What is the status of Mental Health Services in your community?

[Maddy McCall]

The best (or worst) example I can give of the status of mental health services in my community is a view of the involuntary civil commitment process.

In many counties in Mississippi, if a relative needs immediate help, the family member (or friend, or anyone, actually) can go sign papers to have the person picked up for evaluation. (Actually, ANYONE can sign commitment papers on ANYONE, and the process below ensues.) After the papers are signed at the chancery clerk's office, here's how it goes:

1) Sheriff's deputy finds the person, handcuffs the person and takes him (or her) to jail.

2) Person is put into general population at the jail. Yes, with true criminals (often VIOLENT criminals), while awaiting the evaluation. While in jail, the person can't have visitors, cannot have contact with anyone except his lawyer, and is treated the same way as people charged with or convicted of crimes. The person sleeps on a concrete floor, no blanket, nothing. He receives no mental health treatment while in jail, and is lucky to get any medication that was prescribed before he was jailed.

3) Within seven to ten days, the person is evaluated by a social worker and two doctors. (According to law, this is supposed to happen within 24 hours of being picked up. Unfortunately, in Mississippi, many sheriffs don't feel the need to abide by the law.) Usually, the doctors agree with whatever the social worker suggests. The so-called "evaluation" is a joke.

4) After the person has been held in jail for up to ten days, a hearing is held. The person is brought into open court shackled in a jail jumpsuit. After listening to the witnesses and hearing from the person, the judge pronounces his judgment (again, usually finding for whatever the social worker suggests). Either the person is released for lack of evidence (rarely, if ever, happens), or he is found needing mental health treatment at the State Hospital.

5) Since it can take anywhere from weeks to months for a bed to come open at the State Hospital, the person is returned to jail, where he waits for the bed to come open. Back to general pop, back with criminals. When the bed comes open, the sheriff's department transports the person to the hospital. In shackles.

6) The person is evaluated at the state hospital, and the psychiatric team decides either to hold or release the person. Many times the person is released, to make way for people who truly need psychiatric treatment. So, in many cases, everything that happened in numbers 1-5 above was completely unnecessary.

This is just a glimpse of how the mentally ill are treated in my part of Mississippi. It's a horrific thing for anyone to go through, and if you began the process with mild mental illness, when the process is over, you'll be much more damaged by being jailed as a criminal for what is truly a MEDICAL issue. It seems that most citizens don't care--as long as it's not their relative involved in the process.

How are the mentally ill treated in your community?


Edit to add:

Here are the grades for each state, as assigned by the National Alliance on Mental Illness. Mississippi receives a D. Other states receive Fs. I can't imagine the system being any worse than Mississippi's, so I'd like to hear from people in states that do a better job, and those that do a worse job. Can't imagine how bad it must be in Idaho, Illinois, South Dakota, and the other states that received F grades.



http://www.nami.org/gtstemplate.cfm?section=grading_the_states&lstid=701

[Swamp Rat]

1. Same way or worse?

I cannot say for sure.

[Maddy McCall]

3. I think it's pretty rough down in your area.

Read this TIME article:

Shortly after Katrina, the report says, a Centers for Disease Control and Prevention poll determined that roughly half of respondents indicated a possible need for mental health assistance, yet fewer than 2% were getting counseling. A February survey of people living in temporary FEMA-subsidized housing found that more than two-thirds of female caregivers reported feelings of anxiety, depression and other mental health disorders. As many as half of the children they were caring for were suffering from mental disorders of their own. A poll of police officers and firefighters, most of whom lost homes in the storm, found that roughly 20% were experiencing post-traumatic stress syndrome and that one in four emergency responders was suffering from major depression. More troubling, perhaps, is a 25% jump in the mortality rate, including a threefold increase in the suicide rate — a conservative estimate since many self-inflicted deaths are classified as accidental.

To make matters worse, the city is suffering from a dearth of mental health services. By most estimates, a little less than half of the city?s pre-Katrina population of 450,000 has returned. But there are only a total of 20 psychiatric beds available in the few New Orleans hospitals that have reopened, compared to about 300 before the storm. By last April, the report says, only 22 of 196 psychiatrists were practicing in the city, shifting a good portion of mental health treatment to the 140 primary care physicians, out of 617, who had returned. With 96 inpatient psychiatry beds, the Medical Center of Louisiana — better known as Charity Hospital — was once the city's biggest mental health care provider. Now, it dispenses emergency care from a makeshift clinic housed in a former Lord & Taylor department store. The heavily flooded hospital may never reopen.

http://www.time.com/time/nation/article/0,8599,1221982,00.html

:(

[Swamp Rat]

6. Now, they are shutting down Charity Hospital all together.

We are worse off since that article was written. We may lose the VA hospital and eventually the LSU Health Sciences Center... the levees are not fixed.

