How do we support our mentally ill

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    I have seen several threads on the plight of the mentally ill in our country. It is a sad situation that there are so many in need of help and care, but the healthcare system is woefully unable to manage this population.

    Based on the excerpt below we can see that the drive was away from facilities and providers to care for them. Many mental health patients now reside in our prison systems. This cost is exorbitant not only in real dollars, but in productivity and quality of life lost.

    I understand that the ACA has provisions for mental health coverage, however the problem is larger than just saying, "yes you can go to a provider now." Other factors to consider are facilities available, qualified providers etc. Where will the money and manpower come from to support a solution?


    Following is an excerpt from Chapter One of:
    Out of the Shadows: Confronting America's Mental Illness Crisis
    by E. Fuller Torrey, M.D. (New York: John Wiley & Sons, 1997).

    Deinstitutionalization is the name given to the policy of moving severely mentally ill people out of large state institutions and then closing part or all of those institutions; it has been a major contributing factor to the mental illness crisis.

    Deinstitutionalization began in 1955 with the widespread introduction of chlorpromazine, commonly known as Thorazine, the first effective antipsychotic medication, and received a major impetus 10 years later with the enactment of federal Medicaid and Medicare.

    Deinstitutionalization has two parts: the moving of the severely mentally ill out of the state institutions, and the closing of part or all of those institutions. The former affects people who are already mentally ill. The latter affects those who become ill after the policy has gone into effect and for the indefinite future because hospital beds have been permanently eliminated.
    herring_RN likes this.
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    I can tell you first hand we do an AWFUL job of taking care of the chronically mentally ill. I am a psych nurse, so I've seen it first hand. It was most glaring when I worked in the community. The prison system is the new psych institution. Either that or homeless shelters. Those who werent in jail or homeless were living in substandard housing (if they werejt lucky enough to get into a residential program somewhere) and in abject poverty. Really, really sad.
    LadyFree28 likes this.
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    Quote from ShillaBSN
    It is a sad situation that there are so many in need of help and care, but the healthcare system is woefully unable to manage this population.
    It IS a sad situation that the health care system 'refuses' to manage this population. Agreed.
    VivaLasViejas and LadyFree28 like this.
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    Deinstitutionalization was a huge blow. They made mistakes, but were in their early stages.

    If they turned it around, brought back facilities, we would be heading in the right direction again. We simply don't have coverage or resources.
    Retired APRN likes this.
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    This makes me so sad. When you have a fever, you know you are sick. When you hear voices, look for acceptance in heroin syringe, eat ice cube sized portions of food and insist your fat, or just can't bring yourself to get out of the bed in the morning, you don't even know your sick. Even the people around you want you to "shake it off." Many of these people need intensive inpatient programs and many hospitals have cut these programs. We will see more and more lost and homeless people as further cuts are made.
    VivaLasViejas likes this.
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    People with broken brains deserve to be treated with as much compassion and care as those with broken arms/legs/whatever. Instead, we're regarded as alien, even dangerous, and even those of us who are relatively high-functioning are often marginalized by a health care system that is suspicious and mistrustful of us. I hope this will change one day, but regrettably don't see it happening in my lifetime.
    LadyFree28 and Debilpn23 like this.
  9. 0
    I fear that, mostly, in this country we support our mentally ill neighbors by incarcerating them.
    That is the system that receives the greatest amount of government money and treats the largest number of mentally ill citizens.

    What Is The Role Of Jails In Treating The Mentally Ill? : NPR


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