Obsessive Compulsive Disorder (OCD) February 15, 2013Posted by Crazy Mermaid in Anxiety, Mental Hospital.
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Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry; by repetitive behaviors aimed at reducing the associated anxiety; or by a combination of such obsessions and compulsions. Symptoms of the disorder include excessive washing or cleaning; repeated checking; extreme hoarding; preoccupation with sexual, violent or religious thoughts; relationship-related obsessions; aversion to particular numbers; and nervous rituals, such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms can be alienating and time-consuming, and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and potentially psychotic. However, OCD sufferers generally recognize their obsessions and compulsions as irrational, and may become further distressed by this realization.
Obsessive–compulsive disorder affects children and adolescents as well as adults. Roughly one third to one half of adults with OCD report a childhood onset of the disorder, suggesting the continuum of anxiety disorders across the life span. The phrase obsessive–compulsive has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is excessively meticulous, perfectionistic, absorbed, or otherwise fixated.
Despite the irrational behaviour, OCD is sometimes associated with above-average intelligence. Its sufferers commonly share personality traits such as high attention to detail, avoidance of risk, careful planning, exaggerated sense of responsibility and a tendency to take time in making decisions.
OCD occurs in two to five percent of the population, and is the fourth most common psychiatric diagnosis. The majority of OCD patients who have not experienced symptom relief may have not received adequate trials of appropriate medication and/or behavioral therapy. The remainder typically do not respond because of poor treatment compliance, unrecognized cognitive impairment, co-occuring psychiatric illness or poor understanding of treatment. Adequate treatment for OCD often requires that medication trials be longer than those for other psychiatric illnesses. Additionally, behavioral interventions are time- and labor-intensive, frequently requiring close supervision and support.
Located in Belmont, MA, the OCD Institute at McLean Hospital is a national and regional center dedicated to the advancement of clinical care, teaching and research of obsessive compulsive disorders. The program provides partial hospital and intensive residential care for individuals age 16 and older who suffer from severe or treatment resistant OCD. It offers an innovative combination of somatic, behavioral and milieu treatments not found in other programs. It takes Medicare and Medicaid among other insurance plans, and comes highly recommended by a friend who completed the 8 week program in September 2012.
(Reprinted from Wikipedia and The McLean Institute)
Mental Health and Competency Restoration in Washington January 29, 2013Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital.
Tags: Involuntary Committment, Mental Hospitals
Imagine having a mental health crisis and finding yourself in a county jail, with little or no mental health treatment, isolated with no direct human contact, in a cell with no toilet or furniture for 23-24 hours a day, wearing only a smock, as days become weeks, then months, all while the symptoms of your mental illness get worse.
According to a report, released today by Disability Rights Washington (DRW), this is a recurring problem in local jails across Washington State. Over the last few years, people with mental illness, intellectual disabilities, and traumatic brain injuries have had to wait for several weeks or even months to get an evaluation to see whether or not they are competent to stand trial. If they are found incompetent to stand trial, they often wait additional weeks or months to get services at the state hospital where there is mental health treatment designed to restore competency to stand trial. While they wait in jail, they are held with little or no mental or behavioral health treatment, often under severe punitive conditions for disability-related behavior. This includes being held in isolation, where their mental health often deteriorates.
Individuals may be held for low-level infractions, like trespassing or vagrancy, often because mental health services were unavailable. “It is unacceptable that people end up in jail facing criminal charges simply because they cannot obtain the mental health services they need in the community. We are turning these individuals into prisoners when they should be patients,” said Emily Cooper, attorney with DRW.
“Jail is the worst possible place for people struggling with serious mental illness. As a society, we need to stop the pattern of unnecessary incarceration of people with mental illness,” said Gordon Bopp, President of the Washington Chapter of the National Alliance on Mental Illness (NAMI). “They are not criminals. Nobody chooses to have a mental illness, and therefore nobody should be jailed for having one. Instead, they should be offered treatment,” Bopp said.
Along with sheriffs, mental health providers, judges, prosecutors, defense attorneys, and disability advocates, DRW has worked on this issue through multiple legislative sessions. Last year, the Legislature adopted an aspirational, seven-day performance target for the completion of competency evaluations and state hospital admission for restoration services. The Joint Legislative Audit Review Committee confirmed in a report issued last month that the state hospitals are failing to meet this target, and the time people spend in jail awaiting evaluation and treatment is growing.
