Posts tagged mental health
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Let us get prison health care out of jail
In addition to the responsibility of providing adequate healthcare to prisoners,we have a responsibility to society. Most prisoners are released back into the community.To the extent that their blood-borne communicable diseases, depression and other mental disorders, and chronic, degenerative diseases are under poor control, their families and the community will bear the burden of the related health,social and economic costs of inadequate care.
At the Lighthouse, the life expectance of our tenants is much lower than the general population. Sometimes when I share this people state, “Well, they’ve lived a rough life.” Which I suppose is part of it. But there is also a large part of inadequate and sub-standard health care given to them, not being able to afford medicines, not being able to travel to the doctor, poor diet due to lack of resources, toxic home or work environments, and on and on.
When I started working here, the old wives’ tale was that out of our 68 supported living tenants and 40 emergency stay clients, there would be a death every 6 months. That has proved to be strangely, hauntingly accurate.
Young and old, sudden and quick, long and painful, some unpredictable, some drawn out. It makes it more important to check in with everyone to see how they’re doing; it’s important to note if someone has been unaccountably missing from our little community. Everyone looks out for everyone.
Now we’ve added 48 affordable living suites to our community. Some hold families, some hold roommates, some with young babies. I pray and hope that we can change the ‘6 month’ lore curse.
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How Do We Stop the Next Aurora? We need a mental health system that helps men like James Holmes—and Jared Loughner, and Seung-Hui Cho—before it’s too late.
Serious mental illness can be incredibly hard to live with and to deal with. But these shootings keep telling us that we sweep it under the rug at our own peril. After a massacre like Aurora, it’s very hard to see the killer as worthy of any sort of sympathy. “They keep talking about fairness for him,” a man whose sister died in the Aurora shootings told the Associated Press at Holmes’ court appearance this week. “It’s like they’re babying this dude.” It’s an understandable reaction, but if Holmes’ lawyers are right and he is seriously ill, he won’t be coddled by the legal system. He’ll get the treatment he needed, but far too late.
After Loughner’s guilty plea, one of the survivors of his shooting spree had the compassion to point out the lack of mental health services for people like him. “We really have to be our brother’s keeper here and reach out and get them help,” victim Randy Gardner said. Real reform of mental health care, so that dropping out of school doesn’t mean being dropped by your therapist, would be arduous. It would offer no throb of vengeance. But it would make us safer.
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On Being Sane in Insane Places
”But I don’t want to go among mad people,” Alice remarked.
“Oh you can’t help that,” said the cat. “We’re all mad here. I’m mad. You’re mad.”
“How do you know I’m mad?” said Alice.
“You must be,” said the cat. “Or you wouldn’t have come here.”
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The Time I was Accused of Molesting Someone
One of the biggest areas of ignorance my first year at the Lighthouse has exposed is in mental health and the mental health care system.
I never knew that people could be arrested under a mental health warrant, if they were deemed to be a threat to themselves or to others and needed psychiatric care forced upon them. I’ve seen these ‘arrests’ lead to treatment and medication that has completely changed a person’s life so they can be a functioning member of society again. I’ve also seen attempts to get a mental health warrant rejected by a judge and then have staff and clients fear for their lives as we have to watch someone’s mental health rapidly deteriorate.
One of the first times I remember thinking, “Man, this guy is not alright,” was when a gentleman continually complained to us about his roommate, and his roommates germs. It was all well and normal until he started to tell us that their was deadly mold growing in his room and he could see the walls moving. He contacted the health department to look at his room, and they came and left, utterly perplexed as to what the guy was talking about. He continued to yell and then threaten staff saying his roommate needed to clean his room, or else. I was in the hallway coming back from going to the washroom and he stood between me and my exit, at the bottom of the flight of stairs, yelling at me and threatening me. And then he said I had molested him by not cleaning his roommate’s room or forcing the roommate to do it. (Sidenote: We don’t clean people’s suites at the Lighthouse, they are their own responsibility.)
We proceeded to get a mental health warrant against him. He was picked up, brought to the ER, assessed as being stable and functional, and returned back to our place within the day. This made us all walk on pins and needles because now he had reason to be really mad at us.
I told one of my co-worker’s later about it and kind-of laughed. This 250+ pound man saying I molested him, while the nearest we had ever gotten was 12 feet away from each other. My co-worker said this was no laughing matter and that, even as a woman, I could lose my career over allegations like that.
