The Real Mental Health Crisis 2022
There are publications and news articles floating around the nation about mental health. There are movements that have changed how society should see mental health. Some changes had a positive effect and some had negative effects on the public. All of it had some sort of butterfly effect that were unexpected.
In many ways, the healing arts of the mind have changed to more holistic methods than the scary movie scenes we grew up watching. Our current issues really derive from insurance coverage and government funding on mental health. There isn’t much financial support from either. We think they know that mental health is a life-long expense that can’t be acutely solved by medicine or self-care.
Mental health is still an unsure deal in current medicine. Many of the medications on the market today have some major irreversible side effects such as ataxia and tardive dyskinesia. The holistic approach to mental health is long-term or life-long, whichever way you want to see it. There is no ‘cure’ for mental health issues.
In healthcare, we see mental health like a block of swiss cheese. A cube of many holes is an example used to describe an issue that has many causes. As if life could make it any more difficult, these causes aren’t easy to solved and often require life-long management to control it’s growth.
More and more people are coming to the hospital with mental health problems as a secondary issue (beyond their broken arm or diabetic ulcers). Many are hostile, physically violent, or demented. There is no way to immediately control this without suggesting restraining and giving sedatives. To the public, this is barbaric. To the families of these patients, they don’t like that but also don’t want to be caretakers of these patients (likely because it takes a lot of work and an occasional beating from this kind of patient). The governments (federal, state, local) push the responsibility onto the healthcare facilities to take care of these patients. Where do these hostile and aggressive patients go if not flooding into the acute care setting?
The hospitals are really into solving problems, life-endangering problems. Problems that have short-term solutions are the jazz of hospital staff. You got Atrial Fibrillation? We got Xarelto, Cardizem, Heparin, and Lovenox. You have an infection? We got Vancomycin, Zosyn, Rocephin. Broke your arm? We got gear to put it back together. What we don’t have is the patience to work with long-term mental health issues…because there isn’t a fix for it. A mental health patient in an acute care setting is like a fish outside of water.
Let’s talk about insurance and mental health now. Did you know that some hospitals have a “Neuro Unit”? Obviously that is where stroke patients and other nervous system diseased patients go to, but that’s not all. They place mental health patients there. Most mental health patients are placed on these neuro units solely for one reason -Insurance. Insurances don’t cover many hospital expenses if the unit was named ‘Psych’ or other related mental health name.
Government doesn’t help either. Due to the public pressure for them to do something about mental health and the government not wanting to spend tax dollar on an endless, hopeless, burdening mental health issue, they set laws and responsibilities that burden the healthcare industry. Guardianship programs initiate, Case Management and social workers are brought in, and all these other things that hospitals legally have to do when they get dumped a mental health patient. The word ‘dumped’ is exactly what family members, nursing homes, and clinics do to this population. Often times, these legal things aren’t what the patient wants, but this system was created by the public and pushed the financial burden to hospitals.
As a nurse, I’m okay that hospitals are spending their loads of money on patient care. But working at the bedside, I see patients suffer from the red tape and bureaucracy of this system. Some patients wait months in their hospital room and then leave AMA (Against Medical Advice) because it takes so long to solve housing, scheduling caretakers, home health, financials, insurance coverage, etc. Some enjoy hospital care since they have more attention than the freedom the outside world would give them. This burdens the staff that take care of these volatile patients.
What solutions are there for this in 2022? Do we give patients their decisioning power if they have poor mental health? Do we discharge them to the outside environment when they have no place to go? Each mental health case is different, but yet we put them through the same hospital bureaucracy that the public put in place. Are we forcing nurses, doctors and other people to take care of violent mental health patients? At what point are we putting too much responsibility on healthcare professionals and not enough on the family, patient, and outside clinics?
As the count of mental health patients rise and the lack of real headway on the management of these diseases stay the same, there will be a point that caretakers will stop working as caretakers. They will refuse to work in the industry as a whole and the industry will have a harder time retaining staff. The pressure will come back onto the public to start taking care of their community. What do you think?