“The longer a person with a mental health crisis spends in jail, the more devastating and long-lasting the consequence,” said David Lord, DRW Director of Public Policy. “Eliminating the excessive time these individuals spend in deplorable jail conditions must be one of the highest priorities of the legislature,” Lord said.
From January 25, 2013 report from Disability Rights Washington “Lost and Forgotten: Conditions of Confinement While Waiting for Competency Evaluation and Restoration”
Insulin Shock Therapy December 3, 2012Posted by Crazy Mermaid in Medication, Mental Hospital, Schizophrenia.
Tags: Medication, Mental Hospitals, Schizophrenia
In a desperate attempt to find a cure for mental illness in the early part of the last century, barbaric treatments were invented. Insulin shock therapy was one such treatment.
In insulin shock therapy, a patient was put into an insulin coma six days a week for months on end in an attempt to “cure” schizophrenia by “resetting” the brain. Occasionally that seventh day was filled with electro-shock therapy. Sometimes this “treatment” went on for years.
Insulin shock therapy was started by psychiatrist Manfred Sakel in 1927 when he began to use low (sub-coma) doses of insulin to treat drug addicts and psychopaths in Berlin. Interpreting his results as successful, he got the idea of “resetting” the brains of schizophrenics using the same therapy. News of his work spread, and this treatment was picked up by mental hospitals worldwide.
After being injected by insulin, patients experienced various symptoms including flushing, pallor, perspiration, salivation, drowsiness, or restlessness before falling into a coma. Each coma lasted for up to an hour and was terminated by intravenous glucose. Seizures sometimes occurred before or during the coma, and these were viewed as positive events. Only the healthiest patients were chosen for the treatment, since it was so hard on their bodies. Broken bones were common.
For years, this “therapy” was performed on the mentally ill, including John Forbes Nash, the brilliant mathematician whose life story is told in A Beautiful Mind by Sylvia Nasar. The book goes into a little detail about his treatment.
Insulin shock therapy started to fall in disfavor when Harold Bourne, a British psychiatrist, published a paper entitled “the insulin myth” in Lancet in 1953, in which he debunked the therapy. Then, in 1957, Lancet published the results of an experiment whereby insulin shock treatment was shown to be an ineffective treatment for schizophrenia. Over the years, it slowly began to fall into disfavor, and is now thought of as barbaric.
It is relatively easy to see why insulin shock therapy was quickly adopted by the mental health community. Up to that point, there was no other treatment available. Anything that had a remote possibility of working was greeted with open arms, and the “science” behind the treatment made perfect sense. “Resetting” the brain would result in curing the illness, they reasoned.
Eventually, science caught up with insulin shock therapy, and the medical community was forced to abandon this treatment, but not before much pain and suffering occurred.
In the future, it will be interesting to see which of our current therapies are viewed as barbaric as insulin shock therapy and lobotomies are viewed today.
Here We Go Again: Reducing Mental Hospital Beds August 19, 2012Posted by Crazy Mermaid in Delusions, Mental Hospital, mental illness, Schizophrenia, Uncategorized.
Tags: Delusions, Hallucinations, Mental Hospitals, mental illness, Schizophrenia
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Here we go again: more psychiatric hospital beds are disappearing in Washington State. How do I know? Not from anything in the news. It’s because I got a phone call from a 75 year old woman whose 54 year old schizophrenic son is being released from Western State Hospital. She called because she was desperate to find housing and help for her son before he is released, which will be soon. She explained that she is an old lady and can barely care for herself, much less her son, who has been at Western for many years.
At Western, he has case managers and people who make sure he takes his medication as well as living support. He never learned how to shop or care for himself because his symptoms were so severe that they required him to be permanently hospitalized. I’m guessing that even with proper medication, he isn’t symptom-free or he would have been released years ago. Even with proper medication, delusions and hearing voices is fairly common in hard-to-treat cases like his. Once out of that protective environment of the hospital, she is concerned that when he stops taking his medication, his symptoms will increase and he will become unmanageable. She is looking for housing for him that will also provide help in adjusting to life on the outside. And she doesn’t have much time.
