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No Room In Inn: Psychiatric Patients Remain Stuck In ER’s, Sometimes Days Waiting For Beds

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Imamu Baraka came to the aide of a woman discharged on Jan. 9 from a Baltimore hospital wearing only a gown and socks. Baraka recorded video of the incident. (Facebook.com/imamu.baraka)

(12-3-19) Nothing illustrates “patient dumping” better than the viral video of 22-year-old Rebecca Hall being tossed out of the University of Maryland Medical Center into the freezing cold in January 2018 wearing little more than a hospital gown.

Delayed and Deteriorating: Serious Mental Illness and Psychiatric Boarding in Emergency Departments, a recent study released by the Treatment Advocacy Center, warns that Americans who visit emergency rooms with psychiatric problems have a higher rate of being dumped or being “boarded” than those without mental illnesses.

Psychiatric boarding is defined differently but most hospital administrators say having to wait six hours or more after being diagnosed in an emergency room awaiting treatment constitutes “boarding.” A 2016 survey by the American College of Emergency Physicians, found that more than 90% of emergency physicians say psychiatric patients board in their emergency room.

The average emergency room wait in Georgia for psychiatric patients requiring an inpatient bed is a whopping 34 hours, according to the TAC study authored by Elizabeth Sinclair Hancq, Jessica Walthall and John Snook.  Psychiatric patients who required admission to a hospital or transfer to a bed in a psychiatric facility in Massachusetts waited in emergency rooms from 16.5 to 21.5 hours compared to 3.9 hours to 4.2 hours for medical or surgical patients needing beds.

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Harris Releases “Everything We’ve Been Looking For” Mental Health Plan, Advocate Says. White House Planning December Summit To Discuss Its Agenda

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official campaign photo

(11-29-19) The White House will be hosting a summit on Transforming Mental Health Treatment to Combat Homelessness, Violence and Substance Abuse on December 19th.  I will be attending and will report about the Trump Administration’s plan.

Several 2020 presidential candidates are releasing proposals about mental health care. Democratic Senator Kamala Harris (Ca.) posted her goals this week.

D. J. Jaffe, who frequently testifies before Congress and critiques federal policy and agencies in his book, Insane Consequences: How The Mental Health Industry Fails The Mentally Ill, reacted with this email comment:

“Wow! Kamala Harris announces Mental Health Plan with everything we’ve been looking for to help seriously mentally ill: Parity, End IMD Exclusion, more hospital beds, Fund AOT, Fix HIPAA, Focus research on SMI, end solitary, increase workforce, Reclassify schiz, fund clubhouses CIT housing & more! I don’t endorse specific candidates but I sure endorse this plan!”

If you know of another candidate’s plan that you like, please let me know on Facebook.  You can react to Candidate Kamala Harris’ plan by commenting on Facebook or Twitter. I’m told both accounts are monitored by her campaign staff.

KAMALA’S PLAN TO ADDRESS THE MENTAL HEALTH CARE CRISIS AND PROVIDE MENTAL HEALTH CARE ON DEMAND | FULL POLICY

Our country is in a mental health care crisis. Over 45 million adults—nearly 20% of all U.S. adults—experienced mental illness in 2017. Suicide is on the rise, increasing 30% or higher in 25 states from 1999 to 2016. As natural catastrophes and man-made traumatic events like shootings devastate our communities, post-traumatic reactions in children and adults follow.

Yet even as nearly 60% of Americans seek mental health services for themselves or loved ones, more than half of the adults with mental illness—nearly 27 million—did not receive treatment in 2017.

In 2020, mental health care justice is on the ballot.

We need to act. As president, Kamala will make sure we deliver mental health on demand—that is, she will provide services to all Americans who need it, whenever they need it, and wherever they need it.

  • She’ll cover mental health on demand via telemedicine through her Medicare for All plan, providing direct access to mental health care professionals—with no deductibles and no copays.
  • She’ll double the number of treatment beds nationwide, prioritizing states with shortages including Iowa, Nevada, South Carolina, and Michigan, so persons with mental illness can receive the high levels of care they need.
  • As we improve mental health services across the country, she’ll make sure we meet the unique needs of vulnerable populations, including our veterans and our children. For example, she’ll double DoD and VA research dollars to address and treat PTSD, military sexual trauma, and traumatic brain injury.
  • And Kamala knows that children’s earliest life experiences, from poverty to exposure to violence and other trauma, have profound effects on their brain development and long-term health and safety, and that early intervention is key to ensuring that every child has the opportunity to develop to their full potential and become resilient when traumatic events strike. That’s why she’ll fight for evidence-based screenings for childhood trauma to diagnose and treat mental illness as early as possible.
HERE’S HOW SHE’LL DO IT:

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“Two months in jail and put back out the streets.  At least he was fed at the jail.”

