Well, I guess this isn't likely to happen again...

[OldPsychDoc]

Another tragedy chalked up to failure in the "mental health system".

http://www.twincities.com/mld/twincities/news/local/13542788.htm

I'm betting that NO ONE with a psychiatric diagnosis is getting discharged from ER around here for the next six months. So where are we supposed to send them?

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[Doctor Bagel]

Another tragedy chalked up to failure in the "mental health system".

http://www.twincities.com/mld/twincities/news/local/13542788.htm

I'm betting that NO ONE with a psychiatric diagnosis is getting discharged from ER around here for the next six months. So where are we supposed to send them?

Interesting question. There was an article in a local paper recently talking about the shortage of mental health beds. The article was concerning Portland, OR, and mentioned that people were routinely sent to places like Medford and Roseburg for beds -- those cities are about a five hour drive away from Portland. The article mentioned that psych beds aren't profitable, so no one wants them. Isn't that a huge problem with having a mainly privatized health care system. People who need care who don't have profitable problems don't get it, I guess. Or, yeah, they get it but they have to ride 5 hours in an ambulance when they're already in a totally disoriented state.

 

[PsychFuture]

Thanks for pointing this article out. I hadn't heard anything about this case. I don't understand why Southdale didn't arrange for a transfer. It isn't up to the family to get him to Riverside.

 

[Poety]

Another tragedy chalked up to failure in the "mental health system".

http://www.twincities.com/mld/twincities/news/local/13542788.htm

I'm betting that NO ONE with a psychiatric diagnosis is getting discharged from ER around here for the next six months. So where are we supposed to send them?

Hmm, I wonder if they got an actual psych consult for him. I don't know any psych that is going to let a frankly psychotic patient leave, knowing they're degenerating, and send them home after all the med changes? Ack, if there is one out there like that, he/she really needs to revamp their "screening" criteria. jeez!

 

[pschmom1]

This makes me nervous. I have always questioned the procedure that the hospital I volenteer at has with the mentally ill. I volenteer in the ER and when someone comes in and needs a "phych eval" they are put in the "consult room" in the ER and stay there w/a security guard outside of their room for hours until someone comes to evaluate them. Sometimes this can take up to 6 or 8 hours. I have actually had a man (I put in the room 2 hours prior) grab my arm and tell me that he came their suicidal but was about to be homocidal if he didn't recieve treatment. I have heard people scream and cry b/c they are in this room w/no books or TV and no one comes in there for hours. To be in that room like they are for the amount of time they are I myself would start to feel highly agitated. Depending on their insurance and their condition they are given a rx and sent home a lot of the time.

 

[Miklos]

I have actually had a man (I put in the room 2 hours prior) grab my arm and tell me that he came their suicidal but was about to be homocidal if he didn't recieve treatment.

Simply voicing SI/HI, especially in the form of a threat is not enough for a diagnosis. Without a full eval, one can draw no conclusions.

(If I had a dime for every patient that threatened SI/HI, especially after being told "no"...)

 

[Miklos]

Interesting question. There was an article in a local paper recently talking about the shortage of mental health beds. The article was concerning Portland, OR, and mentioned that people were routinely sent to places like Medford and Roseburg for beds -- those cities are about a five hour drive away from Portland. The article mentioned that psych beds aren't profitable, so no one wants them. Isn't that a huge problem with having a mainly privatized health care system. People who need care who don't have profitable problems don't get it, I guess. Or, yeah, they get it but they have to ride 5 hours in an ambulance when they're already in a totally disoriented state.

Regarding the profitability of psych beds or mental health resources, it is easy to blame it on a "private" system (btw, the US system is far from being completely private). However, I've yet to hear of a country where there are "adequate" (whatever that is) resources for mental health (again, however you chose to define it).

 

[OldPsychDoc]

http://www.twincities.com/mld/twincities/news/13551621.htm

 

[pingouin]

http://www.twincities.com/mld/twincities/news/13551621.htm

"If (the family) is giving what sound like valid reasons, it would behoove any physician to pay heed to that," said Dr. Jeffrey Sawyer, who runs a Minnetonka practice in adult care. "Sometimes, patients can pull themselves together and look very reasonable and rational in the emergency room, even though they were psychotic before that."

Agree with the above, have seen it happen. When I did psych intake, the problem was getting the family to commit to their statements in an affidavit. If the patient had "pulled it together", we had no first-hand information that the patient was dangerous, therefore couldn't write our own affidavits. Families might express their concerns verbally, but often didn't want to be dragged into the ensuing court hearings or were concerned about the patient becoming angry with them for getting involved. After we educated the family on the process, if they still refused to put their statements in writing, we had no choice but to discharge the patient if they weren't willing to sign in.