tag:blogger.com,1999:blog-26666124.post460373284667992205..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: A Cry for HelpUnknownnoreply@blogger.comBlogger28125tag:blogger.com,1999:blog-26666124.post-21044031149877405932011-12-19T02:07:49.444-05:002011-12-19T02:07:49.444-05:00I was admitted to the psych ward a few months ago....I was admitted to the psych ward a few months ago. It was the worst experience ever! It was basically a prison. All we could do is take our meds, go to group therapy (the lessons seemed to recycle a lot),eat, and watch tv/play card games. I could barely sleep because the workers would check in our rooms every 15 minutes with flashlights. The only cool thing about the experience was the people I have met. All the patients knew that in order to get out, we had to act happy in front of the workers and psychiatrists, not argue with them, and just basically do nothing. I didnt really want to be at the place, but they induced guilt on me about what would happen if i didnt volunteer my admittance. I was in the ward for 9 days and ive only seen my psychiatrist twice. I wish there were things to do because most of the time I ended up thinking negatively and coloring/watching tv/playing cards didnt distract me that much.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-38118072031200820932011-05-17T01:08:09.344-04:002011-05-17T01:08:09.344-04:00Sounds like they did the right thing by letting he...Sounds like they did the right thing by letting her go. Now, she won't have traumatic hospital memories to work out in therapy or a large bill to add to her list of problems. The ER visit is going to be pricey enough.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-52811292376966517642011-05-16T22:28:12.678-04:002011-05-16T22:28:12.678-04:00I think the hand-off should be better. In my heal...I think the hand-off should be better. In my health system, we would never give someone a cancer diagnosis and then hope they follow up with their PCP. We schedule the follow up appointment the same day with the patient. In fact, for breast cancer we have a special clinic where the patient comes in, watches a video about breast cancer and then sees the radiologist, oncologist, and surgeon all in one visit without leaving the exam room (the docs come to them). They leave knowledgeable about their disease with a treatment plan in place.<br /><br />ERs are rotten places to get mental health care or any kind of care other than keep-me-alive-right-now acute care. What would be better would be an integrated system that had a way to refer clients out for therapy <i>the next day</i> which dovetailed into a more permanent placement that was compatible with the patient's insurance / ability to pay. <br /><br />In a county south of mine, one group of hospitals threw together a pot of money and worked with the county to set up a suite of services for their frequent fliers in the ER. This was a CYA move on the part of the hospitals - an effort to get reimbursement. But they found that by assigning their FFs to a team that included a social worker (who evaluated support systems for the patient and their need for rehab), patient advocate (who helped the patient sign up for medicaid) and hooking them into welfare and housing services helped keep people out of the ER and basically paid for itself. By extension, a resource team that consisted of a psychiatrist, psychologist or MFT, and patient advocate would be the perfect follow up for those with mental health issues that required follow up but <b>not</b> hospitalization. They could do two to four weeks of follow up and transition the patient to regular care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-68024580120440602912011-05-13T16:18:05.440-04:002011-05-13T16:18:05.440-04:00Like "S" above, I immediately wondered i...Like "S" above, I immediately wondered if this was a suicide attempt at all. It very easily could have been self-injury/harm, which is NOT suicidal ideation. Inpatient treatment would do very little to help this issue, long-term (or short-term, depending) therapy is the way to go. Not knowing the full story it is difficult to judge how this happened, why it happened, or if this was appropriate treatment.Battle Wearyhttps://www.blogger.com/profile/01503957693970441332noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-39797607452845098332011-05-11T19:35:38.988-04:002011-05-11T19:35:38.988-04:00I think the system should do a better job of educa...I think the system should do a better job of educating people about how it all works - the difference between voluntary and involunary, the standard for involuntary, how long a person has to stay, etc. I certainly don't know how any of it works. I even read the relevant statutes for my state and I still don't understand it. I imagine that if I were in danger, I would agree to a day or two or three in the hospital, if I knew that I could leave should I change my mind. But I have no idea if it works that way.