We Are People, Too

willowbrookFor those keeping up, I’ve been in a program called Telecare for a week and a half now.  During my time here, I’ve discovered some grave issues related to the care of those with mental disabilities and decided I could no longer remain quiet about it.

I wrote a letter and am submitting it to multiple news outlets, investigative journalists, and even Michael Moore.  I’ve attached it below for your consideration.  I would ask that you share this blog post with your friends, even if you’ve never shared any of my blogs before, because until people recognize this as a genuine problem, it will never be resolved.

My name is John Wolf, and I suffer from mental illness.

There’s a certain stigma attached to those who suffer from behavioral health disorders.  For whatever reason, they’re viewed as lesser people, not deserving of the same rights and dignities as “normal folks”.  There are even some, like my own grandmother, who view mental illness as something only drug addicts or homosexuals suffer from; if you smile hard enough, everything will get better if you’re doing the right things.  The reality is much different.

According to the National Alliance on Mental Illness, approximately one in five adults in the U.S., or 43.8 million people, suffer from mental illness in a given year.  One in twenty five adults suffers from an illness so severe, it affects their ability to perform essential functions required to maintain a healthy living dynamic, such as working or paying bills.  Many of these adults are unable to find a mental equilibrium and wind up homeless.  According to the Substance Abuse and Mental Health Services Administration, roughly a quarter of the homeless population suffer from severe mental illness, as opposed to only six percent of the population as a whole.

So why do those who work in the medical field treat those mentally ill homeless as a burden or inconvenience that’s simply brushed aside?

For many, mental healthcare is simply out of reach.  Either accessibility, finances, or even simply the quality of care are not sufficient to seek professional help for their problems.  Some are even unaware that there’s a need for help.  Then there are others who simply attempt to use the Patient Anti-Dumping Laws to secure a bed and a hot meal, thereby reducing credibility towards the homeless seeking help as a whole.  Instead of individual assessments, everything is looked at through a broad lens instead of determining the credibility of one’s illness.

Many homeless were once simply discharged from the hospital with nowhere to go, having been denied care for reasons related to what I’ve described thus far.  Homeless people can’t pay their medical bills, or are simply not to be believed.  As shown in the Michael Moore documentary, Sicko, hospitals would often simply dump these patients in shady parts of town without understanding of their whereabouts or even a decent set of clothes to protect them from exposure.  Many hospitals have been sued over these civil rights violations over the years, and it seems that they may have found a new avenue to prevent liability.

Hospitals now rely on what are referred to as “transitional crisis residential centers”, which are voluntary programs with an anticipated end date of approximately two weeks.  By transferring them to such facilities, everyone from state services to private hospitals are no longer confined to the Patient Anti-Dumping Laws because they have indeed provided them a place to go.

But what are these transitional crisis residential centers?

Every program has different rules.  However, my experience with one program, Telecare (AKA Treehouse), is designed to house those who are “stable” and “not actively suicidal”.  However, many people during my time in this program that have arrived fit neither criteria, including myself.  Every doctor or clinician I’ve spoken with who has asked if I still want to commit suicide has been notified that my feelings have not changed.  More or less, as long as I don’t do it here, that’s all they care about.  Meds are routinely changed around and not given a chance to fully take effect before being changed again, thereby making one’s mental status worse.  In layman terms, imagine drinking alcohol, going from wine before beer before hard liquor within a short amount of time.  Afterwards, you’re going to feel pretty sick.  Frequent complaints of adverse side effects are ignored.  Even the group sessions that are provided offer little for one to cope with their mental illness.

Due to confidentiality agreements and privacy laws, I cannot give specific examples of other instability exhibited by other clients.  However, I can say that in my time here, I have witnessed assaults, frequent bouts of shouting between clients, and even meals forgone due to a lack of clean dishes.  The staff seem quite content in doing the bare minimum to assist, while preaching about the good works performed by the program.

One of these good works is to help those who are homeless find housing.  The help in its entirety is to hand the patient forty pages of phone numbers for shelters and housing programs, the vast majority of which are duplicates, no longer in existence, or so backlogged there are waiting periods extending months, or even years.  One of the numbers provided was even for a cult, which somehow always has a bed available.  Naturally, most of the homeless who come to Telecare are placed right back on the street.

To put this in perspective, the idea behind the Patient Anti-Dumping Laws are designed to prevent hospitals from simply kicking patients to the curb.  However, this new system allows them to skirt those laws and escape any fines/penalties, loss of funding, or lawsuits.  By sending them either directly to these facilities, or even indirectly through a county agency that holds patients for a max of twenty-four hours, these organizations can still dump the homeless right back on the street with little, if any, healthcare being provided.

But this presents one problem: not every homeless person who visits an emergency room, claiming a desire to commit suicide, is simply saying so for a place to sleep and a meal to eat.  Myself?  There’s an even money chance that I will end up killing myself within the near future.  Does it mean I want to die?  No.  But death seems like a sweet relief compared to the pain I’ve felt for my entire life, a pain that no one in the medical field seems keen on helping relieve.  And even as I talk about myself, I cannot help but feel terrible for those who are in my shoes, trying to get the help they need so they can keep a job longer than a month at a time.

Outpatient services are often ineffective at addressing patient needs, as well.  Most mental health services are now county or state run throughout the United States, and with poorly managed bureaucracy comes poorly examined results.  Most patients who attempt going through a program quit within the first five visits and are actually considered success stories because they never came back.

This country used to place the mentally ill in asylums until Geraldo Rivera exposed the deplorable conditions of one such place, Willowbrook.  However, instead of reforming the broken mental healthcare system, Democrats and Republicans threw the baby out with the bathwater and instead left a system of poorly managed programs that have had to adapt to the increased demand.  Finally, it seems, they just found a way to drive patients away, literally in a taxi cab.

We need another investigation like we saw with Geraldo Rivera to uncover the truth about mental healthcare in this country.  The homeless are treated as undesirables undeserving of the same healthcare that is afforded to the homed.  Those who need the services most are often the ones denied, discredited, and removed from one’s mind.  I implore you to research this problem, because it will only be growing as time passes and more organizations are permitted to act in such a way.

We are people, too.

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