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Painful memories from inside the mental health crisis system | Mental Health Perspectives
Seattle Times - 9/4/2022
Sep. 4—Nearly every day across Washington, people experience mental health crises. It could be brought on by a sudden psychotic break, a recurring mental health disorder, or some other trigger.
A network of care, including emergency departments, psychiatric institutions, courtrooms and law enforcement, is supposed to work together to respond to mental health crises. But often, the system is siloed, and agencies are working separately without the information to create a full picture.
For people going through crisis, and their families and friends, the system can be overwhelming and scary.
Over the past month, The Seattle Times has been reporting on the discordant network for crisis response care in Washington. We've heard from dozens of people who have experienced the system firsthand as a patient, loved one, or professional. Below are some of their stories.
My ex-wife went from being "quirky" to having paranoid schizophrenia over a period of 10 years late in life. Because many days were normal, it was hard for me to recognize there was a problem. The National Alliance on Mental Illness (NAMI) helped me understand I was not alone.
The police were very clear about what needed to be documented before they could take any action. Crisis responders were available, coordinated with police and an ambulance and prepared a court order for a psychiatric hold. No one told me how none of the agencies communicated with each other.
Ultimately, my ex-wife volunteered for a 21-day stay at a hospital.
About a year later, after our divorce was final and no one had heard from her for several weeks, I asked her landlord, the fire department, the police department and the crisis team to do a wellness check.
It took three weeks and my insistence they do multiple checks until they were willing to break open her door. She had been dead for seven days from a heart attack.
If only someone had been willing to make a little extra effort, my children might still have a mother.
And to add insult to injury, she then received a bill from the hospital for $49,000 because our insurance policy refused coverage, labeling her stay a preexisting condition.
— Rick Blythe
I was admitted for just under a week back in August 2019.
They do a strip search on every patient, which is the standard operating procedure. However, they didn't do it in a private area. Doors were open and windows weren't covered. I tried to decline but they insisted on it before threatening to make my voluntary admission into an involuntary one.
They left me locked in a room with a single table and chair while they did paperwork. In that room was days-old blood splatter on the wall and ceiling that was never cleaned up.
Finally, on the last day of my stay when I was being released, my discharge papers were mixed up with someone else's. They prescribed nicotine gum, high cholesterol medication and the wrong antidepressant to me.
The worst part was the psychiatrist that I had to talk to each day. I'm a transgender woman and he made me indescribably uncomfortable. I told one of the other staff members about it and they threatened me with making my stay involuntary if I questioned anything or tried to report the psychiatrist again.
After I finally got to leave the hospital I had nightmares about the place for several weeks. I left it in worse shape than when I went in.
— Erin Bouck
I made hundreds of calls this year asking for help while my 34-year-old schizophrenic son, who also has diabetes, was missing for three months. I kept hearing "no" from everyone in the system.
In the first six weeks my son was missing, I had not been allowed to file a missing person's report, which can include a person's medical and emergency contact information along with instructions to get the missing person to an emergency room.
I told police and designated crisis responders about the missing Indigenous persons law, and that my son and I both have tribal ID, and was told, "Well, I suppose we have to try to find your son now."
I was traumatized on how we were treated and neglected despite begging for help. This experience taught me that my son's medical care for schizophrenic decompensation is not a priority call. I was humiliated.
— Andrea Boyd
I spent seven days in my local hospital's care due to issues surrounding sexual assault.
The psychiatrist in charge of my care had decided that I wasn't sexually assaulted. He instead forced me to talk about my childhood and created information that did not actually occur. He wrote a fraudulent diagnosis on my discharge paperwork.
I could not leave. I could not refuse participation. I could not simply tell my story and get the care I deserved.
— Abby Gustchen-Reeff
As a former designated crisis responder (DCR) of 25 years, a typical case starts with a brief call noting the crisis. A DCR evaluates and consults only about the presenting crisis.
We are the home-plate umpires of the crisis baseball game. Others in the system do not have the skills, jurisdiction or access to resources. Often, they do not want the anxieties or liabilities.
The presumption is we have the magic to make things copacetic. For DCRs, rarely is the client horrifying. Horrifying is the lack of integrity, resources and commitment to those in need of compassion and grace.
— Tim Justice
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