mental health system | crisis intervention
My friend who, a few weeks ago
, was losing touch with conventional reality and spending more time in a parallel one, ended up in a psyche hospital last Friday. Although he was a client of what is known as an ACT Team
they really had no involvement in his going to an in-patient setting.
Although he had provided the community provider agency with the proper consent [in writing, authorizing I could speak to them about his situation] three weeks ago the ACT Team Coordinator [the boss] not only refused to talk with me, but refused to even listen to my observations outlining my friend's increasing fragile mental state. ...and he slammed the telephone down. End of discussion.
In frustration and alarm, I got in touch with someone I know who works at a state agency who agreed to intercede with the ACT Team coordinator's boss. This led to a week-and-a-half of back and forth calls that involved neither myself nor the Coordinator nor my friend. "What does Will want
?" was the weak defense.
Stupid me, I though what I wanted was pretty obvious. Namely, for staff who work on what is supposed to be a "...24 hours a day, seven days a week...
" basis with and on behalf of people who experience "...debilitating symptoms associated with mental illness... and to minimize or prevent recurrent acute episodes...
" and to aid in avoiding unnecessary hospitalization.
Now, this ACT Team doesn't have an attending psychatrist, whose job would be to assess how well a multi-medication regimen might be acting for someone to minimize or blunt the severity of psychiatric symptoms. They haven't had one of over a year. They have a prescribing nurse. Not that I have any disagreements with the nurse, but presumably a psychiatrist ought to know the finer points of psychopharmacology more so than a nurse.
And this ACT Team doesn't make daily stops to my friend's house, either. The agency has sub-contracted that obligation out to a home-visit nursing organization. The staff from that place see him, maybe
, 10 to 15 minutes a day.
Point being, the staff who are legally and clinically assigned to treat this man on a 24/7 intensive involvement basis, spend hardly any time assessing his condition. And they are this lax about these things when working with a man who has never been shy about speaking his mind; when working with a man whom the Agency staff know has a friend who is well connected AND whose job is to investigate neglect and abuse cases.
What do they do with their less connected, and possibly even more symptomatically compromised clients?
There's more... that's for the next post.
Labels: crisis intervention, mentally ill, social comment, social justice