They are preparing for our death... the next hurricane.

[KamaAina]

8. Meanwhile, the richies across the park from you

shot down LSU's plan to reopen DePaul Hospital as an acute-care psychiatric facility. Can't have no crazy nonwhite people wanderin' 'round our neighborhood, no sirree! :sarcasm:

And all this is happening just as the city is suffering from what has been described as "like PTSD, only it isn't 'post-'." :scared:

Any and all ideas are welcome; my latest plot to rejoin the team revolves around providing supportive housing services, which would clearly cover mental illness. Here's one: La. just granted psychologists authority to prescribe drugs. Not that medicating the city is necessarily the ideal solution, but this would make it easier to deploy psychologists as paraprofessionals to get the city out of crisis mode.

[Maddy McCall]

10. Thanks for the info on that.

Yeah, like I said, NOLA is being reconstituted, without the people who gave the city so much cultural depth and richness.

:(

[Swamp Rat]

14. I am

I am suffering from it, and have physical problems too, but I have no insurance. Hell, I have a cracked ankle (the broken toe healed) hurting me for 6 months but I cannot afford an x-ray.

... and there are people much worse off than I.

[Maddy McCall]

15. I wish I could help you.

Would you qualify for medicaid?

:hug:

[Maddy McCall]

16. .

dupe

[Maddy McCall]

9. You are kidding.

My god, that's TERRIBLE.

I have no doubt that New Orleans is being restructured to ostracize the have-nots, by denying them the ability to find a place to live (refusing to reopen section 8 apartments and such), and by terminating the social services that are so necessary, even in cities that haven't experienced the utter destruction NOLA experienced.

[commander bunnypants]

2. Well,

in my part of Virginia. The person is seen the next day for an eval. I am trined as a prescreener. I can involuntarily commit someone in an acute psychiatric decompensation. I am also a social worker. I do have to submit paperwork to a magistrate in order to proceed. They usually sign off 9 out of 10 times. I cannot send someone to jail though only community hospitals or the state in rare instances. I do not take it lightly though.

Miss sounds like a poor sysytem

CB

[Maddy McCall]

4. Get this.

Our legislature authorized counties to build temporary holding facilities (small hospitals, much better than jail) so that people wouldn't have to wait in jail for the hearing and for a bed at the state hospital.

But they haven't FUNDED those holding facilities. :(

So, while some of those facilities have been constructed, they've not been funded. I wish some of Mississippi's legislators would go through the involuntary commitment process, just to get a taste of it like those politicians who tried to live a month on food stamps. Something would be done, I'd like to think, if they knew how bad it truly is.

[commander bunnypants]

5. want me to sign a warrant

:)

Thats sucks.

It would open their eyes.

A few times I did commit from jail to the state hospital. But that was when the person was truly psychotic. Not that forensics is better.

Most of us really want to help and feel for the sick although I have met some that like power to much

You know mental illness is a sign of weakness not a true disease :sarcasm:

CB

[Maddy McCall]

23. That's the way it's looked upon here.

A sign of weakness.

Who was the US congressman who discussed his mental illness? Do you recall? It was a couple of years ago, and he came out with having bi-polar disorder.

I was greatly encouraged at that time that maybe having him discuss it publicly would open up the topic for serious discussion and advocacy by some of the PTB. Unfortunately, not much has been done since.

:(

[KamaAina]

7. Where is your Protection and Advocacy agency??

Every state has one; its job is to prevent exactly this sort of abuse. The Hawaii State Hospital is under a Federal consent decree for waitlisting people not nearly as long as that.

Your sheriff, or one from one of the other counties that does this, needs to be hauled into Federal court pronto!

http://www.mspas.com

Mississippi Protection and Advocacy System, inc.

5305 Executive Place Jackson, MS 39206

601-981-8207 800-772-4057 fax: [phone]

[Maddy McCall]

11. Thank you for this info!

I did not know of such an agency. The person I know who just went through this terrible system has hired a lawyer. I don't know if the lawyer is aware of this agency--I'll certainly pass this info along.

Thanks!

[EFerrari]

12. If CA gets a C, we're screwed. The biggest provider of mental

health "services" is the L.A. County Jail and they're just dangerous.

