,400 mentally ill patients in one of its two identical hulking structures in downtown Los Angeles.
The End Of Public Mental Hospitals
Until the 1970s, the mentally ill were usually treated in public psychiatric hospitals, more commonly known as insane asylums.
Then, a social movement aimed at freeing patients from big, overcrowded and often squalid state hospitals succeeded. Rather than leading to quality treatment in small, community settings, however, it often resulted in no treatment at all.
As a consequence, thousands of mentally ill ended up on the streets, where they became involved in criminal activity. Their crimes, though frequently minor, led them in droves to jails such as Twin Towers, says Los Angeles County Sheriff Lee Baca.
And yet, we do incarcerate the mentally ill. All the time. Because there seems to be no where else to place them. It’s awful when the police become involved. At a minimum the person with AMI will be dragged to the ground and handcuffed as if they had committed a crime before they are dropped in some overcrowded, understaffed county hospital. There they will receive minimal care and a quick discharge. In the worst case scenario someone with AMI can end up dead simply because they do not understand what the police are telling him to do. Like drop a weapon, or to lie on the ground. Just google “mentally ill man killed by police” and you will find hundreds of incidents.
Most insurance plans do not provide adequate coverage for mental health, as if it is less important than someone’s physical health. There are limits to the number of doctor visits, hospital stays are too short. How does the insurance company know if you are healthy enough to leave after just 2 weeks? It must be up to the doctors to determine when a patient is well enough to leave. And what about someone who will spend their life institutionalized? I’m sure most insurance plans do not have that covered. There are not enough doctors and nurses. There is just not enough.
My cynical side tells me that the only way we can make changes is with money. Sure, there’s legislation, but that does not help people who cannot find a facility that will admit them. There just aren’t enough beds. That must change! More mental health facilities need to be built. MDs and hospital staff need to be made aware of symptoms of a mental health emergency. Mental Health America is important to the improvement in mental health care and education. Please support their #b4stage4 campaign on Facebook and Twitter, and take the pledge now to help make mental illness stigma free.