Care for All Noggins
Jumping right in to it this week… Behavior, communication… all depends on the way our brain is wired…
Mental Health. It’s real. It is something that if it hasn’t touched your life, in some way, I would imagine it is hard to grasp the severity of the moment we are living in at this moment. It’s one of those health avenues you either completely ignore and disassociate yourself with (red flag!) or you live it, watch it, and/or advocate for better.
Real tragedies, current and resurfaced/documentaries, have sparked my interest in why state mental hospitals were closed. I read a couple of books about Dorothea Dix in the past couple years, and what she did, in the time that she lived, was beyond what some people would even try to achieve today! So I did a little digging, and learned some more about these hospitals and the pros and cons of their existence, as well as the aftermath of them closing.
Before I begin, let me clarify my knowledge on this subject and what I am about to lay before you. I am not as knowledgeable about these state hospitals as I am the vaccines I wrote about last week. I have researched this out of my want and need to learn what, why, when, and how. What did these hospitals consist of? Why did they close? When did they close? and How are we handling mental health hospitalizations today? So I have a lot more research to do, this is only a starting point. I will attach links at the bottom of the post for more knowledgable articles.
Dorothea Dix, I can’t do her story justice- so google her. I just found out about Thomas Story Kirkbride, who was also a huge contributor to the mental health world. He was a doctor who believed these hospitals should be built in the victorian-era style, well furnished and decorated, with plenty of fresh air and sunlight, on lots of land, sometimes even farmland for the patients to work. He did not see that there was any need to belittle his patients simply because of a mental diagnosis.
These state operated mental hospitals, over time, became overcrowded due to more false commitments instead of true mental commitments. The elderly and patients with syphilis began being admitted and never being discharged, which led to most beds being taken by these patients. (The Rise and Demise of America’s Psychiatric Hospitals Article- link below)
The general goal in closing all the state operated hospitals was that the funding and support would go to the community, who would instead care for those who lived around them, ultimately striving for the end of isolation. However, the money taken from state hospitals didn’t go to helping communities, instead it when into building prisons and other tax funded programs.
When state mental hospitals closed, then came state regulated commitment laws, less beds, and shorter stays- if at all. Voluntary commitment, it’s the patient who has to agree they need help and evaluation. Involuntary commitment, someone close, usually a family member, that feels like the patient is a danger to themselves or others can admit them to the hospital. I’ve watched both, voluntary and involuntary, some get admitted and some get turned away. And for most the four day stay only touches the surface. How can we expect to assess someone in four days, when they are in a crowded hospital, usually locked unit (as it should be-but this too can be a contributor to mental health!), and all the patients around them are needing mental, emotional, physical evaluations as well?
Patients and families who get turned away are then faced with what now?? Access, treatment, knowledge, and resources is all they have to rely on. And these are all well and good until someone becomes a danger to others or themselves, then there is life on the line.
There have been two tragedies near me recently that have involved a male killing a female. It’s not about gender- it’s about what comes to light after these tragedies, the moms of the sons. In both cases the moms have spoken out and said that they had exhausted all their resources and options. They had gotten them help, placed them in the hospital, did what they could for treatment, but they could no longer help. Too many families are landing here. Too many people with mental health challenges are living either in prison or are homeless. The devastating truth is some are self-medicating, some have been turned away so many times they don’t know what it’s like to be welcomed in- a lot of times this has to come from outside their family, some, if going with out medication or therapies, cannot comprehend what their actions are and the effect it has on them and those around them.
The strength that comes with brain chemicals is out of this universe. I’ve witnessed it with dementia, Alzheimer’s, Parkinson’s, panic attacks, anxiety, you name it – your strength becomes a weapon you don’t even know you are capable of. And just this fact is unsettling. Our brains are woven and knit together, and they are not all alike, and are not supposed to be. But we all deserve care for our noggins.
I wish I could say I have a solution for the brokenness, but I don’t. I see why state mental hospitals were put in place and I also see why they were closed. I see why there is a difference in voluntary and involuntary commitment- and a need for both. I still have a lot of questions:
- Do we stand up to the ignorance and arrogance about mental health? Do we speak up and tell the truth, and not hide behind it anymore?
- Will we advocate for clear and effective commitment laws that improve diagnosis and care?
- Do we advocate for funding longer stays for those who need it at inpatient or outpatient private facilities?
- Will we be the community that families need? Churches that offer classes, one on one care, counseling, financial help with bills? Or just come alongside?
- Will we encourage and thank our mental health nurses, doctors, counselors, teachers, etc when we see them? Every time we see them!
Mental health is real and it’s not going anywhere, but there is help and there is hope. We have to be the community that they wanted when they closed these hospitals. Not perfect, but beautifully broken together.
Life Book of the Week: Last Stop on Market Street, by Matt de la Pena
https://psychiatryonline.org/doi/10.1176/appi.pn.2019.3b29
https://www.psychiatrictimes.com/view/mental-illness-civil-liberty-and-common-sense
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