After a very tough four years dealing with a adult child's mental health problems which will never go away but will only wax and wane, I have come to the conclusion that it is what it is and I can only control my reaction to this persons very poor decision making. I am able to assist in some ways being the legal guardian but that also has many, many limits. But, I can be a voice. I can be an advocate for this adult child.
The government is not helping persons with mental health by eliminating many of the institutions which the person had lived. Now trying to "mainstream" those that were once institutionalized into society. As a nation that has seen an increase in horrendous crimes (those of which I do not feel the need to mention since we are all very much aware of them). With many of these crimes committed by the hand of an individual with mental health issues, I have to ask is this new system really working? Is it best to "pretend" that there are not that many people with mental health problems? Is it really best to release (throw) these people into a community that is not very accepting of them and expect that they will thrive without adequate resources to help them?
When you see a homeless person on the street, what do you think? Do you think that the person is homeless due to drugs? Poor decision making? An alcoholic? Do mental health problems ever enter your mind as a reason for homelessness? Many people with mental health problems are unable to deal with their life and therefore turn to ways in which they can "escape" life and the escape for them many times will be alcohol and drugs.
Then, on top of eliminating institutions, it is even harder to obtain any inpatient services that these people need. Since mental health is apparently NOT a profitable form of healthcare, many hospitals have closed their mental health units, decreased the number of people that they can accept, have tightened the criteria for admission, or have adopted the mantra that a mental health person in crisis can be effectively managed in the emergency room.
Is treating mental health issues in the Emergency Room effective? From my stand point, NO! How is it adequate care if the person is in a "safe" room for a duration of 24 to 36 hours. Then constantly reassessed to see if he/she meets the criteria for inpatient psychiatric hospitalization while awaiting this inpatient bed. Once a bed is available after this long wait, the person is most likely deemed to not meet the criteria for admission. Why? Most likely the person has developed learned behaviors from frequent visits to the Emergency Room (ER) or Crisis Center and now knows exactly what to say to get out of the ER. Whether the person still suffers from the crisis at this time is irrelevant if the person says the right thing and signs a "safety" contract. A safety contract is a legal document that the patient places her/his signature on to agree to not hurt her/himself when released. Basically to release the hospital of being liable if something happens when discharged.
Is a safety contract valid if a person who signed it is under guardianship and has been deemed unable to adequately and safely manage her/his medical management? I do not believe it is. So what happens when the person with a guardianship hurts her/himself after signing this safety contract her/himself? Is anyone liable when the staff were well aware of guardianship? Such a good question and one that this writer was given the "run around" when I asked the hospital mental health staff in the ER. No one wanted to answer directly or did not have the answer to this question. So again, let's ignore the question just as society does those with mental health issues.
Once one is discharged from the ER for a mental health crisis or has voluntarily signed her/himself out of the crisis center, the next "best" option is to utilize outpatient services. Does anyone follow-up on any outpatient services? No.If the person is lucky enough to already have a mental health counselor or psychiatrist then he/she only has to wait one to four weeks for a follow-up appointment. However, if the person is not already connected to the mental health outpatient system then a person will typically wait four to twelve weeks until there is an available new patient appointment.
Now, would making more mental health services available to people in need help? I do not have that answer. However, having those that need to be institutionalized so a person can function and not released into a society so that the person cannot function, may be helpful.
Have violent crimes increased with the "mainstreaming" of mental health people into society? Maybe and Maybe not. But closing down institutions is definitely not the answer. Neither is making mental health services harder to access for those that need them.
I am frequently reminding myself that you cannot "make a horse drink when you bring it to water". A person has to want to live a decent life and not want to self defeat her/himself at each and every possible opportunity. It is extremely difficult and at times feels like you are banging your head against a brick wall when dealing with a family member with mental health problems. Many times the person with mental health issues has distanced her/himself from loved ones. I am constantly reminding myself that being present for my adult child and doing the best that I can at that moment is all that can be asked. And sometimes you have to let go and allow your adult child to "fall" and hopefully one day learn how to deal with her/his mental illness.
However, those that have mental health issues do need guidance and the support of families when possible. And families need support for themselves; whether it be a spouse, friends, therapist, support group, a massage, a walk, or anything else that can make you smile for a moment. Because it really is a moment and moments are to treasure because they are so few when you deal with a loved one mental health problems.
