Psych
First, some background: In the 1980s the country's services for psych patients were dismantled by the Reagan. We used to have long-term care and services available for our mentally disable citizens. What is available now is not good for the patients or the taxpayer.
Here's how it works today: Somebody becomes psychotic. They go to the local Emergency Department (because that is their only option for immediate "care"). The medical staff (MDs and RNs) "medically clear" the Pt. This basically means that we make sure they do not also have any medical issues and treat them if need be. If they are completely out of control we will subdue them with a combination of drugs and possibly physical restraints if needed.
At that point they enter the psych system. They will wait anywhere from 1 to 8 hours to be evaluated by a psych counselor (usually someone with a BS, sometimes an MS). That person spends usually an hour or two evaluating the Pt then puts him/her into one of 2 categories:
A. Pt is not a danger to himself or others.
B. Pt is a danger to himself or others.
Pt's in group A go home (or to the streets more often). If they have insurance (Ha!) they can follow up with whatever psych services are provided by their insurance (Ha!). Pt's in group B are put on a 72 hour hold.
A 72 hour hold means that you are stripped of your civil liberties and mandated to inpatient Psych treatment. Now the psych worker needs to find a place for you to get that treatment. If you have insurance, that is usually fairly easy, but if not you might be spending up to 24 hours of your 72 hour hold in the Emergency Department (essentially not getting Psych treatment).
So, you eventually get to this inpatient psych facility... For the 2-3 days you are there you will be stabilized with meds and counseling. By the end of your treatment, you will probably be acting like a somewhat normal person. Just as that happens, you are discharged as there is no more money to pay for treatment. You are sent back to whatever living situation you came from (often, the streets) where you may or may not be able to fill prescriptions for your drugs and you almost certainly won't have access to counseling.
It is almost certain that this Pt will last about 2-3 weeks out there on their own and then they will start the process all over again in the Emergency Department.
Some obvious flaws with this system:
-Emergency psychiatric care is enormously more expensive than routine psychiatric care.
-It is near impossible to keep any job when you disappear for 3 to 4 days every 2 to 3 weeks.
-I cannot imagine what a stressful and miserable life that must be.
OK, now for a story...
Here's how it works today: Somebody becomes psychotic. They go to the local Emergency Department (because that is their only option for immediate "care"). The medical staff (MDs and RNs) "medically clear" the Pt. This basically means that we make sure they do not also have any medical issues and treat them if need be. If they are completely out of control we will subdue them with a combination of drugs and possibly physical restraints if needed.
At that point they enter the psych system. They will wait anywhere from 1 to 8 hours to be evaluated by a psych counselor (usually someone with a BS, sometimes an MS). That person spends usually an hour or two evaluating the Pt then puts him/her into one of 2 categories:
A. Pt is not a danger to himself or others.
B. Pt is a danger to himself or others.
Pt's in group A go home (or to the streets more often). If they have insurance (Ha!) they can follow up with whatever psych services are provided by their insurance (Ha!). Pt's in group B are put on a 72 hour hold.
A 72 hour hold means that you are stripped of your civil liberties and mandated to inpatient Psych treatment. Now the psych worker needs to find a place for you to get that treatment. If you have insurance, that is usually fairly easy, but if not you might be spending up to 24 hours of your 72 hour hold in the Emergency Department (essentially not getting Psych treatment).
So, you eventually get to this inpatient psych facility... For the 2-3 days you are there you will be stabilized with meds and counseling. By the end of your treatment, you will probably be acting like a somewhat normal person. Just as that happens, you are discharged as there is no more money to pay for treatment. You are sent back to whatever living situation you came from (often, the streets) where you may or may not be able to fill prescriptions for your drugs and you almost certainly won't have access to counseling.
It is almost certain that this Pt will last about 2-3 weeks out there on their own and then they will start the process all over again in the Emergency Department.
Some obvious flaws with this system:
-Emergency psychiatric care is enormously more expensive than routine psychiatric care.
-It is near impossible to keep any job when you disappear for 3 to 4 days every 2 to 3 weeks.
-I cannot imagine what a stressful and miserable life that must be.
OK, now for a story...