CA should get a solid D- and I have 12 years of daily notes to back that up. :(

[Maddy McCall]

17. Sounds like Mississippi, Beth.

Right now, if you need to see a mental-health-center psychiatrist in this district, you have to wait until at least October.

I've kind of kept up with what you've gone through in your family. My heart aches for you.

:(

[EFerrari]

19. I learned a LOT. I learned that all over this country our families

are tilting with illness at home and with indifference if not outright fear from the community. And as usual, D.C. is completely out of touch.

At least now, we know what we're dealing with. It's a start. :hug:

[Maddy McCall]

21. Let's stay in touch.

I'll PM you soon and tell you the details of what I've witnessed with a loved one.

:hug: :loveya:

[EFerrari]

22. Sounds like a plan to me.

:loveya:

[hunter]

29. If CA gets a C what's an F ???

Oh my... that's some awful class curve. An "A" must mean 30% or higher.

If this nation had merely a "C+" approach to mental health issues, on a scale where a "C" is 70% or higher, then the prisons would empty, the homeless would find stable living situations, Hospital Emergency Rooms would be quiet, drug and alcohol abuse would become much less common, and fewer people would die young.

I wonder what it must be like to live in a civilized nation, because this ain't one. We throw people with mental illnesses and the people who care for them to the wolves.

[EFerrari]

13. Afterthought: There are a lot of programs that exist on paper only.

Like the Los Angeles Co. program to provide appropriate therapy for people with Borderline Personality Disorder. It's a fiction as we found out the hard way.

We have great tech. It doesn't get delivered.

[mdmc]

18. We are much better in NYS

It is very hard to commit someone against their wishes in NYS. I have a hard time believing your OP, but thank you for posting about mental health. K/R for the discussion.

[Maddy McCall]

20. I would not have believed it, had I not seen it happen.

Every step of the way, as I watched someone close to me go through this, I thought, "There has got to be something we can do."

The sheriff wouldn't listen to the family's concerns that the patient was placed in general population, even when presented with evidence that doing so was forbidden by law. The mental health system sees this as routine and offered no help to the family--I guess they become callous after hearing so many complaints. Only when the person got to the state hospital and was evaluated did the family finally find someone receptive to their complaints. At the evaluation at the state hospital, the psychiatric team found that the person did not meet the criteria for commitment at the hospital, and turned the patient away.

Sad thing is, as more people become aware of how the system works in Mississippi, they are less apt to find help for loved ones who need it.

It's horrific, and something that I hope I never have to witness again. (I am going to call the advocacy agency that kamaina provided above, to tell them what I witnessed--I have a fire lit under me about this, and I'm not going to shut up until I find someone who'll listen to how terrible it is here.)

[EFerrari]

32. There is a great program in Canada (worldwide but based there)

from the World Fellowship for Schizophrenia and Allied Disorders.

The program is called "Families as Partners in Care" (or, it might be, "in Treatment"). Go read it and you'll be very heartened that someone has already figured this out -- this family thing and this community thing and here in this country, we simply need to get the model applied. We can't take no for an answer. :)

http://www.world-schizophrenia.org/

[KamaAina]

24. What about "Kendra's Law" (forced treatment)?

Not the same as commitment, obviously, but still... I was thinking a lot about that during the backlash against people with mental illness following Va. Tech.

KamaAina's First Law of Laws: Any law with someone's name attached to it is invariably bad, feel-good law that tramples on civil liberties.

[Mabus]

25. Kansas gets an "F" and I believe it. There is no local service

The local hospital closed its in-patient mental health unit back in 2004. My stepdaughter has needed emergency mental health care more than once in the past few years. We've had to go either Kansas City (both Kansas and Missouri) or Topeka to get her emergency help.

[FloridaJudy]

26. Florida gets a C-

Better than the national average, but not by much. Locally, we're in relatively good shape, which doesn't say a lot: the City and County commission voted extra funds for a limited program of medical care for the "working poor", but most of the mentally ill aren't working. There's also a strong advocacy group for the homeless, and the local medical school and medical society provide some free medical care, but a lot more is needed.

What we do have is an excellent Crisis Stabilization Unit, and a stream-lined system for medico-legal evaluation for those who are Baker Acted or Marchman Acted . There's actually a really good publically funded facility for treating substance abusers, as well as a private psychiatric hospital , and an excellent comprehensive VA program.

The problem - of course - is follow up. Outpatient services are woefully limited. If a client is really, really crazy, we can hospitalize and stabilize him or her, but once let out in to the community, all bets are off.

