This was a great, informative video. Many people don’t realize that psych patients face screening at every level of care. Where I live, the wait list to see a psychiatrist is about 4 months on average, and so they can afford to be picky about which patients they see. They might reject a potential patient for addiction issues, “undesirable” diagnoses such as Borderline Personality Disorder, medical comorbidities, bad or no insurance, being on disability or seeking disability paperwork, and many other reasons. If you’re under 18 or over 65, you have very few options in the first place.
Inpatient psychiatric hospitals also decline patients all the time, claiming they can't handle certain disorders. Developmental disability, autism, complex medical needs. If the patient presents with any sort of aggression toward others, finding a bed gets much harder. They say they’re not equipped to meet the patient’s needs. “He needs a specialist. He needs xyz facility [that is already full].”
As a result, many patients get stuck in emergency rooms for days while they wait for an inpatient bed at a hospital willing to take them. This puts pressure on emergency rooms and contributes to their dislike of psych patients. It also puts pressure on law enforcement officers who arrive with patients under psych holds--often they must stay with the patient in the emergency room until a bed is found.
There are some efforts to bridge the gap between outpatient care and inpatient hospitalization: Crisis stabilization units, partial hospitalization programs. But in most places, they aren’t adequately funded.
Jan 13, 2022·edited Jan 13, 2022Liked by Freddie deBoer
One option that I am recommending to no one but that I have seen/experienced first hand is to use the alcohol and drug detox system as a way in. There you present with a "regular" medical problem that has you in safe lockdown for about a week. Once the detox is done, they will ship you out. The types of places vary widely, but at minimum the doctors there are familiar with psychiatric issues, and you can get some sort of support for follow-up.
Our system sucks, but that approximates the "third way" you mention.
"Get Some Help" is Often Necessary, Sometimes Unkind
This was a great, informative video. Many people don’t realize that psych patients face screening at every level of care. Where I live, the wait list to see a psychiatrist is about 4 months on average, and so they can afford to be picky about which patients they see. They might reject a potential patient for addiction issues, “undesirable” diagnoses such as Borderline Personality Disorder, medical comorbidities, bad or no insurance, being on disability or seeking disability paperwork, and many other reasons. If you’re under 18 or over 65, you have very few options in the first place.
Inpatient psychiatric hospitals also decline patients all the time, claiming they can't handle certain disorders. Developmental disability, autism, complex medical needs. If the patient presents with any sort of aggression toward others, finding a bed gets much harder. They say they’re not equipped to meet the patient’s needs. “He needs a specialist. He needs xyz facility [that is already full].”
As a result, many patients get stuck in emergency rooms for days while they wait for an inpatient bed at a hospital willing to take them. This puts pressure on emergency rooms and contributes to their dislike of psych patients. It also puts pressure on law enforcement officers who arrive with patients under psych holds--often they must stay with the patient in the emergency room until a bed is found.
There are some efforts to bridge the gap between outpatient care and inpatient hospitalization: Crisis stabilization units, partial hospitalization programs. But in most places, they aren’t adequately funded.
One option that I am recommending to no one but that I have seen/experienced first hand is to use the alcohol and drug detox system as a way in. There you present with a "regular" medical problem that has you in safe lockdown for about a week. Once the detox is done, they will ship you out. The types of places vary widely, but at minimum the doctors there are familiar with psychiatric issues, and you can get some sort of support for follow-up.
Our system sucks, but that approximates the "third way" you mention.