This situation is tragic. They’re taking a man who has spent most of his life in an institution getting the help and support he needs in order to function, and throwing him outside to fend for himself. Had there been any adjustment support for him, she wouldn’t be so desperate. Programs like those he needs are overfull. He won’t be able to get into those programs for years because they’re at or over capacity right now. And with the State releasing more people like this man, more people will fall through the cracks. The State hasn’t funded stop-gap programs for people like him. There simply isn’t anywhere he can go. Who knows what will ultimately happen to this man?
Although I understand the need to balance the State budget, balancing it on the backs of the more vulnerable population is unconscionable.
Contrary to popular opinion, 99.9 percent of people housed in institutions like this aren’t dangerous when released. So we shouldn’t be afraid of him. In fact, statistically they are the ones who are more likely to be assaulted and victimized because they’re not equipped to survive outside their institution. Turning a man out who has been taken care of most of his life will not make his quality of life improve. In fact, the type of living situation that he was in had allowed him to have his “home base” at the hospital, able to freely come and go at will. The point of the hospitalization was to keep him taking his medication allowing him to live with and manage his schizophrenic symptoms. If he is left to his own devices at this late stage of his life, he will likely discontinue taking his medication, which will mean the symptoms of his illness, barely contained anyway, will return in a big way. I’m not saying he will be a danger to others. I’m just saying that hearing voices and other negative symptoms will likely return in a big way without proper medication and supervision. Clearly, his case must be particularly difficult because had he had an “easy” case, he would have been released years ago. He’s there because that’s where he needs to be.
His institutionalization is very different from involuntary commitment, so his release shouldn’t scare anyone from the standpoint of him being a threat. Far from it. He is allowed to come and go at will, but his base is always at Western State Hospital. He goes on outings and to visit his parents, but he never stays there for any length of time. He always has to return to Western so they can give him the care he needs. He hasn’t gone grocery shopping or done the dishes or any number of things we are all used to doing in order to survive. If left to his own devices without any education in performing these relatively easy tasks, he will risk his well-being to the point of being dangerous. Just turning him loose out into the world will be a hardship. His 75 year old mother won’t be much help, and because of his symptoms he can’t live with her- especially once he’s off his medication.
They say the mark of a civilization isn’t how they treat their rich. It’s how they treat their poor and vulnerable population. And from the way this gentleman is about to be treated, it’s clear that we’re not exactly the best civilization in the world.
Lobotomies and Rosemary Kennedy March 7, 2012Posted by Crazy Mermaid in Mental Hospital, mental illness.
Tags: mental illness
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During World War II, the military became increasingly more interested in treatment of mental illness, given the high number of war-related new cases it was seeing. Coinciding with that new interest was the development of new mental illness therapies including lobotomies, where part of a patient’s brain was cut away in an attempt to cut out their mental illness- much as we cut cancer away from a body now. But instead of removing a cancerous growth from a brain, they removed part of the patient’s brain. Between 1936 and 1960, about 50,000 lobotomies were performed on mental patients in the United States alone, with devastating results.
The ugly spotlight of reality was finally shined brightly on lobotomies when the sister of a President of the United States got one, with disastrous results. Rosemary Kennedy, the sister of President John F. Kennedy, received a lobotomy in 1941, when she was 23 years old. At the time, her father was told by her doctors that a cutting edge procedure would help her DEPRESSION (Note: Many media reports incorrectly say she was treated for retardation, but in reality she was treated for depression). At the time of her operation, only 65 previous lobotomies had been performed. Dr. Watts, who performed the surgery while Dr. Freeman supervised/observed, described the procedure on Rosemary as follows:
We went through the top of the head, I think she was awake. She had a mild tranquilizer. I made a surgical incision in the brain through the skull. It was near the front. It was on both sides. We just made a small incision, no more than an inch.” The instrument Dr. Watts used looked like a butter knife. He swung it up and down to cut brain tissue. “We put an instrument inside,” he said. As Dr. Watts cut, Dr. Freeman put questions to Rosemary. For example, he asked her to recite the Lord’s Prayer or sing “God Bless America” or count backwards. … “We made an estimate on how far to cut based on how she responded.” … When she began to become incoherent, they stopped.
Instead of producing the hoped-for result, however, the lobotomy reduced Rosemary to an infantile mentality. She had to wear diapers because she was incontinent. She could do nothing except sit in a chair and stare blankly at walls. Her verbal skills were reduced to unintelligible babble. The procedure left her completely incapacitated, and her family was devastated and filled with guilt.