Edited to add: thanks for the link!

[kickysnana]

27. Minnesota Agencies are trying but Pawlenty is mucking it up.

A TV in depth story did a ground breaking story getting inside Hennepin County Medical Center Crisis Center, the Hennepin County jail and a prison. They talked about thousands of people falling between the cracks. Homeless, off meds a danger to themselves and others or getting themselves in situations where they end up in jail. They interviewed a police officedr who early in his career was blindsided by a mentally ill person and he and his partner killed the prson when the person tried to attack them with a weapon. His partner resigned from the police force and he took all the training he could to prevent it from happening again and he said most local police forces now have policies in place to try to deal with mentally ill ciitizens in crisis in ways other than shooting them.

They talked about the tremendous costs of people going through these crisis over and over and the waste of human potential and the effects on the families of the sufferers.

Pawlenty vetoed the budget and I ams sure that there was help there since everyone but him and his neocon friends are on the same page about trying to solve the problem for the sufferers and the taxpayers who have to pay for the failed system.

[warren pease]

28. The mere fact that I'm allowed to walk the streets around here...

...is highly suggestive of a disordered mental health system.

But really, it's amazing anybody's left in this scam of a country. There are dozens of very fine countries out there to move to -- the Scandanavian socialist democracies at the top of the list for everything from standard of living to health care indices to educational attainment and opportunity to real research on green energy to support for the arts to... You name it, they do it way, way better than us.

I'm too old for countries other than, say, Somalia or Sudan to want to have anything to do with me, but if I had truly understood what really makes this country run, and what makes it such a sucker's paradise, I'd have been out of here in my mid-20s, degree in hand, European grad schools beckoning in countries that actually function for the benefit of their citizens -- at least some of the time.

The truth is a powerful motivator and, had I gotten a proper dose of Howard Zinn rather than the toadying idiots who crank out those self-congratulatory alleged history texts that lie from page one on, I'd have had a very different life.

Anyway, my sympathies to all on this thread who seem so utterly screwed by the whole concept of America that there's really no way out except to literally find a way out -- preferably with a proper border crossing and a real "land of the free" waiting just across the striped gate.


wp

[bobbolink]

33. You'd have had a very different life

Yes, that could be very true. And I agree that the Scandanavian countries are doing a much better job all around.

BUT... you were born here, this is your country, and this ME thing of "as long as I can get out of it" is a big part of what's wrong here.

What about all those who CAN'T get out? Isn't it up to us to make this country better? Isn't it our duty to pull this mess out of the fire, so others aren't left holding the bag?

This is just what Michael Moore is trying to get across in SICKO--it isn't about just me and the fact that I have my medical care taken care of. It's about ALL of us, and that if some of us are in dire straights, then ALL of us suffer.

Can we ever get back to "We're all in this together"?

[intheflow]

30. kick

Katrina- and Rita-hit areas have higher depression rates than people living in Darfur and Sudan, but our mental health services are actually being cut. Their ratings don't surprise me in the least.

Neither does Massachusetts' D rating. I lived there when they closed all the state residential mental facilities. The homeless rate exploded overnight. Then they started passing laws to incarcerate indigent people. :eyes:

This country treats people with mental illness criminally--both figuratively and literally.

[mdmc]

31. kicking

the conversation:kick:

[OzarkDem]

34. Ohio talks a good game, delivers little

and the non-profits and agencies who handle pts w/ mental illness have HUGE budgets, but little, if anything is done to help those with mental illness. High turnover of low paid social workers, but lots of nice paychecks at the levels above.


Here in Ohio, mentally ill people are just a means to a billion dollar budget, salaries and nice offices for those in charge. Most could care less. But they will corral them together and parade them around to get more money.


I know, I advocate for cancer patients and they dump people on us all the time who are mentally ill. We were so happy when one of the mental health agencies on the same floor where we rent won a multi million dollar federal grant. They were able to buy new furniture for the conference and break room we shared, as well as a microwave, refrigerator, catered lunches during meetings (we got to eat the leftovers).

In one year, they never served a single client, just had meetings, hired people, etc. They weren't planning to serve patients for 2 yrs while they planned everything.

On edit: Also, NAMI here in Ohio is in bed with the Pharma companies. They're giving the governor a hard time because his budget is calling for only reimbursing Medicaid coverage for generic drugs for the mentally ill (not generic equivalents, just generic). It will save the state $95 MILLION, but these clowns are lobbying to keep the brand name drugs for patients, when generics work just as well.