Better Mental Health Care?
What would it mean?
A tragic mass killing in Texas. Everyone is asking for solutions, as we reasonably do after these events. One thing that is always discussed after school shootings is mental health. Celebrities and politicians pick up microphones and write op-eds saying ‘we need better mental health care.’ There is a belief that we can stop these events if everyone has, what, a therapist?
I couldn’t agree more that we can do better. But what does that mean, exactly? From my vantage point in the ER, mental health care means poor people and addicted people with serious mental illness get brought to the ER over and over on commitment papers. We try to calm them down, put them in paper gowns, maybe sedate them, give them sandwiches and put them in line for a consult.
In most community and rural hospitals like mine, they usually see a tele-psychiatrist and may (or may not) be committed to a psychiatric facility. If they are it lasts for a few days, some of their medications are adjusted, they are discharged, don’t follow up and quickly run out of medications they either can’t afford or don’t really want to take anyway. And the cycle repeats itself as they come back over and over again. Their options and ours are very, very limited.
We need 1) governmental will to tackle the problem 2) money to train and hire more mental health professionals 3) facilities where these people can be seen expeditiously without languishing in an already crowded ER which has little time for their care due to its staff handling trauma, stroke, heart attack and whatever the pandemic du jour happens to be. Finally, and I’ll call it 4) we need new construction of residential psychiatric facilities where some of our patients can stay long-term or simply be consigned permanently as wards of the state. In the end it would be better and safer for them and everyone else.
It’s the easiest thing in the world for social workers and law enforcement or just concerned family to take people to the ER for their psychiatric issues; maybe it’s better than nothing. On the other hand, maybe it isn’t if it’s just a little band-aid on a giant wound.
What are your thoughts on what ‘better mental health care’ means? Any suggestions?