Although Dr. Watts’ license to practice medicine was revoked after he performed over 3,000 of those operations, it wasn’t because of the horrendous nature of the operation. It was because of the death of one of his patients. After the procedure destroyed many lives, it finally became viewed as the destructive tool that it was. It is no longer in use.
The Law and Involuntary Commitment January 2, 2012Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: Involuntary Committment, Mental Hospitals, mental illness
You’d think that once a bill gets passed by the House and Senate and signed by the Governor, there would be no question whether the bill goes into effect. But that’s not true.
Back on March 17, 2010, I posted a blog entry about the passage of House Bill 3076. I was excited because it would no longer required Designated Mental Health Professionals to disregard evidence given by friends and family members of people with severe mental illness in their decision of whether to involuntarily commit a person with severe mental illness. Prior to this law, the Designated Mental Health Professional could not take into account testimony by friends and family members regarding the mental state of their friend or loved one.
Senate House Bill 3076 was a major victory for people with severe mental illness because it enabled them to get much-needed help by enabling their friends or loved ones to give evidence to the Mental Health Professional doing the assessment of the person with severe mental illness to determine whether that person should be involuntarily committed.
“Chapter 280, Laws of 2010 (Second Substitute House Bill 3076) expanded in two ways the factors that Designated Mental Health Professionals and the courts may consider when determining whether to commit a person to involuntary treatment. First, the 2010 law provides that a Designated Mental Health Professional must consider all reasonably available evidence from credible witnesses when determining whether to detain a person. Credible witnesses are defined as family, landlords, neighbors, and others with significant contact and history of involvement with the person. Second, the 2010 law additionally provides that, in determining whether to detain and commit, Designated Mental Health Professionals and the courts may consider symptoms and behavior that, standing alone would not justify commitment, but that show a marked deterioration in the person’s condition and are closely associated with symptoms and behavior that led to past involuntary psychiatric hospitalization or violent acts. The 2010 law set January 1, 2012 as the effective date for both of these changes”
At the time the bill was passed, I assumed that it would become effective immediately. In fact, I assumed this whole time that it was in effect. That assumption was obviously wrong. Had I read the bill more closely, I would have known that the law wouldn’t become effective until January 1, 2011.
I made another assumption as well. I assumed that, once the law came into effect, it would not and could not be revoked. That, too, was an assumption that was wrong.
In fact, another bill, Senate Bill 5987, gutted House Bill 3076. I was shocked at this turn of events.
Basically, the summary of Senate Bill 5987 changed the effective date of the 2010 statuary changes from January 1, 2012 to January 1, 2015.
The reason for the change, said the Staff Summary of Public Testimony, is that there isn’t sufficient treatment capacity to meet current involuntary needs, let alone increased demand. Already, said the new bill, between 25 to 50 percent of all persons involuntarily committed in King County are “boarded” in facilities that are not certified to accept such patients. The legislation, it said, needs to be passed in the special session before the January 1, 2012 effective date of the original legislation. Department of Social and Health Services supports to purpose of the 2010 legislation, but lacks the resources to implement it.
Although it is frustrating that the law is now delayed another three years, the reason it was delayed makes perfect sense. It’s yet another victim of our funding crisis.
Involuntary Commitment in Washington State November 1, 2011Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: Involuntary Committment, mental illness
Washington State Mental Health System: Involuntary Commitment
At all times in the legal process, patients have the right to agree to entry of a court order detaining them in a facility. Involuntary commitment should not be confused with competency to handle financial and legal affairs. Patients have the right to refuse psychiatric medication 24 hours prior to any court hearing. Patients have the right to have: an attorney to represent them (a public defender if unable to afford private counsel), witnesses to testify for them, to cross-examine witnesses against them, and to present documentary evidence. Patients have the right to testify or to remain silent. The Rules of Evidence apply to these hearings. Patients have the right to view and copy all petitions and reports in the court file as well to have adequate time to prepare for the hearing. Hearings are not closed but the patient has the right to object to the presence of others not involved with the case. The court decides if the hearing should be closed.