One of my other co-worker’s spent the next month gather new evidence. You can’t present the same case twice, so he gathered new incidences, talked to his case workers and other mental health staff. He also contacted the ER so that they would know that the client was going to arrive, that he needed treatment, no matter how he presented himself, and they determined what medical treatment they were going to provide. The client ended up staying in the local mental health hospital for 3-4 weeks, made a great recovery and completely changed his demeanor.
And that is a success story.
Tomorrow I will return to work, and again be confronted with people in desperate need of mental health care but who would not qualify for a mental health warrant. Which not only puts the staff at risk, but also leaves those who reside in our building in a complicated predicament.
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When My Crazy Father Actually Lost His Mind
… Chief among those laws were strict new standards: only people who posed an imminent danger to themselves or someone else could be committed to a psychiatric hospital or treated against their will. By treating the rest in the least-restrictive settings possible, the thinking went, we would protect the civil liberties of the mentally ill and hasten their recoveries. Surely community life was better for mental health than a cold, unfeeling institution.
But in the decades since, the sickest patients have begun turning up in jails and homeless shelters with a frequency that mirrors that of the late 1800s. “We’re protecting civil liberties at the expense of health and safety,” says Doris A. Fuller, the executive director of the Treatment Advocacy Center, a nonprofit group that lobbies for broader involuntary commitment standards. “Deinstitutionalization has gone way too far.” According to Fuller’s group, there was one public psychiatric bed for every 300 Americans in 1955; by 2012, that number was one for every 7,000. That’s less than a third of what is needed, the organization asserts. The recession has made matters worse: since late 2008, more than $1.5 billion has been cut from state mental health budgets across the country. In the past two years alone, 12 state hospitals with a total of nearly 4,000 beds have either closed or are in danger of closing.
Already patients in crisis can spend several days in an emergency room waiting for a psychiatric bed to become available. In New Jersey, it can take as long as five days; in Vermont — where, as Bloomberg News recently reported, there are virtually no state psychiatric beds left — severely mentally ill patients have been handcuffed to emergency-room beds. For lack of other options, many patients who clearly meet the imminent-danger standard are released. “The lack of resources has triggered a devolution of the standard,” says Robert Davison, executive director of the Mental Health Association of Essex County, a nonprofit group that connects patients to services in northern New Jersey. “Twenty years ago, ‘imminent danger’ meant what most people think it means. But now there’s this systemic push to divert people away from inpatient care, no matter how sick they are, because we know there’s no place to send them.”
When I asked Davison for specific examples, he rattled several off the top of his head. A man who was convinced that aliens were on the roof and that bugs were coming out of the walls and who would not sit on furniture but only lie on the floor was not committable. Neither was the man who refused medication and mutilated his own testicles. Nor the woman who wouldn’t eat because she believed the C.I.A. was trying to poison her. “It is unbelievable the condition of people who are found not to meet the standard,” Davison says.
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Anonymous wealthy couple's $30-million gift to help homeless in Vancouver
Coun. Kerry Jang, a University of B.C. professor of psychiatry who specializes in mental health issues and is the city’s representative on housing and homeless issues, was nearly moved to tears by the donors’ largesse. He said he and city staff, including Judy Graves, the coordinator specializing in dealing with the homeless, have sometimes despaired at trying to solve the complex, interwoven issues of homelessness, addiction and mental health.
“It is a bit of an emotional moment for me, simply because for many years Judy and I and many of our staff have been out there and we see the suffering every single day. And every day I feel hopeless because what can we do? We put [people] into hospital for a while and they are let back out on the street again with no hope. It is just a revolving door, a revolving door, a revolving door,” he said.
“Taylor Manor is fundamentally different. Taylor Manor provides that hope, that place of belonging, that place of care. It is like when you come home from a long trip and you come in through the front door and sit down on the couch and breathe ‘I’m home.’ This is the vision of our donors and one that I am so glad to help bring forward.”
It’s stories like this that give me hope that people do care about the homeless.
Edit: I found this article through someone on facebook who wrote:
the numbers are stupid. 30 mill for 50 some people?
And I wrote:
The article says, “$14 million renovation and expansion plan for the 1915 Tudor Revival-style heritage mansion” so that’s to get it started and the annual operating budget is $900,000.
