What is the ideal model of mental health care within psych wards?

medical stethoscope and mask composed with red foiled chocolate hearts

Mental health care within psych wards, in my opinion, based on my experience and others whom I have spoken with, has a great deal of opportunity for improvement. In fact, I would personally describe the current mental health system as broken. Did you know that patients hospitalized in psych wards are 100-200x more likely to die by suicide upon discharge?

It is 2021, our eyes are open to the economic disparity more than they have ever been in the past. Yet, we still live in a world where quality mental health care is a privilege NOT a right. There is no valid reason as to why there is no minimum standard of care within psych wards on a national level that sets patients up for success rather than failure.

In the beginning of 2021, Inspiring My Generation partnered with More Than Mental Project to create a petition that addressed this. Below is an explanation of points covered in the petition.

When patients are admitted into the psych ward, many are not thoroughly evaluated.

In fact, most evaluations are a simple, standard check the box. These evaluations are commonly not personalized for the specific patient and their story or experience. This results in the professional assigned to the patient receiving only a partial understanding of the patient. Instead, imagine if the first 24-48 hours after a patient is admitted was an evaluation period where a patient is assigned a case manager who works with the 3 licensed professionals to develop the right treatment plan from the number of individual and group therapy sessions to proper medication (if prescribed), post admission treatment plan, and resources.

Patients are typically required to take a standard medication without a thorough evaluation.

As we know, medication is not a one-size-fits-all. The same medication will not work well for individuals living with different mental illnesses. The same medication will not affect every individual living with the same mental illness in the same way. For example, an antidepressant is known to cause manic episodes in individuals living with bipolar disorder. Thus, if an antidepressant is the standard medication, it can have an adverse effect on various patients. As a result, we should not prescribe medication without a formal evaluation and diagnosis. Furthermore, not everyone is comfortable with medication or cannot continue to afford medication upon discharge. Therefore, these situations should be taken into consideration prior to prescribing the medication. When a medication is started and stopped abruptly, it can create a severe adverse reaction.

Patients are not assigned an effective treatment plan during admission.

After the recommended 24–48-hour evaluation period, over the next 24 hours, the patient should work with an assigned case manager to develop a treatment plan that makes both parties comfortable. The treatment plan should comprise of options recommended by the medical team as well as be considerate of the person’s financial situation upon discharge. Thus, the treatment plan should be customized to the individual. Imagine if the treatment plan included a mix of both individual and group therapy sessions while admitted as well as resources and coping mechanisms to use upon discharge, with additional medication or therapy as recommended, prescribed, and financially reasonable. The system would be setting the individual up for success upon discharge rather than throwing them back into the fast-paced world with little to no support.

Individual therapy sessions are not typically offered, specifically not regularly during admission.

When someone is hospitalized in a psych ward, it is usually a direct result of suicidal ideation (active or passive). This is a critical time, where support is needed. Patients should receive consistent individual therapy sessions focused on exploring what led them to admission, relevant trauma from the past, and transitioning to life outside the institution / facility. Imagine if daily or every other day, patients were receiving therapy that explored their specific situation and symptoms, while creating a solid plan to transition back home.  

Group therapy sessions do not provide enough variety in a range of coping mechanisms nor are they separated by mental health disorder.

Group therapy sessions are a great opportunity to explore coping mechanisms in a safe and fun environment. However, not enough variety is provided within the coping mechanisms. In fact, patients should have the opportunity to explore a range of coping mechanisms during group therapy. Also, patients should also not be “marked off” for not attending group therapy sessions that do not feel right or comfortable for them. There should be specific groups created for specific conditions. For example, imagine if we created specific groups for individuals experiencing suicidal ideation / anxiety / depression / schizophrenia.

While admitted, psych wards should have resources that allow patients to explore various coping mechanisms.

Imagine if psych wards had a range of approved movies, books, art supplies, journals, games, etc. that are constantly available for patients to use. This would be a great way for patients to explore different coping mechanisms that may work for them and create their “coping toolbox.”

Upon discharge, patients should have a valuable resource that sets them up for success.

Psych wards should provide all patients with a completed workbook post release with the treatment plan they followed during admission, their recommended treatment plan post admission, a comprehensive list of coping mechanisms, local affordable options for therapy / counseling, crisis hotline and text line numbers, and a supportive message.

Treatment costs are extremely high. Hospitals and/or governments need to reallocate funding to allow for quality treatment.

Many patients leave the mental health treatment facility drowning in bills from their admission on top of any additional costs (such as ER visits and ambulance). If the costs were significantly reduced, this would help transitioning to life post admission more feasible and less stressful, while simultaneously encouraging more individuals to reach out for help.

After discharge, patients are thrown out into the world with no one checking in on them.

Every hospital should have a case manager that checks in with the patients on a routine basis. We recommend: a monthly check in for the first year, a bi-annual check in for the second year, and then annual check ins afterward. If the case manager feels the individual should be re-evaluated, they may call them in for a FREE evaluation appointment to see if treatment plans need to be adjusted. This creates a safety net for individuals who are struggling upon discharge and can help to reduce the suicide rate among patients discharged.

The federal or state government should reallocate more funding toward psych wards to help cover the costs of treatment.

We strongly encourage the Federal Government to increase spending on mental health and set a minimum per capita spending on mental health to ensure all states are allocating enough money toward making these improvements. Currently, we have the majority of states operating at around 1% of the total budget going toward mental health AND many insurance policies not efficiently covering mental health treatment and medications. Imagine if the Supreme Court passed legislation that requires insurance companies to cover a decent percentage of mental health treatment and medications to ensure it is affordable for ALL, not just the privileged. Furthermore, imagine if our State Governments enforced equal distribution of funds per capita to every hospital with behavioral health wards. Funding would be based on city population size and need, not based on wealth. 


Add your signature to the petition:

https://www.change.org/p/kamala-harris-mental-health-treatment-for-all?utm_source=share_petition&utm_medium=custom_url&recruited_by_id=5d2948a0-73df-11eb-9605-43c0b2a74b94

Take part in other Policy Change initiatives spearheaded by Inspiring My Generation: 

https://inspiringmygeneration.org/policy-change/

Category:
Blogs

Leave a Reply