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Mental Illness: Short Term Care Facilities February 17, 2010

Posted by Crazy Mermaid in Mental Hospital, mental illness, Psych Ward, Recovery.
Tags: , , ,

With the advent of the changes wrought by the new Parity law that just went into effect January 1, 2010, one of the consequences will be that short-term hospital stays will be lengthened beyond the standard 2 weeks period now in effect, since this 2 week period of time is currently driven by insurance requirements rather than patient need.

As the parity law increases the length of visits, demand for hospital beds, which are already in short supply, will be increased. I’d like to think that the end result of the new parity law will be that more facilities will be built to house those patients not ready for discharge. But building those new facilities will be difficult since anyone trying to build them will run smack dab into neighborhood NIMBY’s (Not In My Back Yard).

The communities where these new facilities will be built are already up in arms about siting short-term mental health care facilities in their neighborhoods because of misunderstandings about the nature of  medical care for mental illness. They don’t understand the concept of short-term care. Encouraged by the entertainment world, they perceive those receiving short-term psychiatric care as a bunch of crazies running around killing and/or maiming people, especially young children.  Thus is the picture the entertainment world has provided to society at large regarding the nature of those afflicted with mental illness. So if they’re not the psychos of the world, then just exactly who are those people receiving short-term care?

A vast majority of short-term patients are people who are severely depressed. So depressed, in fact, that want to and/or try to commit suicide. They have either been talked into seeking help themselves (voluntary commitment) or have been taken to the hospital by others (involuntary commitment) for short-term inpatient treatment. The treatment is designed to alleviate their depression and get them to a point where they no longer desire to kill themselves.

The second group of patients are those who have psychotic breaks with reality in some form. In some cases (like me) they believe they are Mermaids. In others, they hear voices.  Or they believe people are out to get them. Or they believe they can fly.  Like their severely depressed brethren, they have been talked into seeking help themselves or have been taken to the hospital by others for short-term inpatient treatment.  The purpose of their treatment is to bring them back to reality.

A handful of patients are previously stabilized mentally ill people who have, for whatever reason, become de-stabilized.  They have either stopped taking their medication for a short period of time and need to get re-stabilized, or their medications have stopped working through no fault of their own. Either way, they are readmitted for some intensive care as they receive the care needed to restabilize their medication, thus enabling them to be re-released back into society.

One group of mentally ill people  not found in these short-term care facilities are the “forensic” mentally ill people.  “Forensic” in this usage designates a mentally ill person who has committed a crime.  Forensics are under the strict supervision and control of the Criminal Justice System, and have a snowball’s chance in hell of winding up in a short-term care facility.

Besides the fact that the criminally insane cannot get treatment in short-term psychiatric care facilities, people should take comfort in the fact that nobody can just walk out of a mental health hospital. In fact, unlike any other medical care they will ever receive in the world, patients check their civil rights at the desk when they walk through the door to get treatment.

If the neighbors think they’ll have some lunatics loose on them, I challenge them to visit one of those facilities. The razor barbed wire, locked gates, and other security measures taken by the staff of these facilities virtually guarantee there will be no loose “loonies” in the neighborhood. No more likelihood of violence than your average suburban neighborhood, in fact.

So the NIMBY crowd should take comfort in the fact that only the “good” loonies are treated in these facilities, and that it’s almost impossible for these “good” loonies to get out of the facilities and wander around the neighborhood unsupervised. It’s okay to have a short-term mental hospital in your neighborhood. Nobody will bite you. Or stab you. Or whatever. They’re only there to get better.



1. Astrid - February 20, 2010

Althugh I agree with your understanding that having short-term psych wards in the community does not increase the risk of “having crazies let loose on the neighborhood” – in fact, I would say the risk is decreased due to the fact that people can get care more easily -, I dsagree with your implicit suggestion that long-term patients are somehow conforming to the stereotype of entertainment crazies. I am a long-term patient, and I don’t know anyone who conforms to this stereotype. I and most other patients at my ward do hav ethe ability to leave whenever they want (well technically speaking eveyrone has that ability since the doors are not locked, but there are people who are sectioned and hence need permission). That, however, does not mean that no care is taken that we do not endanger the community. In fact, when I was still residing at a locked ward, my privileges were withheld for far longer than technically necessary because people could not be sure I wasn’t going to pose a risk in the community.

Crazy Mermaid - February 20, 2010

I’m sorry if I offended you regarding my piece on short-term care by not addressing long-term care at all. I didn’t mean to imply anything in my failure to address long-term care. There simply was no long-term care at my mental hospital. None. Another significant difference between us was that we didn’t have the ability to leave the ward whenever we chose to do so. We were, in fact, locked in. All of us. Until our psychiatrist decided we could leave. When we were no longer locked in, we were released. There was no such thing as not being locked in and remaining in the ward.

Astrid - February 21, 2010

The thing about open wards like mine (where you aren’t locked in) seems to be soemthing that differs from country to country. In fact, I heard that in some countries or states, no open wards exist, while in the Netherlands in fact you can be on an open ward while sectioned if your psychiatrist deems it appropriate. We in fact had open acute wards (I was n ot on one, my acute ward was locked), which seem to be pretty specific to the Netherlands sicne I haven’t heard of them in any other country.

2. melly gutierrez - June 10, 2010

i have a serious concern over my husband. he was diagnosed with bi polar 1 in the middle of march and since then has exploded into manic depression episodes. the state facility that he is in is looking to free him when i know for a fact my husband is not well enough to step out into the world. i need help please as to where i can place him in order for him to recieve the proper attention, he won’t stay voluntary so it has to be a place where the family can check him in. i’m worried over the life and safety of my husband and for those around him. he tends to get extremely aggressive and violent towards anyone and everyone. i want to save his life, i love him and want him back, please help me.

Crazy Mermaid - June 10, 2010

Where are you located?

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