WHAT IS MISSING IN THE SYSTEM?

      Recently, I was hospitalized and since have been pondering what is missing in the formal mental health care system.  I was in a personal crisis when I decided to see if the hospitals have changed in the last 18 years since I was incarcerated the last time.  Indeed, I was willing to go in open-minded and see for myself.   My husband and I waited for hours in a grubby little room at outpatients and noted that a man with chest pains was immediately rushed in for treatment. The first lesson was that a mental health crisis is put on the back burner compared to other diseases.  After seeing the psychiatrist, I was processed and put in the belly of the beast.  My personal belongings were rummaged through and all my pills were confiscated.  I was feeling violated, but still entertained the possibility of getting help.

      The thing that came next was a shot in the butt.  This, I was told, was supposed to help make the withdrawal from antidepressants smooth and painless.  For the next 72 hours I was supposed to sleep.  It didn’t quite happen like that though.  I lay on a lumpy bed and was given so many doses of Zyprexa that my restless leg syndrome made me pace the halls in physical torment.  I found myself treated like a bad child and subjected to silly, inconsistent, and petty rules.  Although I am nearly 50 years old and have survived fires, floods and everything in between I was not allowed down in the hospital lobby to get a Tim Horton’s coffee.  This was supposed to be behavior modification, but what was the objective?  To make me a trained seal that flapped my flippers on command?  There was an absence of being treated with dignity and no respect for my surviving a life of so much pain.  Instead of the harbor of safety that I sought, the hospital was a police state complete with video cameras to watch my every move.

      My expectations of being hospitalized were that I would receive counseling, occupational therapy, and group therapy.  On my own initiative I went once to group therapy and to crafts, but did not receive any form of counseling. ( It was explained to me that I was too upset to get counseling).  The group therapy revealed a half dozen consumers who all said that they had no hope left.  It was obvious that the system was not meeting their needs, but leading them to despair.  In my opinion some common sense, compassion, and caring would have made the difference.  I have attended many consumer groups in different parts of the country and felt compassion, concern, comfort, and inner healing, however, the hospital seemed to have no soul.  The routine seemed to reduce individuals to mere cogs in a wheel.  I was not  treated like a person with dignity, but a thing to be pushed around.  Essentially, all the experience did was make me angry and outraged.  In the end I have concluded that the hospital system is no more enlightened than it was 18 years ago and a place to be avoided like the Plague.

      An American National Research Project for the Development of Recovery Facilitating System Performance Indicators sponsored by nine different states  comments that: “We must fully acknowledge that the formal system often hinders recovery through the bureaucratic program guidelines, limited access to services and supports, abusive practices, poor quality services, negative messages, lack of ‘best practice’ program elements, and a narrow focus on a bio-psychiatric orientation that can actually serve to discount the person’s humanity and ignore other practical, psychological, social, and spiritual human needs.  At the core of such hindering forces is the operationalization of society’s response to mental illness, that of shame and hopelessness and the need to assert social control over the unknown and uncomfortable.” 

     This same National Research Project which I found on the internet ( www.namiscc.org/ Recovery/2002MentalHealthRecovery.htm) points out that recovery for consumers/survivors points to many universal components, some of which the system could help provide if it had the will.  Those who have material resources such as a livable income, safe housing, healthcare, transportation, and a telephone do better than those who live in poverty, and a lack of basic resources.   Attitudes of fear, shame, lack of personal responsibility, self loathing, and invalidation impede recovery, whereas recovery chances are boosted if the system encourages self-reliance, personal resourcefulness, self-advocacy, choices in treatment and a holistic view of health.

      Some personal traits that should be encouraged by mental health professions and are vital to recovery are attitudes of purpose, faith, expectancy, and finding meaning in one’s illness.  Also, persons who got well had goals, options, spirituality, and role models.  The belief in recovery itself is also very important in wellness, whereas the formal mental health system focuses on illness.  Also, consumers/survivors do better when

they don’t have to relate to detached professions or a different professional every time they seek help. Consumers/survivors do better when they can relate to someone who cares about them.  This is where peer counseling and consumer groups can help as well.

     The National Research Project says that the mental health system needs to have a new paradigm based on the following:

1.      mental health services should be recovery enhancing respecting the patient’s life experience and expertise.

2.      People should be empowered by gaining control over their lives and involved in the consumer movement

3.      Holistic treatment in which a person is seen as more than a disease should be implemented

4.      there should be an emphasis on hope, positive mental health, and wellness

       instead of just biochemical imbalances and medication

     While the hospital and formal mental health care system provide the expertise on medication, it is largely up to the individual patient to work on getting well.  Social connectedness, and feeling part of a community are key components in recovery and left to the individual to work on.  Finding role models is important as well.    In the United States there are safe houses where a person in crisis can talk to peer counselors.  I would like to see the day when that happens in Canada.   It would be ideal to build a center where the mentally ill could get both medical advice and also be able to talk to other consumers/survivors who could give us hope and encouragement.