Basis for Involuntary Commitment
A person can be detained on any of three grounds: likelihood of serious harm to others; likelihood of serious harm to self; or most commonly, grave disability. Grave disability is defined as a condition in which a person, as a result of a mental disorder (a) is in danger of serious physical harm resulting from a failure to provide for his or her essential human needs of health or safety, or (b) manifests severe deterioration in routine functioning evidenced by repeated and escalating loss of cognitive or volitional control over his or her actions and is not receiving such care as is essential for his or her health or safety.
A person can be detained by a Designated Mental Health Professional for up to 72 hours without a court order. The 72 hours does not include weekends or legal holidays. When being interviewed by the DMHP, the patient has the right to speak to an attorney and the right not to participate in the DMHP’s evaluation. The legal standard for the initial detention is probable cause.
14 Day Hearing
If the patient is not ready for release within the 72 hours, a petition for involuntary treatment is filed seeking detention for up to 14 days (calendar days). If the patient elects to have a contested hearing, then a judicial officer decides the outcome. There is no right to a jury trial. The petitioner cannot request detention for any other period of time (i.e., 9 days or 13 days). Once the court order is entered, the petitioners can release the patient before 14 days is completed if the patient is ready for release. The legal standard is preponderance of the evidence.
90 Day Hearing
If the patient requires treatment beyond 14 days, then a petition seeking detention for up to 90 days (calendar days) is filed. The petitioner cannot file for another 14 days nor for any other number of days. It has to be up to 90 days. The patient has a right to a jury trial (using a jury of 6 or 12 persons) or to have a bench trial as in the 14 day hearing. Jury trials may take up to 20 business days to occur. The patient also has the right to seek a second opinion regarding their mental status as well as the use of a professional such as a social worker to seek less restrictive placement for the patient. There may be a preliminary hearing for the court to formally advise the patient of his/her rights as well as to allow the attorneys and the court to deal with scheduling issues for contested cases. Once the 90 day order is entered, the petitioners can release the patient early if the patient is ready for release. The legal standard is clear, cogent convincing evidence.
180 Day Hearing
If the patient requires treatment beyond 90 days, then a petition for 180 days (calendar days) is filed. The petitioners cannot ask for another 90 days. It has to be 180 days. As with the 90 day hearing, the patient has the right to a jury trial, a second opinion and a preliminary hearing. The legal standard is clear, cogent and convincing evidence. The petitioners can release the patient early if the patient is ready for release.
Less Restrictive Alternatives
At any point the petitioners can ask that the patient be on a Less Restrictive Alternative (LRA), court-ordered treatment outside of the facility. Conditions the patient must comply with include living at a specific address, maintaining compliance with treatment, taking medications as prescribed, refraining from threats or acts of harm to self, others or property, as well as maintaining one’s own health and safety in the community. Possession of firearms is prohibited. Failure to comply with any of the LRA conditions results in being returned to the facility for a revocation hearing. The rights in Step 1 apply to revocation hearings. If the LRA is revoked, the patient is detained at the facility for the remainder of the commitment period (e.g., revoked 30 days into a 90 day LRA = 60 days at the facility). The patient may later be re-released on a new LRA. LRAs can be extended in 180 day increments (they start with 90 or 180 days).
This article was written by Carolyn Annette Elsey.
My experience was very different from the way this article is laid out. The Designated Mental Health Professional that handled my case interviewed me in a local hospital to determine whether I should be put on a 72 hour hold. I entered the local hospital at around 10:00 a.m., and the DMHP finally interviewed me at around 5:30 p.m. She determined that I should be involuntarily committed, and the search was on to find a mental hospital that would take me. It took until midnight for a bed to open up. At that point, I was strapped to a board (a four point restraint system) and loaded into an ambulance for my trip to the mental hospital.
Around 48 hours after I arrived a the mental hospital, the mental hospital presented me with a public defender who was supposed to represent me before a judge to determine whether I was going to be committed for 14 days. Unfortunately for me, that representative took ill the day of my hearing, and I was represented by a different public defender who didn’t know my case. In order to transport five of us to the court, we were loaded onto a van with windows tinted so dark that we couldn’t see out. The interior was outfitted to transport prisoners. We had no idea where we were going, and no one told us anything. When we got there, contrary to what this article says, I was not allowed to say anything to the judge in my defense at my hearing. I sat there in disbelief as the hearing happened right in front of my eyes as if I were a piece of furniture.
