Help Fix Our Broken Mental Healthcare System.

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The current system for hospitalizing a mental health patient in Massacusetts during a psychiatric emergency involves calling the police for a well-being check or a Department of Mental Health Crisis Team for an evaluation, if the patient is a DMH client. The police can "section" the patient involuntarily with a 72-hour hospital stay, if the patient appears to be a danger to himself or others. Often, these decisions are made quickly by professional individuals who are not familiar with the patient. The patient will sometimes deceive others into believing they are well when they are not well. Often they are set free. The DMH Crisis team needs approval from the patient's psychiatrist before transporting the patient to the ER. Because of delays in communications due to heavy caseloads, many times the patient does not receive the care he needs. However, once the patient IS transported to the ER, his/her condition usually worsens, especially if the patient is manic or experiencing a psychotic break. Inside the ER, each mental health patient is isolated in a tiny cubicle containing a gurney and nothing else--no TV.  All of their personal belongings are taken away, including cell phones. The patient will remain in this environment until an available hospital bed is located and accepted by their insurance. This could take up to 4 or 5 days, or even longer, as the patient grows more agitated. Whether or not the patient receives medication depends on communications with the healthcare provider, and whether or not the patient agrees. They have the right to refuse. The mental health system has many flaws, and this is a huge one. The ER doesn't work! Everyone involved knows it doesn't work, as I have spoken to many DMH workers, hospital personnel, doctors, emergency services employees, and patients themselves. Yet, this protocol continues. The mental health patient deserves better care. The ER is not the place for them. It is isolating and degrading to stick someone there for days on end with nothing but the Johnny they are wearing. That would be difficult to endure for someone without mental health issues. Patients in crisis need to be taken to a quiet and supportive environment, such as the office of a specialist who is skilled in handling the situation, and then transported to a hospital, if necessary, to eliminate the horrors of the ER experience. The reason I care is because I am the mother of an adult son with severe bipolar disorder and psychotic tendencies. He has had seventeen hospitalizations during the past seven years, and they have all involved ER visits. He has relapsed on his medications, but all they do is add more drugs and send him back to his group home where he is free to come and go as he pleases. He has gotten lost in his own neighborhood at 2:30 a.m., has been confused about his name and birthdate, has spent all his money leaving himself without rent money, walks around talking to himself, and yet he remains free. I worry something bad could happen because he has no filter when he is psychotic. I broke down and begged his doctor to hospitalize him so my son can get shock treatments, which help stabilize him. But they just keep increasing his meds and hoping he will get better. I know it takes months for my son to get well. So my husband and I live day by day, and go minute by minute. My son calls numerous times telling me things that do not make any sense, and insisting he is not sick, has three wives and three daughters (he's never been married and has no children) and all kinds of other madness. So we wait. His doctor will consider outpatient shock treatments, but there is a mountain of paperwork to do and insurance to deal with before that can happen. And so we wait some more. I am continuously on the phone, but I get nowhere. I know I'm not the only one in this tortuous position. I want my son to be safe. I don't want to look back and wish I could have done more for my son. 



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