Committing ourselves or a loved one into a mental health facility is frightening. We remember movies where mental health patients run amok, rock uncontrollably or froth at the mouth. Pills are forced down seemingly unwilling patients and half of them don't seem to know why they are there. Doctors and nurses who see this every day can seem unsympathetic. And stories like the recent death of a Jamaican mental health patient who was left to die on the floor of a hospital strike fear in all of us.
On the other hand we see celebrities checking in and out of mental health facilities like hotels! Some for a day or two, some for an hour! One minute they are seeking help, the next they are downing shots at a bar and having their picture taken by paparazzi.
Is it all this crazy and chaotic? Where is the happy medium in this?
The happy medium is actually a lot more common and actually a lot happier at times than the dramatic spectrum we might imagine when we have not been affected by mental illness, or the facilities that can help.
It's estimated that 6% of Americans suffer from a serious mental illness (ranging from major depression to schizophrenia, from bipolar disorder to borderline personality disorder and many others) and about 25% of American may suffer from some kind of mental illness - many not diagnosed or treated.
There are private and state run mental health facilities where some people may receive treatment for free - depending on their circumstances and others use their health insurance (often times until it runs out and they are forced to leave since it can cost upwards of a thousands dollars a day). It would be foolhardy to say that all mental health facilities are warm and cosy. Some are inviting and some are downright cold and dreary. But most see their patients leave in a better state than they came in. Unfortunately, I don't include our homeless in this category - all too often they are discharged to the streets to be recommitted again a short time later. A never ending cycle that appears nowhere near ending.
To be committed voluntarily, a person is evaluated by a team of medical professionals, from nurses to psychiatrists and evaluators. It may start with the person simply visiting a doctor's office or presenting him or herself at an emergency room. Certain criteria needs to be met - that the person requires help, that he or she has a mental illness of some kind and that he or she can respond to treatment. Medication is often used and then combined with group and/or individual therapy until mental health professionals feel the patient has the skills necessary to return to the outside world, usually with out-patient therapy recommended.
As for involuntary commitment, it is lesson common these days than before, when patient rights were often deemed unimportant. Most involuntary admission are when a person is shown to be an immediate danger to themselves or others, is incapable of taking care of themselves on the outside and showing signs of serious mental distress. Family members have had to bring doctors letters or even a letter from a judge to force commitment, although in the case of homeless persons (who have very high incidences of mental illness), they are more likely to be held without these criteria.
A stay at an in-patient facility can vary from 24-72 hours to 120 days or more. Factors for length of stay include insurance and payment, as well as how much help the patient requires.
Does inpatient treatment work? It depends on the kind and severity of the illness as well as the patient's commitment to recovery, and his or her support system on the outside. Continued medication and therapy, sometimes for life, is necessary at times. Patients with depression (including post-partum depression) have seen fantastic recovery results, as have patients with schizophrenia, although continued lifetime medication is often necessary.
Seeking help in a mental health facility is no different than going to a hospital with chest pain. There is no shame and no blame. Mental illness is very common in the United States and people suffering should expect the same expert care as anyone who needs to see an internist with a physical illness. One place treats the body, the other treats the mind. And both deserve the same care and respect.
For more information on mental health and commitment procedures, see the National Alliance on Mental Illness at www.nami.org
And tell us
Have you or a loved one received in-patient care to a mental health facility? How was the experience? Did it help you (or them) more than out-patient care?