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-20752759916934353532011-05-10T22:27:07.882-04:002011-05-10T22:27:07.882-04:00I don't know, I think in the end of the day th...I don't know, I think in the end of the day the major issue is lack of resources, and the "how" problem is a direct result of that. If patient A tried to kill herself, received medical care to ensure she was in no longer in physical danger, and was no longer endorsing suicidality, then yea, I do think that the bed she would have held would better serve someone who perhaps did not yet try to commit suicide but came to the ER actively suicidal. Do you both need help? Undoubtedly. But resources are limited, and you can go home without killing yourself, even if you hate your sister and she hates you, and the second patient hasn't tried to kill himself and perhaps has the best sister in the world, but can't stay alive independently...well, it's an issue of resources. It's cruel and unfortunate, but in the end of the day life simply counts more then comfort. Comfort and stress and emotional pain can be treated and handled outpatient. Inpatient resources are limited and should go to those who are truly a danger to self or others - and in the present, not as having been either in the past.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-76421793095023515952011-05-10T19:26:42.953-04:002011-05-10T19:26:42.953-04:00I felt compelled to post my experience because in ...I felt compelled to post my experience because in showing what I felt DIDN'T work, it might show where improvements could be made, even without specifically saying what changes, it would at least show what I thought was wrong which meant I thought they should have done something different. I even say what I thought should be different at the end of my second post, but I still think posting the experience in response to your request for more concrete ideas about what to do, is an innate response to your query, because I (and it seems others) feel that explaining our unpleasant and even seemingly to us problematic care or lack thereof in one or some aspects, that I or we felt that through our experience you'd see where we thought the problem was . . . It's not too hard to imagine what could change our perceived problems. It's not like I thought through all this before posting, rather I just really FELT that sharing my experience would highlight the problem areas which is practically the same thing as me telling you what I think needs to change, although perhaps not HOW it needs to change or WHAT it needs to change to.<br /><br />Understand what I'm saying?Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-37990746124018704322011-05-10T10:10:46.133-04:002011-05-10T10:10:46.133-04:00I just want to add something for the benefit of th...I just want to add something for the benefit of the "court-appointed attorney" who posted(and those who may be inclined to think this sort of process is at all fair).<br /> Court hearings are held however all judges refuse to listen to patients and instead accept routinely the opinion of the Psychiatrist--whatever this may be. This is in part due to the fact that Psychiatry has injected itself wholly into the law and thus perverted it for the most part. Thus, judges feel obligated to operate this way, although patients in such a process are never afforded any notable civil or human rights either according to established law or according to international standards of law on such matters--that's a fact.TruthHurtsnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-66130024277609424362011-05-10T10:04:45.379-04:002011-05-10T10:04:45.379-04:00Let me see if I can post the truth without trippin...Let me see if I can post the truth without tripping your "ad hominem" and "slander" standards(eye of the beholder of course).<br /> First of all, any individual can be and are routinely admitted to an inpatient facility if someone--and this could mean anyone no matter how credible they may be in their lives or what their motives may be--decides that someone else is a "danger to self or others". No actual evidence of this "danger" is needed, and indeed, the patient is very often "convicted" without being either given a "fair evaluation" or provided with ANY rights under the applicable state statutes nor recent federal civil rights rulings. Period. Once a person winds up as an inpatient, all civil rights of that person in practice END. Some states have agencies in theory charged with protecting such rights but they routinely fail to enforce such rights and are in fact thus part of the entire hospital system. Next, the staff usually decide to at minimum "embellish"/twist the record--and often falsify the record--and this is sometimes(such as by E. Fuller Torrey, MD, a Psychiatrist who thinks these practices are "lifesaving" thus necessary)a process that is vocally advocated by Psychiatrists(and always accepted by same). So this is the basic situation we have--and this exists for the very reason many other things exist in the American Marketplace--there is a huge profit to be had by too many