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Photo by Dev Asangbam

(11-25-19) Anyone who advocates for persons with mental illnesses quickly begins receiving emails and telephone calls from desperate families seeking help. In Montana, those pleas end up being directed to Dr. Gary Mihelish, a recipient of the highest award given by the National Alliance on Mental Illness -its’ Distinguished Service Award.  I am posting this recent exchange between Dr. Mihelish and a Montana family NOT because it is extraordinary but because it is so common. 

11-14-19
Hi Gary,
I thought I’d give you a quick update about my brother who is in jail.

The Center for Mental Health said they are willing to work with him but all we got back from them is a big stack of paper work to fill out. Upon seeing the papers and remembering that they basically fired my brother as a client several years ago (I’m not saying it was unwarranted-but that he’s been with them before) we called Aware. (A mental health provider.) The woman there was very nice and helpful and she is going to try to get my brother to consent to work with them. It sounds as if they have great resources and at the very least if they could help with the payee work then my mom wouldn’t have to be the one giving him money.

We are crying tears of joy because someone offered us a ray of hope by saying they are willing to help and to not give up on my brother. You can’t believe how important and how good it feels just to have someone say they are willing to help and to tell us don’t give up.
As it stands now Aware is going to try to get my brother to agree to work with them. It’s the first sign that something may get done.

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“I’ll Do It” Spirit Cited At Advocate’s Memorial, Challenging Others To Serve Their Communities

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(11-22-19) A close friend of long-time mental health advocate Betsy Greer urged those attending her memorial service yesterday to adopt Betsy’s “I’ll Do It” mantra.

I noted Betsy’s death and tireless efforts to improve the lives of those with mental illnesses, primarily through the National Alliance on Mental Illness, in an earlier blog. Acting NAMI CEO Angela Kimball and long-time NAMI advocate Bob Carolla spoke eloquently about their memories of Betsy. In addition to being honored by NAMI, a sign of her importance in her home state of Virginia was that Mira Signer, chief deputy commissioner of the state behavioral health department, was in attendance.

Betsy’s good friend, Rayna Aylward delivered a eulogy that should inspire all of us.

TRIBUTE TO BETSY GREER,

Rayna Aylward 11/21/19

     Betsy was an exceptionally smart and articulate person, and an accomplished writer and public speaker.   But the words I most remember from her are just three simple ones:     I’LL DO IT

    If there were something that needed to be done, or someone who needed to be helped, Betsy would say:  I’LL DO IT

    Betsy and I were longtime members of the Kol Ami congregation, but I didn’t really get to know her well until about two years ago, when I joined the Kol Ami Care & Concern Committee, which focuses on supporting members in times of need.  

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A Hoax? Questions Raised About Famous 1970s Study That Found Doctors Eager To Hospitalize Sane Patients Faking Schizophrenia

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(11-18-19) In 1973,  Dr. David L. Rosenhan, a professor of psychology at Stanford University, announced that he and seven others had pretended to have a serious mental illnesses and were subsequently hospitalized and diagnosed with schizophrenia even though they were faking.

His report, On Being Sane In Insane Places,  published in Science, the journal of the American Association for the Advancement of Science, shocked the country and deeply weakened the public’s faith in psychiatrists, state mental hospitals, and psychiatry itself.

The article has been embraced for decades by the anti-psychiatry movement as proof mental illnesses are a “social construct” and do not exist. His study  “plunged the field into a crisis from which it has still not fully recovered,” the New York Times recently noted. “It made Rosenhan an academic celebrity. Nearly 50 years later, it remains one of the most cited papers in social science.”

Dr. Rosenhan, who died in 2012, claimed that three psychologists, a pediatrician, a psychiatrist, a painter and a housewife, joined him in posing as patients. None of the other pseudo-patients was identified in his article, which he intended to publish as a book, nor were the doctors and hospitals that were bamboozled named.

It now appears his study might have been a hoax.

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Advocate Encourages Doubters To Use Jail Form To Meet With Sheriff’s : “Get Involved! Organize!”

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Doctor Filling Syringe in Prison

(11-15-19) Earlier this month, I posted a blog entitled: Advocate Creates Medical Form & Handbook Telling You What To Do If Someone You Love Is Arrested.  It offered readers a sample form that could be used to inform jail officials about the medical needs of someone who has been arrested. Mark Gale, who created the form, also prepared a handbook that described what needed to be done in the Los Angeles area if someone was jailed.

Dear Pete,

I want to follow up on your blog. I agree with several readers who commented on your Facebook page that there are far too many jails across our nation that either do not deliver medications and treatment, or simply ignore their constitutional obligation to provide at least a minimal adequate level of health care to all who are detained.

Their cynicism and frustrations are well-founded, but they don’t solve the problem.

My message to them is “Get Involved! Organize!”

The Inmate Medication Information Form is not just a well-intentioned informational form to assist clinicians with continuity of care, it is a well-defined simple advocacy tool that can be used to begin a dialogue with the Sheriffs and Custody Commanders who run your local jail.  You are being handed a reason to call for a meeting.  Don’t pass up the opportunity.

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