I have written several times on the consequences of the well meaning, but misguided trend of deinstitutionalization for people suffering from mental illness. My family unfortunately just got to experience the outcome of that trend directly..Recently, a close family member experienced a sudden and severe mental breakdown. While he thankfully wasn’t threatening to harm himself or others, he was in a state of agitation so serious, he couldn’t be safely managed within a family household, though we tried. He was not capable of taking care of himself and we couldn’t keep him contained. The decision was made to take him in for professional help and evaluation..This wasn’t a situation where we could schedule an appointment and wait a few weeks to see a counselor or psychiatrist. It was acute and he needed immediate help..Our family member was taken to one of Calgary’s hospitals and we began the admission process at the emergency department. This is the only way to check somebody in during such an episode. As with pretty much all emergency departments across Canada, they were harried and backed up with admissions. It took over nine hours of waiting before a temporary bed could be found and another day in that state before a bed could be found in the mental health unit for more thorough assessment and to seek treatment options..As is typical in our health care system, the medical professionals are fantastic, incredibly hard working, and patient people doing a hell of a tough job. The problem is getting through the queue to get to them..The triage area of a hospital is by nature a chaotic and high-stress environment. It is unfair and unhealthy to keep somebody in a serious state of mental health distress in such an environment. It doesn’t do those waiting for physical medical help any favours being seated next to a paranoid, delusional person for hours either. That’s all the options we all have right now unfortunately..Canada’s monopolized, public healthcare model has evolved into a very hospital-centric model. We pack every type of specialty, treatment, and procedure into overcrowded and often poorly managed general hospitals when many of those services could be provided in specialized facilities outside of the hospital..One of those specialized services is acute and long-term mental health treatment..Calgary has a metropolitan population of 1.5 million people yet doesn’t have a single, generalized psychiatric hospital. Major hospitals have wards dedicated to secured mental health treatment, and there is a forensic psychiatric facility for the criminally insane, but there is no specialized facility for general patients..We recognize pediatric health care is so singular in nature we build children’s hospitals, yet we can’t accept there is a need for psychiatric hospitals..Psychiatric hospitals boomed in North America at the turn of the 19th century when it was noted a large segment of inmates in the prison system were suffering from mental health disorders. Facilities were built to humanely house and treat people with psychiatric disorders and initially, that’s what they did. Unfortunately, these facilities became dumping grounds for people the state didn’t want to deal with over time and funding began to run short. Conditions became inhumane and abuse was rife. In the 1950s, more than a half-million Americans were secured in mental hospitals. Canada had tens of thousands secured as well and conditions were unacceptable..The advent of chlorpromazine anti-psychotic medication was a breakthrough and a game changer. Patients who'd previously been out of control, were stabilized and responded excellently to the medication. They could have perfectly functional lives as long as they maintained their medication. Unfortunately, psychiatric patients have a bad habit of not taking their medication when not closely supervised. That's not to say they shouldn't be released, but it does mean they still need ongoing support and care in the community. .With the growing negative perceptions of mental institutions and with effective new medications hitting the market, medical professionals and politicians eagerly began the pursuit of deinstitutionalization. .Deinstitutionalization began in the 1960s as North American mental hospitals began reducing their size or closing altogether. No new facilities were built and the remaining ones are often outdated and poorly maintained. People were turned out into the communities with well wishes, but little support. We are seeing the consequences of that today..It’s estimated today 25% of the homeless suffer from mental health disorders as do up to 15% of inmates in prisons. While we don’t like the idea of securing the mentally ill long-term in hospitals, can we keep pretending they are better off on the streets or in jail?.We have destigmatized a lot of mental health disorders. It’s time to destigmatize mental health hospitals..Extended stay mental health facilities need not be inhumane as they used to be. I assure you right now the current wards in existing hospitals are not good spots for people to reside long term..Our healthcare system needs many reforms. One big one, though, would be to decouple mental health wards from general hospitals and build facilities that can provide comprehensive mental health care services from admission to evaluation, to day treatment to secured treatment if need be. Specialized facilities can offer more effective treatment and take the pressure from other hospitals. The ward my family member is currently in has 40 beds, which I'm sure the hospital can make good use of if they were to be freed up..Committing somebody is and should always be a last resort. We need to have that option available and quickly at times, though, even if we don’t like to think or talk about it. A person can experience a debilitating and dangerous mental breakdown at any time within any family and as with any ailment, speed in diagnosis and care are critical to their recovery. .Building new facilities or expanding current ones is expensive. We can't pretend we aren't already spending the money to house psychiatric patients though. They are in our prisons, our hospitals and our homeless shelters. .I understand we want to respect people’s dignity..However, there is little dignity remaining when a person is on the streets, in jail or possibly even dead for lack of mental health treatment facilities..Had my family member not had family support, I am certain he would be facing one of those fates. .Due to a high level of spam content being posted in our comment section below, all comments undergo manual approval by a staff member during regular business hours (Monday - Friday). Your patience is appreciated.