players(hospitals, pharmaceuticals, staff).TruthHurtsnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-22726670434225879832011-05-09T20:55:51.938-04:002011-05-09T20:55:51.938-04:00I'm somewhat confused; was it determined that ...I'm somewhat confused; was it determined that her cut wrists a suicide attempt? Personally i never cut on my wrists (too visible; i injured pretty much everywhere other than forearms) but i knew plenty of girls who did, and it had nothing to do with suicide. Of course if it _was_ a suicide attempt, that would be something that requires immediate attention; i'd guessed that's what the extended conversation between the patient and the on-call shrink was intended to discover. Nonsuicidal cutting as a release also, of course, does eventually require long-term attention, as it's an indication of significant distress and lack of coping skills, but if that's what was happening, then i'm not sure i see what a hospital stay would accomplish.Snoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-82464822622977722962011-05-09T19:49:50.871-04:002011-05-09T19:49:50.871-04:00Interesting that most commenters want to tell us a...Interesting that most commenters want to tell us about their experiences. I was interesting in knowing How you think the system should work. <br /><br />RL: in this story, we did not have the impression that involuntary commitment was at the heart of the issue, it seemed the sister had come to the ER voluntarily, and I thought would sign in voluntarily if that was recommended. Since the sister did not speak to the psychiatrist, we don't know if he recommended inpatient treatment, we can assume, however, that he chose not to certify the patient as someone who was at imminent risk. <br /><br />Roy mentioned the voluntary vs involuntary issue because that often does become an issue.<br /><br />Remember: we didn't know the questions beforehand and we had no time to think about them--not even seconds. And we had very little information to go on in terms of the facts of the case.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-10915295934787873822011-05-09T09:04:26.043-04:002011-05-09T09:04:26.043-04:00Roy, what DID you say about voluntary vs. involunt...Roy, what DID you say about voluntary vs. involuntary treatment. The distinction is crucial, perhaps the most important feature of this case study. Please explain to us how you justify committing a woman against her will on the basis of "dangerousness" and especially on the basis of "disorganization" as you say in your postRobert Lindemanhttp://natickpediatrics.netnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-22062939713843807762011-05-08T19:55:20.125-04:002011-05-08T19:55:20.125-04:00They will discharge you very quickly after a suici...They will discharge you very quickly after a suicide attempt involving pills esp if you say that you were just upset and didn't really want to die even if that is a lie.<br />If you are psychotic they will keep you longer but like you said not long enough for the meds to fully start working. I don't know why anyone would talk about a hotel and a psych ward in the same sentence. Well people check into spas and hotels and not so well people get admittd to hospital. I have known people who feel crappy and think that a hopsital will admit them for a therapeutic experience but that is not what hospitals do. they are set up for crisis care and even if you swallow a truckload of pills, you can be let go very quickly once they see you are not dead. if you are dead, they will keep you in the morgue. Rule of thumb is walk around the streets naked and you will get admitted. OD,not likely. Anyhow, these places are not fun and are about the worst place to get better. They serve their purpose as a holding pen if you are a danger but no criminally so in which case you go to a different sort of jail.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-4382858745360057572011-05-08T17:35:23.747-04:002011-05-08T17:35:23.747-04:00Wow. Well written and I think, fairly accurate ass...Wow. Well written and I think, fairly accurate assessment of how it all works. My dear best friend had a serious suicide attempt a year ago - she ingested over 100 pills, combination of Tylenol, Klonipin, xanax and who knows what else. She did reach out in time, and ended up spending 3 days in the ICU with a Picc line iv in her to flush out the toxins. Then another 5 days after that in the psychiatric unit. Good support from family, friends, therapists in the months to follow. Unfortunately, she attempted again 6 months ago and was successful and I lost my best friend and it hurts to lose someone that way.<br />The psychiatric units at the hospital are always at capacity and those that have extended stays (here) seem to fall in that small percentage of patients that are schizophrenic or psychotic and have completely lost touch with reality. <br />I've had my own brief stay in the hospital due to severe postpartum depression a decade ago... it was no picnic. If it weren't for my spouse and Dr. insisting that I needed to go in, it wouldn't have happened. It was because of their insistence and support. I ache for those that don't have that understanding from family/friends. <br />It is about a 4-5 week to get into a psychiatrist here as a new patient. And around a 3 week wait with a therapist if they are any good and taking new patients.