As a practical matter, when I was involuntarily committed, I wasn’t privy to the laws, so I didn’t know that my rights had been violated. Besides, who would I, a “crazy mental patient”, complain to?
Close to the end of my 14 day hold, the hospital wasn’t ready to release me, so the original public defender (who had fallen ill before my first hearing) again represented me at my second hearing. But she convinced me not to attend the second hearing. As I hadn’t been involved in the first hearing, I assumed the next hearing would be a duplicate of the first (with no opportunity to speak), so I went along with her recommendation and stayed away.
I was released a week later, which meant I spent 21 days in the mental hospital at a cost of almost $60,000. But it was a conditional release, called Least Restrictive Treatment (LRT) instead of the Less Restrictive Alternative it was called in this article. They pointed out to me that I was still in treatment, and that if I didn’t follow the LRT, I would be re-committed to the mental hospital.
Mental Health Court September 10, 2011Posted by Crazy Mermaid in Healthcare, Mental Hospital, mental illness, Mental Illness and Medication, Uncategorized.
According to the news program Frontline, as of January 2010, one out of every 100 people in the United States is incarcerated . Of that population, nearly 25% of these 3 million people have a diagnosed mental illness, and 16% of the prison population has a severe mental illness. At a cost of 7% of the operating budget of the United States, the figure for incarceration of the mentally ill totals $910,000,000. It’s no wonder that prisons are the largest mental health institutions in the nation.
The latest weapons to help reduce the population of mentally ill in prisons are Mental Health Courts. Designed as an alternative to incarceration of the mentally ill, the cost of these courts is substantially less than the $62 per day that prisoners cost the taxpayer, saving taxpayers tens or hundreds of millions of dollars.
Designed for violators who have committed a crime as a direct result of their mental illness, the program doesn’t allow anyone who has committed a felony to participate. The purpose of the program is to get those targeted mentally ill individuals help by giving them intense judicially supervised treatment including help with their mental illness that has up until that time eluded them in the judicial system.
In the Mental Health Court program, the prisoner, or client as he is known in the program, is given a choice of attending Mental Health Court or serving time in prison or jail. This program is entirely voluntary. If the client chooses Mental Health Court,he must participate in the entire program for the two year duration. A large part of this participation is receiving the needed mental health services as well as supervision by members of the mental health team, including the judge, prosecutor, public defender, and court mental health specialist. This team of people encourages the client to stay on track with the program.
As a result of attending Mental Health Court, the client, now medicated and a productive member of society, will graduate from the program in an official ceremony, receiving a certificate of graduation in front of friends and family. He then becomes a productive member of society rather than a burden on the already over-crowded prison population.
If the client drops out of the program or is terminated for any reason, he is sentenced for the crime. The penalty is no greater than if the client had not participated in the program, and the judge will normally take into consideration the fact that the client did make the effort to try Mental Health Court.
The goals of the Mental Health Court are to increase access to mental health resources, encourage a focus on recovery, prevent revolving door to the jail, give an opportunity to contribute to society, and spend less time in jail or prison.
As anyone with a mental illness can tell you, staying on the program and taking the needed medication goes a long way towards keeping the client out of the revolving door of jail. By the end of the two year period, the client is generally stabilized and capable of making the realization that he needs medication in order to function well in society. Hopefully, this realization will be enough to keep him medicated and out of the prison system, thus increasing his quality of life and decreasing the cost to American taxpayers.
The cost of housing mentally ill in jails is an expense we can all do without, as long as we are as a nation kept safe. We can use all the help we can get in these uncertain financial times.
Mental Health Triage Facility June 12, 2011Posted by Crazy Mermaid in Mental Hospital, mental illness.
Tags: Mental Hospitals, mental illness
I like to share good ideas in the hope that they can be successfully replicated elsewhere. This is one of the better ideas I have come across, and it just happens to be in my own county (Snohomish WA, USA):
(Reprinted from An Editorial published May 10, 2011 in The Herald, Everett WA)
The news is a constant reminder that our prisons are overcrowded, as are our emergency rooms, and that the state doesn’t have the means or infrastructure to deal with all the mentally ill people who need help.
These are monster social problems, all related, for which there is no single fix. So when a good idea emerges, it’s important to add it to the social services/law enforcement toolkit. Which is what happened when a “triage facility” bill, originating from a pioneering Snohomish County (WA) program, was signed into law at the end of April.