Sounds like the rest of the money is being put in an account where the interest will continue to pay for operations. Restoring buildings is crazy expensive and housing in general in Vancouver is very costly. This insures that after renovations, that the place will continued to be used for its intended purpose to help the homeless, and not be bought by some developer when times get tough.
Besides being a really long winded answer to somebody complaining on their own facebook (I’m waiting to be mocked), I forgot to mention, government funding is very fickle stuff. While the current municipal gov’t in Vancouver is striving to end homelessness, the provincial gov’t hasn’t been as gung-ho about putting homeless people in new units.
If funding is freely given by one gov’t, when a different one is elected that funding can just as easily stop. Which makes operating a non-profit very precarious - cozy up to close to one gov’t and the next pulls your funding, don’t cozy up enough to the one you have and they’ll forget the great work you are doing. It’s best not to have to rely on gov’t funding at all, but that requires donors and often very generous donors, so that groups can adapt to the needs of their community and the lean times can be weathered.
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I’ve officially been working at The Lighthouse for a year now and I’ve made a commitment to write more about life at an emergency shelter and supported living facility.
It’s hard to though, because I want to say positive things. But I become so enraged over the way life is for people living in poverty or experiencing homelessness, it clouds my thoughts and often makes me forget the victories. When I started I was so excited to help marginalized people, share about what the Lighthouse does and make a difference in Saskatoon.
For you I was a flame
Love is a losing game
The Lighthouse is basically an old hotel that has been re-purposed, so the hotel rooms are now apartments for people in need, often because of being in poverty, having been homeless, having a mental illness or addiction, having an acquired brain injury, or other cognitive or physical disability.
When I started, there was a list of people whose needs were not being met. Out of 69 people, there was at least 4 elderly tenants who needed more care than we provide (all had mental health issues and incontinence problems). Since we wanted to help the people staying in our emergency dorms move on to an apartment, it is better for everyone if we move the higher needs clients to the right level of care in the wider community, so other people who are in need can have a suite with us.
I and the rest of the staff have been desperately trying to find better homes for these elderly clients. It has been an almost impossible task. If you are elderly, poor and have a mental illness in this city there are very few resources. There is such a low vacancy rate and such high demand for nursing homes, care homes, group homes, and mental health group homes, they can decide a client’s issues are too complicated to be able to help them.
Self professed… profound
Till the chips were down
Recently I got one of these tenant’s assessed. They did not qualify for a care home but were promised that services would be brought in to help them do better at our place.
The in-home services find every excuse in the book not to come. It gets to the point where they haven’t bathed in weeks. I have bathed someone twice since working here and I know other staff have as well. We are not paid to do this, nor do we have the time, or resources. We love our tenant’s and see them in need, so we fill in the gaps where other services are supposed to be.
Today I found out this tenant was turned down for a care home for a second time even though she wants to go to a place which provides more care. This person can barely swallow liquid, can’t manage stairs, is incontinent, and can’t maintain personal hygiene. The tenant doesn’t qualify because of ‘personality issues’ stemming from diagnosed mental illness and dementia. As well the in-home services to support her where she is currently living have also stopped.
I pleaded with the assessment manager to tell me what to do to allow this client of mine to have some sort of care. She suggested that I stay in the room the whole time anyone is there giving her help, to make sure the client was well behaved and compliant. I could also appeal their refusal of accepting her in a care home, which would require me to record all incidences including outbursts, tantrums, incontinence issues, dizzy spells, falls, and lapses in her memory for one week.
Played out by the band
Love is a losing hand
More than I could stand
Love is a losing hand
So I have a week to prove this tenant is in such poor health but has a pleasant enough personality for her to qualify for a nursing home. Because I love her I will try. The assessment agency is counting on the fact that I won’t evict her to make them actually do something. And that she will be allowed to live here, inability to swallow, incontinence problems and all, until she falls and breaks a hip, or worse.
I care deeply for the people I work with. Therefore I will try my best to provide my (what I know to be inadequate) services. The professionals who are paid to provide these services refuse to do so. It shouldn’t be that you have to ‘win’ services by fitting into the right categories. If someone needs and asks for help when their health begins to fail, it should be provided, regardless of economic status. People in poverty die from lack of preventive medicine and care, and treatable illnesses. The more I love my clients, the more I realize how society has failed them and continues to do so, no matter how much I fight for them.
Over futile odds
And laughed at by the gods
And now the final frame
Love is a losing game