<br /><br />On my end, it absolutely sucks having a mood disorder. I hate how it affects my family and I hate feeling this way... once again, I can't imagine not having a good support system or having family members that won't advocate for me even when I don't want to be advocated for.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-39072654786502208592011-05-08T16:50:28.433-04:002011-05-08T16:50:28.433-04:00You may be right that the caller would have said h...You may be right that the caller would have said her sister had died after being released. I know I would have said so.<br /><br />I have a 16 to 17 year old high school student I teach in my biology class who was admitted to a psych unit a few weeks ago (when he was not at school) because he felt suicidal. About 2 weeks later he fell out of his seat in another class, but before he did he told a fellow student he had taken 4 sleeping pills. Emergency responders took him to the hospital, but he lied about the circumstances of taking the pills and was immediately released. Wednesday of last week, the next week, his eyes started rolling back in his head and then he started to vomit. Finally he admitted taking 15 sleeping pills and once again was taken to the hospital. I assume this time he was admitted since he did not return to school Th., Fri. (His father is angry at the teacher for suggesting the school call 911.) These 2 outcomes were at the same hospital, same student, similar time of day. If the patient does not tell the doctor they are suicidal, then I assume the doctor does his/her best to assess if the patient is a danger to him/herself or if the emergency is the result of an accident.Sunny CAhttps://www.blogger.com/profile/11451116932556227816noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-18388339671336960662011-05-08T13:32:19.614-04:002011-05-08T13:32:19.614-04:00Oh, it would have been a really different discussi...Oh, it would have been a really different discussion if the final result was that the sister did indeed commit suicide that day.<br /><br />People often have good outcomes and feel distressed with the process, and this is not unique to psychiatry.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-58012689185190104352011-05-08T13:31:04.430-04:002011-05-08T13:31:04.430-04:00SunnyCA, interesting take on it! I thought "...SunnyCA, interesting take on it! I thought "How could that happen?" was simply a question of how could someone who attempted suicide be sent home...I did assume that if the story ended with a successful suicide, then the caller would have said so, but as I said, there were a lot of unanswered questions here. The format did not allow for us to have a back and forth.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-3749525048199177992011-05-08T12:54:29.312-04:002011-05-08T12:54:29.312-04:00When I heard the woman pose the question on your N...When I heard the woman pose the question on your NPR interview, my first thought was that the suicidal sister left the hospital and successfully killed herself. Recall that she said "Why did they allow that to happen? And what would you change, if you could? ----". Allow that to happen implies to me that there was a bad result. With a good result she would not still be thinking about it. Neither of you asked the outcome. It did not sound to me as though the caller thought the outcome was good. Also, the caller's thinking her sister is intelligent is not necessarily a medically correct assessment of the suicidal sister's emotional state. Do you know anyone who thinks slicing both wrists with a razor is a great way to get attention? There is purple hair and nose rings to accomplish that. I don't understand the hospital doctor not taking sliced wrists as a suicide attempt without needing to question the sister of the patient. People who make an unsuccessful attempt are very distressed about their life, in my opinion.<br />The doctor who was assigned to me in the hospital inpatient unit did not accept Blue Cross and so I had to pay his entire $480 per session (usually about 10 minutes) in full by check. That was over $10,000 just for the psychiatrist with no insurance to pick up any part of that tab. When I tried to change doctors I was prevented from changing.Sunny CAhttps://www.blogger.com/profile/11451116932556227816noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-83482636453418434012011-05-08T11:53:56.050-04:002011-05-08T11:53:56.050-04:001) Even a luxury hotel is probably way cheaper tha...1) Even a luxury hotel is probably way cheaper than a night in a psych unit. Imagine how a patient feels on discharge with a $10,000 - $20,000 hospital bill on top of whatever illness + situation made suicide seem like a good option.