The law allows counties to operate triage facilities as a cost-effective alternative to jails and emergency rooms for evaluating mentally ill people and those needing substance-abuse treatment who have been arrested for non-felony crimes. In March, Snohomish County began a successful test run of such a facility at the Bailey Center in Everett (WA); it’s operated by North Sound Mental Health Administration and Compass Health.
The law allows persons to be held involuntarily at a triage center for a maximum of 12 hours, while they stabilized and evaluated for treatment and the appropriate course of action. Before, people arrested for non-felony crimes could only be held involuntarily at jails or hospital emergency rooms.
The creation of the triage center came out of the (Snohomish)County Council’s 2008 adoption of a tenth of a cent increase in the sales tax for mental health and chemical dependency services, as allowed by state law. The center is funded through a partnership with the county and North Sound Mental Health Administration.
Approximately 24 percent of the people booked into the Snohomish County Jail have mental health issues and about 6 percent have a serious and persistent mental illness, Snohomish County Human Services Director Ken Stark told Herald reporter Diana Hefley in the 2009 article, “Mentally ill often adrift in the criminal justice system.” About 70 percent of the people booked into the jail have a drug or alcohol addiction, Stark said.
Tom Sebastian, Compass Health CEO and president, said the new program is cost effective because most people in crisis are not in need of acute medical services, saving the costly trip to the emergency room. The triage center is staffed with peer counselors, mental health technicians, clinicians and nursing staff.
Snohomish County officials, mental health workers, law enforcement and legislators made this smart step happen after creatively trying to come up with way to help the mentally ill and/or drug addicts, and save money at the same time. Now the rest of the state can benefit, too.
Mental Illness: I Want A Divorce March 7, 2011Posted by Crazy Mermaid in Mental Hospital, mental illness.
Tags: Divorce and Mental Illness, mental illness
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A few days after I was released from the mental hospital, I sat at my computer, checking my email. Noticing a Word icon at the bottom of the screen, I clicked on it, curious about what it was.
“Legal Separation Between…”
Oh No! My husband wanted a divorce!
Then it dawned on me. Of course he wanted a divorce. In a four month period of time, I had wrecked our finances. I had blown through tens of thousands of dollars, landed in a mental hospital for three weeks, and then racked up a $60,000 medical bill for my hospital stay. Due to my medication, I was unable to work, unable to peel a banana, or even wash my own hair. What was there to love about that?
I shouldn’t have been shocked by the divorce document, but I was. It blindsided me. Just to be sure that I understood the situation correctly, I called over my shoulder, asking my husband to join me. Detecting the fear in my voice, he came running, stopping abruptly when he saw the screen.
“What’s this?” I asked him.
“Oh,” he said, looking at the computer screen. “That’s a legal separation document. Remember in the hospital when you asked me for a divorce? I consulted a lawyer.”
Back in the hospital, in the throes of my psychosis, I decided I wanted a divorce. Believing that my husband was holding me hostage in the mental hospital, I believed that in order to get released from the hospital I would have to divorce him. So while I was in the hospital, I had called my attorney, directing him to start divorce proceedings. My husband’s trip to the lawyer was simply a self-protecting measure.
“When I talked to my lawyer, she told me I was screwed,” said my husband. “You don’t have a job, aren’t self-supporting, and just got out of a mental hospital. If we divorced, I’d still have to support you.”
A light bulb came on. Once I was better, he was going to divorce me. And who could blame him? He was biding his time, waiting for me to get well.
“So I need to get better so you can leave me?”
“No, that’s not it at all. Kathy, I love you. The only reason I saw the lawyer was that you saw your attorney. I don’t want a divorce. Never have”.
At first, I didn’t believe him. That’s exactly what someone in his position would say.
“Let’s delete this,” he said, pushing the “delete” button. “There. All gone. Okay?” He bent down, kissing me on the cheek.
It’s been two and a half years since I left the mental hospital, and I am about as stable as I am going to get. Jobless and 35 lbs heavier, I have regained many of the skills I had before I got ill, such as driving, peeling a banana, and washing my own hair. But I will probably never be at the level of functioning I was at before I was ill. That said, however, I am now “divorceable”. So if he were going to leave, he would have done it by now. After two and a half years, it looks like we’re going to stay married.