I Wrote a Letter: A Missive on Mental Health

I\’ve come to understand more and more that getting health care is not for the faint-hearted. Instead of the system getting better, it\’s become more complicated, scary, and less caring than ever.

Remember the neighborhood or \’country doctor\’? If you\’re on the younger side, you might not have had the pleasure and pain of such a person, but for those of us a bit longer in the tooth, it was nothing to pick up the phone and call your family doctor (called that because they likely had been treating every ailment in the personage of every local relative for generations) at home for anything from asking for an eye exam to pulling out a splinter to checking for a heart murmur to delivering a baby to dealing with chickenpox to … everything.

Now, we have medical conglomerates. Need an eye exam? Go to an eye doctor. Wait: you have cataracts? You can\’t go to an optometrist, you need an ophthalmologist. Your child needs a physical to play sport? Fill out this form and we\’ll have a nurse practitioner or physician\’s assistant meet with you.

I don\’t mean to say that any of those professionals is a problem specifically.

The system is broken.

I just sent a message to Senators Menendez and Booker, who are politicians in my home state of New Jersey. According to the website I quoted, nearly 3.1% of adults in the Garden State are dealing with a serious mental health issue of some sort. Services are there, but only if you fit in this teeny window. Are you older and have physical ailments? You might not qualify for in-patient medical services because most facilities don\’t handle the body and the mind at the same time.

I know what you\’re going to suggest: what about the hospital? [Fill in the name of your facility of choice here] Hospital also has an in-patient area.

Sure, but here\’s the thing: if the person doesn\’t have insurance, or doesn\’t have the right insurance, or has a physical issue that precludes them from caring for themselves (like if they can\’t get up and walk to a bathroom or if they are not willing to take certain medical treatments because, ya know, they are in a mental health crisis), they can\’t be sent there.

And before you say it, yes, there are mental health facilities that have medical beds.

Most of those places only have one or two, maybe five beds, which are filled.

Long-term nursing facilities don\’t all have the mental-medical combo either, and if they do, it may be for a specific challenge, like Alzheimer\’s only, or there are only a few beds available — again, all of which are taken.

As I explained to the Senators, that means the person is either too medically sick for in-patient mental health or to mentally sick for a traditional facility, but not mentally sick enough for a state hospital and by the time they get to that point, they are too medically sick to live. Add age on top of that and you\’ve got nearly every layer of Dante\’s Inferno, right before your eyes.

And there we are.

The only alternative seems to be to provide \’comfort care\’, where medications are given to keep the person from feeling pain while they leave this existence.

In this place that many proudly call the land of the free and the home of the brave, how does this happen? Why is no one talking about the individuals and families who are dealing with such red tape, day in and day out?

The individuals, the families themselves are likely tired, afraid, sad, and overwhelmed by the horror.

I know I am.

And it could happen to anyone, anywhere … not just people in New Jersey.

It could happen to me, to you, to someone you love.

Are you sure it can\’t? I hope you are, because I know it can. It\’s happening right now, which is why I wrote the letter. It isn\’t happening to me but it is happening to someone I love and there\’s nothing else I can do right now but watch and wait.

But you? You can investigate what it\’s like in your area and in the places where your loved ones live. Write letters, make phone calls. Do it before it\’s too late for you or for them.


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