An Atrocious Mental Health System

“We have an atrocious mental health system,” someone once said to me, followed moments later by, “We’re going to require psychiatry of you.”

My, you make it sound so attractive. 😉

Unfortunately, it’s a very true statement. Some areas are better than others. I feel badly for people living in Texas. The care given for the mentally ill is done at the same place as the care given for people with developmental disabilities. It is known as the Texas Department of Mental Health and Mental Retardation: https://www.tshaonline.org/handbook/entries/texas-department-of-mental-health-and-mental-retardation. With all due respect to everyone involved, it’s not the same thing. This is only my opinion, but it’s incredibly disrespectful to all parties involved. Not all persons with developmental disabilities have severe mental illness and many with mental illness are incredibly intelligent people. And offering services for both from the same agency contributes to the stigma on mental illness.

I’ve been involved with the public mental health agencies for years (until I recovered from FD and BPD), and at times, fairly intensively. And much of it was not helpful, some of it is on me for not being honest with them, but not all of it. You sacrifice a lot of privacy in so many areas of your life. On a disability, it is difficult to afford to find a place to live where you can afford to pay the rent, so you’re frequently in public housing. I had to give them my bank statements. At times, the housing came from services offered by mental health agencies. The good part is having a place to live, and help you do need.

But often, I felt like I had little to no control over my life. When you are living in housing offered though both HUD and the mental health center, they are involved in nearly every aspect of your life. I’m no longer angry or resentful. But a boundary is where I stop and you start. So there were few, if any, boundaries. And sometimes though services are necessary, they are not of the best quality.

When I lived in Washington state, most of the time, I was in housing that was funded through HUD and administered by the mental health center. And I hated it. But I had no place else to go. But around 2003 or 2004, I was told I made too much money (on a disability of about $600-700 a month). I no longer qualified for Medicaid. Well, I had to meet what is known as a spend-down. For a time it was only a few hundred bucks a month (still a lot of money when it is supposed to come straight out of your pocket (on $600-700/mo). In 2012, that spend down was $1200/mo when I only made $921 a month. And Washington state is a very expensive place to live (wore now than it was back then though). So I had no access to any mental health services. Not that it stopped anyone from telling me I should go.

When I was dying (for real) of a severe dental infection, and weighed about a hundred and twenty pounds at six foot, told me with a dismissive wave “I know how to fix this! Go to mental health and take your meds.” And denied the Medicaid that would have allowed me to go. Medicare doesn’t cover dental, few, if any take Medicaid and I had no money.

Meds were mostly what rotted my teeth (so did neglect and pain meds, but my psych meds had the biggest effect), I didn’t want them and they hadn’t even helped me much over the years. It also wasn’t going to fix the fact that unless the teeth were removed, I was going to eventually die. I was turned away from the teaching hospital in Seattle because I had no ability to pay, and lived in the wrong county-or so they said. But then they turned around and treated the buddy of a close friend. Their problem with me wasn’t that I lived in the wrong tax bracket. It was that I had a mental illness-the atrocious mental health system is so closely tied to the fact that there is a huge stigma on mental illness.

The only thing I can say is when you’re dying of a dental infection, it is not pretty. And it is accompanied by an indescribable amount of physical and mental suffering. The burning used to feel like it was coming from inside my head, and it was intense. And I could not even afford to see a therapist at the one place who would see me without Medicaid (you had to pay cash for the visits, a percentage based on income but it was a hundred dollars a month I didn’t have. And it would have been nice to have someone to talk to during that time.

The treatment for a FD is mental health. The things I found most helpful in terms of therapy was a limited amount of talk therapy, and EMDR. The rest was Alcoholics Anonymous. And some therapy is absolutely critical for the recovery of someone suffering from a FD. Or borderline. The development of these disorders is predominantly trauma related. The sad fact is the mental health system is ill equipped much of the time to treat the cause of these disorders. I have needed EMDR for years and could not get coverage for the EMDR until more recently when I moved to a state that has (in my own experience) a generous Medicaid program that paid for it.

We have an atrocious mental health system. You’re preaching to the choir. But what have we been doing to change that observation?

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