Mental Health

Cracks in the System Resurface…But it’s not so simple.

When I saw the news of the Creigh Deeds shooting, I had to tune in.  This incident was different than the usual nightly montage of shootings and killings and robberies and general malaise. The spotlight has once again turned on the mental health system.  Where did it go wrong?

I was flabbergasted when I read the following on CNN: Virginia law requires doctors to find a bed for a patient under an emergency custody order within four hours or release them.

Seriously?! I looked up VA law for what emergency custody means just to be sure I understood.  It states:

“Based upon the opinion of a licensed physician that an adult person is incapable of making an informed decision as a result of a physical injury or illness and that the medical standard of care indicates that testing, observation, and treatment are necessary to prevent imminent and irreversible harm…”

I only included an excerpt but I highlighted two sections that I thought relevant.  The part about preventing imminent harm struck me. This notion of preventing harm seems just a little, maybe a little…important.

The question is how do we determine when imminent harm exists and what systems are in place to protect the rights of the individual involved while also diffusing what could be a potentially dangerous problem should precautions not be put in place. (wow, that was a mouthful…because as mental health consumer myself, I know we have rights too and we need to remember that)

What baffled me at first was…how is it that the hospital had four hours and they weren’t able to contact one of the area hospitals that apparently had available beds? I thought that seemed like it was a time crunch BUT could be done if you had a central database where you could look up what hospitals had available psychiatric beds. I also thought the process was a whole lot simpler.  I didn’t account for the fact that you don’t just wait for the doctor, see the doctor, get a diagnosis and then have your decision.

I did a few minutes of eye opening  research and you can extend the time limit to six…but I also read all of the things that are involved in the process.  Whoa.

First off, four hours is NOT enough time. Have lawmakers ever considered how long this whole process takes? The clock starts ticking when you enter police custody.  Then you have to drive to get assessed by the community service board. Then, you have to go through various tests like drug testing.  You also have to be sober to be admitted. Other health problems are considered as well.  Then, there is the determination if you are violent. Some hospitals don’t have the nursing staff to handle violent individuals that need one-on-one care. Your gender is also a factor when determining bed space. As I mentioned in a previous article, a male patient exposed himself to me while I was briefly in inpatient treatment many years ago. This absolutely can’t happen.

And when I started writing this article, I so ignorantly thought: how hard would it be to look up number of psychiatric beds available in each hospital? Whoa, was I wrong. And I am a mental health consumer. I know more than the average person but as I am learning, know very little about the complicated mental health system. My experiences have been very minimal due to the fact that I never had shown any threat of imminent harm to others or myself.

A source from the National Alliance of Mental Illness was quoted as saying, “After the VA Tech incident, the legislature funded 42 million for mental health services but by 2010 it was gone due to the recession.”

How many incidents have to occur? We keep going over and over this again and again. Each time the mental health system keeps coming up. However, upon closer and closer examination of the mental health system, it gets trickier and trickier.  There are so many variables to consider. You can’t just check off a few boxes and have your answer in a minute. (And you can’t keep an individual in custody indefinitely.)

One problem. Most people don’t care enough like me to try to understand the mental health system.  They look at the TV and think either the dudes crazy and we can’t help him… Or they think a bed was available…what inept person screwed that up? Unfortunately, you also need an attention span of more than 30 seconds when trying to understand the complexity of the system.

The brain is our body’s most powerful organ. It is both brilliant and dangerous. We have got to consider how important it is to put funding into understanding mental health and fixing a broken system. We also have to educate the public about how important this issue is. How are we going to fix something we don’t understand?

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