<br /><br />2) Unless the "hospitalist" psychiatrists refer to their own clinic after discharge they have little incentive to manage the patient's treatment in such a way that optimizes for outpatient follow up. It's very different when you admit, attend the patient in hospital, and discharge them back to your own practice.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-43293307172104792402011-05-08T01:29:58.421-04:002011-05-08T01:29:58.421-04:00I hope I didn't alarm anybody. While I wouldn...I hope I didn't alarm anybody. While I wouldn't WANT to go inpatient psych, after some comments I've read here, it's more if I NEED to even if I don't WANT to.<br /><br />If I ever end up not going when needed, it's more about my fear of being trapped which I had long before I read anything here.Sarebearhttps://www.blogger.com/profile/09208596053319110470noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-49231861220225280772011-05-08T00:49:42.675-04:002011-05-08T00:49:42.675-04:00Some of these rules you list depend upon the state...Some of these rules you list depend upon the state you are in and the mentality of the ER and the hospital. I am a court appointed attorney for involuntary mental health commitments and in my state a good number of people get admitted as involuntary patients and forced to take meds into psych units from the ER for at least the statutory 96 hour hold - if they want to hold the alleged incapacitated person longer, it requires a court hearing. Most people are released within the 96 hours (which does not include holidays and weekends in the computation of time).Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-14933410739538244152011-05-08T00:22:59.184-04:002011-05-08T00:22:59.184-04:00It was clear that the caller, Ann, had not been in...It was clear that the caller, Ann, had not been interviewed by the psychiatrist. She relates, "And she [the patient] spoke with him for a while. And he sent her home, saying: Well, if you need me, I'm here."<br /><br />What would lead the psychiatrist to say that to the patient (we do not know whether the Ann heard the psychiatrist saying this, or whether it was the recollection of the sister)? Did he suggest an outpatient psychiatrist to the patient, but she refused?<br /><br />The model of medical care that is discussed often involves teamwork. One doctor handing off treatment to another. But psychiatry does not fit the model as well as other branches of medicine. If a patient broke her wrist she might readily accept a referral, but a psychiatric patient is different. If the caller's sister had actually had an engaged and connected interview with the on-call psychiatrist she might not at all have wanted to continue care with someone she did not know. And if she had not had an engaged interview she would be even less likely.<br /><br />It does appear that the patient did not subsequently cut her wrists again. But I find it hard to construct why the psychiatrist would not have wanted to talk with the sister.jessehttps://www.blogger.com/profile/11077223398907532291noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-24288906624325483652011-05-07T23:58:52.518-04:002011-05-07T23:58:52.518-04:00"A few days" is pretty hilarious to me. ..."A few days" is pretty hilarious to me. I got to spend four weeks, with another six as a very real possibility, based on about 30 minutes of conversation with a real doctor. Why then did they think I might need to spend 10 weeks in a locked ward? Apparently I was not forthcoming enough with a psychologist who was continually insulting me and enjoyed making me cry in public places. Stay classy, guys!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-59799089846787771002011-05-07T23:34:52.741-04:002011-05-07T23:34:52.741-04:00i tried to commit suicide in my early 20's. I...i tried to commit suicide in my early 20's. I took pain killers that I'd saved up and lots and lots of aspirin. A friend called soon after I'd swallowed the last pill and I answered the phone. I confessed, she came and took me to emergency. <br />One of the docs there asked me if I had a "headache"? He was sarcastic and rude and contemptuous. Whatever my problems at the time (now long since healed but not forgotten), I did not deserve that treatment. <br /><br />I hope young docs are better prepared to handle emergency psychiatric problems. I would hope they would at least delve deeper. <br /><br />Mental health problems should take the same priority as other health emergencies.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-37254672228818340502011-05-07T22:40:01.440-04:002011-05-07T22:40:01.440-04:00I don't want to discourage anyone from getting...I don't want to discourage anyone from getting help. Even if a psychiatry unit in a hospital is not a fun or restful place, a few days there to have some distance from stressors, to maybe get a change of meds, to reflect and stabilize, is a whole lot better than being dead for eternity. <br /><br />Sometimes even just the conversation/evaluation with the ER staff is enough to help a person regain their composure, come up with a plan, and regroup.<br /><br />But it's not about fun, it's about survival.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.com