Mentally Ill Adult Child

From our very first experience with the County funded Mental Hospital, it was clear that uninsured mentally ill patients receive poorer quality care than those with insurance, or better yet, those who may have private funding. Since our son is an adult, he is ineligible to be included on our medical insurance, he was unable to work so he had no insurance from a job, and we are a family with two working parents, and still just making ends meet. Paying for his care would have bankrupted us in about a week. When my son was 20 and had his first recognizable psychotic break, and he was committed to the County Hospital for the uninsured, which is about 45 minutes from our home, we found it to be a dirty, outdated facility, where violent patients were left in the common area with all other patients; while the hospital less than a half mile from our home is newly constructed with the very best doctors and facilities - if you have no insurance, you don't get in there. My son was given the misdiagnosis of schizophrenia after spending only about a half hour with the psychiatrist. Upon release he was given no more instructions than to report to the county mental health clinic once a month, and was given a handful of prescriptions. We brought him home knowing nothing about how to care for a person with this illness, and calls to his hospital psychiatrist were endured with some patience, then we were reminded that our son was no longer a patient there, so they couldn't help us. The hospital psych social worker did absolutely nothing to help us, or to help him with follow up care - which really is part of the job. The county mental health clinic was about an hour from our home, it was filthy, and smelled of urine, where the patients and families sat in an overcrowded waiting room for up to an hour at a time. When it was his turn, his new psychiatrist spent 10 minutes each month to check how he was doing and to make sure his meds were right. He was constantly overmedicated, and this psychiatrist never thought to question his diagnosis. We had a totally drugged adult mental patient on our hands, who was not getting meaningful help, or improving in a meaningful way. It was as if we were now supposed to warehouse him in our home. We were doing our best to learn about this illness, while trying to find out about programs or additional help for him. His case worker was overworked, underpaid, and unqualified for the job of helping my son. When I learned of programs in our area for people like my son and brought the ideas to her attention, she actually had never heard of them. Trying to get medical assistance to pay for his many, very expensive medications was a whole other maze which seems designed to be so user unfriendly that people would just give up. His case worker knew nothing about it either. I finally made enough noise to get another case worker, who was qualified to help a patient with the intensive needs my son had at that time. She was also overwhelmed with cases, and proved to be of very little more help. And when she got a new job, my son slipped through the cracks and was not assigned another. After over 6 months of this, daily traumas, living with a person with such a fragile mental state, often delusional, paranoid, disruptive to say the very least, and no help in site, we decided to take him to a private psychiatrist, even though we could not afford it. It had become clear that the county doctor was too overworked to spend quality time helping my son. The private psychiatrist immediately recognized that my son is not schizophrenic. This was a relief, because his prognosis improved greatly with this news. But we lived with that diagnosis and stigma for all that time while he was being treated for the wrong illness and was so overmedicated that the first job of the new doctor was to begin to taper off all of the incorrect meds, and get him on the correct ones. By now he was addicted to a couple of drugs and this complicated things greatly. He has been in and out of crisis residence, rehabs, hospitals, and recovery houses. But his county insurance will only pay for 3 weeks at a time, which is long enough to 'stabilize' him, but never long enough to allow for lasting changes. There is excellent help for people like my son if they have money to pay for it, or private insurance. My son has been in some of these exceptional facilities, but again, with his county insurance, he can never stay long enough. I have met truly caring, truly qualified, truly compassionate workers in all of these places and agencies, but the funding is not equal to the need. There are far more mentally ill people in need of help than there is help available. The difficulty of getting any help is so limiting. I believe this is a cost saving feature. How many homeless mentally ill patients do you think have internet access, or even phone access? Or transportation to get themselves to the facilities and agencies even if they know where to go? These people roam the streets in a state of hopelessness, because the funding is not available to help even a fraction of them. The homeless shelters are full! Did you know that? There are few open beds, and only when it is very very cold or hot do they have to take in anyone who wants to seek shelter. And many of the shelters are dangerous places where theft, threats and violence are common. We have all heard people say that some homeless people choose not to be in shelters, they choose to be on the street. But peopel who say this don't really grasp the reality of the choices. Given only those two choices, it often seems to them to be the better choice to remain out of the shelters, that's how bad it is. These people often turn to petty crime, drug possesion and theft, out of hopelessness, poor judgement due to thier illness, and drug addiction which is quite common among mental patients. Many will end up warehoused in prison, where no doubt they will become more ill, often easily victimized, and will emerge into society with less potential to be productive citizens. Adding greatly to the problems of getting help are the laws meant to protect patient rights. We give mentally ill patients the right to choose what help to accept, even when they are obviously unable to make wise decisions about their care. Only when they become violent does the law provide care if they do not ask for it. I understand that people have and would still abuse the right to 'put away' people who may not deserve it, but the current protection they enjoy is not helping these patients in many cases, it hurts them, and many other people who care for them. Right now my son has an Intensive Case Manager, a very good counselor, a good psychiatrist, and uses a comsumer center for patients like him, where they recieve guidence and other kinds of help - all county funded and all working together. After 2 1/2 years since his first hospitalization the layers of the system are finally peeling away. My son is currently on a long waiting list for a Community Rehabilitaton Residence, commonly known as a 'group home'. There is far more need for these facilities than there is funding to run them. Being in such a program is the best hope for young adults with mental illness, where they can be professionally supervised, treated, and taught how to rejoin society. Without more funding and acceptance of these homes, many more of these patients will end up on the street, or in prison, or unfortunately for some, dead. I can't see the future for my son, by the time he is considered for the program, he may no longer be in a well enough mental state to be accepted. His future could include becoming a model patient in the CRR program and learn to have a 'normal' life. Or there may not be enough help for him, and others like him, and his outcome could be less optimistic. When the laws were changed some 30 years ago to protect mental patients from being warehoused in sometimes deplorable conditions in sometimes cruel facilities, this liberated many people who undeservedly were virtual prisoners. But this was also a cost saving measure, because there is no profit in treating mental patients. It is a costly endeavor. But these are some of our society's most vulnerable members, who we relagate to the streets to beg and steal and sleep in filth. It is true that a society should be judged not by how it's privileged citizens live, but by how that society cares for those who are most needy and vulnerable.