The sorry state of mental health care.

When I was in college I had changed my major several times.  I had started off wanting to be a computer programmer.  Computers had just became commonplace when I was in high school so I figured why not get in on the ground floor?  Well a few shitty teachers  dissuaded me from that pretty fast.  I then switched to a pre-law series of classes, intending to go into politics and/or be a lawyer.  I soon realized that most politicians suck and I didn’t like sucking up to people enough to want to be that, so I changed yet again.  I ended up with a degree in Business Management and Psychology.  The psych stuff really interested me in how the brain worked and some of the reasons behind it.  I gave serious thought to a few more years of school to add some letters after my name and become a therapist but I knew that I couldn’t stand people THAT much, so I ended up in business, and then printing.
I mention all that because I am currently struggling with the mental health system in our country in regards to my brother in law.  Let me tell you that it sucks ass.   First, background.  Bro-in-law has a bad case of depression.  Several years ago it got bad enough that he came to our house and cried for help.  We helped him get checked in to the local hospital where they pumped him full of meds so he could get stabilized. I am not a fan of drugs,  but I KNOW that most things like depression are a result of a chemical imbalance in the brain.  Drugs are needed, and it takes a few days for the levels to get high enough to be effective. After a week or so he got out and we moved him in with us, where he stayed for a few years until he was better.  he bought a townhouse close to our house and was seeing a doc and taking his meds.  All was good.
About a month ago BIL shows up at our house again in an very similar situation saying he needed help.  So off to the hospital we went again.  After spending the whole day there they finally found a room for him in Forest Park, about an hour away.  Now if you have never visited or been in a place like this, here is how they work.  The patients are kept severely restricted.  You bring them clothes and maybe a few books, but other than that, they get nothing. No radio, electronics, and extremely limited contact with the outside world.  You can’t bring them pictures, or food, nothing.  It is just like jail.  So anyway here he is at this place and they start pumping him with drugs to get him stabilized, which is to be expected.  But every 2 days they keep screwing with the dosage or adding a new one or taking one away.  It takes 3 days to get yourself saturated for the drugs to work right, so they keep messing with his chemistry, making him worse. The shitty part about this is his doc visits are limited to asking about the drugs and then giving him more.  No questions about why he was there, how he is doing, etc.  Part of BIL’s problems was also a lack of sleep. Brain working way too much to let him sleep until he was exhausted, and then he still never got enough.  For almost 2 weeks they kept screwing with his meds, never giving them a chance to work.   The lack of sleep issue wasn’t even addressed until 7 days in.  Seriously, the term ‘quack’ is used in a bad way towards docs.  It fits in this situation.  BIL was getting crazier every day from lack of sleep, no interactions and no therapy.  So wife and I finally managed to get him transferred.
That didn’t seem to help, or go smooth.  The first place we had contacted SAID they had room,  but when they went to transfer him, they were suddenly full.  So BIL finds out it is delayed he almost lost it.  Two days later we find a new place for him to go.  A brand new facility that had just opened 3 weeks prior. He gets transferred there late Friday night. Now the hell begins again.  Since this place is new, they are not fully staffed, so no fucking doctors there on the weekends.  Since it is new, they didn’t have all the drugs he was taking at the previous place, so they had to start all over again with those. Since it is new they seemed to be flying by the seat of their pants, making shit up as it went.  We go to see him that Sunday and he is literally crying as he hasn’t talked to anyone yet, is pretty much going stir-crazy with nothing to do and nobody is talking to him.
We go back on Tuesday and it is worse.  He saw a doc once for about an hour.  The doc started asking him all sorts of questions like ‘Do you know who the President is’ or holding up a pen and asking what it was.  BIL snapped back that he wasn’t stupid, just depressed and can’t sleep and bored shitless.  So now he has seen a doc twice, once to discuss drugs and once to be treated like a moron.  The only other thing they have there are group therapy sessions.  These won’t help him as he is naturally an introvert.  Plus the sessions are manned by interns, not a doc or therapist, and the questions were all similar stuff.  One such group they handed out paper and crayons and asked them to write down how they were feeling today.  OK, I get the overall aspect of group therapy, but in BIL’s case, this isn’t helping.  He needs meds that will stabilize his depression, something to help him sleep and then actual adult conversation as to why things happened and how to prevent them from happening again.  Until today, almost 4 weeks from his initial admission,  none of that was happening.  Credit the wife for being very persistent and hounding the hospital until they did something.  Today she had a phone session with BIl and the therapist.  After that hour they believe that they will have BIL stabilized enough medicine-wise to be discharged within a week.  However the plan to try outpatient afterwards is probably not the right one.  More research showed that they were ALL heavily reliant on group therapy.  So now the plan is for BIL to get twice a week meetings in private and spend the next few weeks at my place, where he will be surrounded by loved ones and his dog, as well as being able to watch TV, read or just sit outside.
These inpatient places bill thousands of dollars a day for this crappy level of service.  He would get better lodging and food in a hotel for less.  He would get better direct care from a private therapist and psychologist, for half the rate.  And he wouldn’t be going crazier if they were allowed more contact with the outside world, loved ones, etc.  I swear all these places should just burn to the ground.  You always hear complaints that we don’t have enough mental health facilities around.  The complaint should be that they suck at their stated mission and only serve to keep the money flowing in. I don’t know what the answers should be.  For the money that is charged, it would seem as if expecting a few hours of actual clinical care from a combo of docs and therapists would not be unreasonable. Yet just about any level of personal interaction seems to be hard to come by.
We have had a few friends who have dealt with the system on an out-patient basis and have had good results.  The heavy reliance on group sessions makes those places not a good option for BIL, as he would not participate and therefor not get anything out of it.  Waste of time and money.  I pray that you or your loved ones never have to go thru this, as the system is broken.  If you are a religious person, please say a prayer for my BIL. I will keep you updated on the crapshow that is mental health care in America.

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