With that said, I am going to try to help my adult child when possible and not lose myself in this long process of the disease that is called mental illness.
The government is not helping persons with mental health by eliminating many of the institutions which the person had lived. Now trying to "mainstream" those that were once institutionalized into society. As a nation that has seen an increase in horrendous crimes (those of which I do not feel the need to mention since we are all very much aware of them). With many of these crimes committed by the hand of an individual with mental health issues, I have to ask is this new system really working? Is it best to "pretend" that there are not that many people with mental health problems? Is it really best to release (throw) these people into a community that is not very accepting of them and expect that they will thrive without adequate resources to help them?
When you see a homeless person on the street, what do you think? Do you think that the person is homeless due to drugs? Poor decision making? An alcoholic? Do mental health problems ever enter your mind as a reason for homelessness? Many people with mental health problems are unable to deal with their life and therefore turn to ways in which they can "escape" life and the escape for them many times will be alcohol and drugs.
Then, on top of eliminating institutions, it is even harder to obtain any inpatient services that these people need. Since mental health is apparently NOT a profitable form of healthcare, many hospitals have closed their mental health units, decreased the number of people that they can accept, have tightened the criteria for admission, or have adopted the mantra that a mental health person in crisis can be effectively managed in the emergency room.
Is treating mental health issues in the Emergency Room effective? From my stand point, NO! How is it adequate care if the person is in a "safe" room for a duration of 24 to 36 hours. Then constantly reassessed to see if he/she meets the criteria for inpatient psychiatric hospitalization while awaiting this inpatient bed. Once a bed is available after this long wait, the person is most likely deemed to not meet the criteria for admission. Why? Most likely the person has developed learned behaviors from frequent visits to the Emergency Room (ER) or Crisis Center and now knows exactly what to say to get out of the ER. Whether the person still suffers from the crisis at this time is irrelevant if the person says the right thing and signs a "safety" contract. A safety contract is a legal document that the patient places her/his signature on to agree to not hurt her/himself when released. Basically to release the hospital of being liable if something happens when discharged.
Is a safety contract valid if a person who signed it is under guardianship and has been deemed unable to adequately and safely manage her/his medical management? I do not believe it is. So what happens when the person with a guardianship hurts her/himself after signing this safety contract her/himself? Is anyone liable when the staff were well aware of guardianship? Such a good question and one that this writer was given the "run around" when I asked the hospital mental health staff in the ER. No one wanted to answer directly or did not have the answer to this question. So again, let's ignore the question just as society does those with mental health issues.
Once one is discharged from the ER for a mental health crisis or has voluntarily signed her/himself out of the crisis center, the next "best" option is to utilize outpatient services. Does anyone follow-up on any outpatient services? No.If the person is lucky enough to already have a mental health counselor or psychiatrist then he/she only has to wait one to four weeks for a follow-up appointment. However, if the person is not already connected to the mental health outpatient system then a person will typically wait four to twelve weeks until there is an available new patient appointment.
Now, would making more mental health services available to people in need help? I do not have that answer. However, having those that need to be institutionalized so a person can function and not released into a society so that the person cannot function, may be helpful.
Have violent crimes increased with the "mainstreaming" of mental health people into society? Maybe and Maybe not. But closing down institutions is definitely not the answer. Neither is making mental health services harder to access for those that need them.
I am frequently reminding myself that you cannot "make a horse drink when you bring it to water". A person has to want to live a decent life and not want to self defeat her/himself at each and every possible opportunity. It is extremely difficult and at times feels like you are banging your head against a brick wall when dealing with a family member with mental health problems. Many times the person with mental health issues has distanced her/himself from loved ones. I am constantly reminding myself that being present for my adult child and doing the best that I can at that moment is all that can be asked. And sometimes you have to let go and allow your adult child to "fall" and hopefully one day learn how to deal with her/his mental illness.
However, those that have mental health issues do need guidance and the support of families when possible. And families need support for themselves; whether it be a spouse, friends, therapist, support group, a massage, a walk, or anything else that can make you smile for a moment. Because it really is a moment and moments are to treasure because they are so few when you deal with a loved one mental health problems.
With that said, I am going to try to help my adult child when possible and not lose myself in this long process of the disease that is called mental illness.
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