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“Troubled minds: Discharges creating treatment backlog, experts say”

The following article was found in the September 20, 2008 Johnstown Tribune-Democrat at the following address … http://www.tribune-democrat.com/local/local_story_264234435.html

The article discusses the impact of the closure of Mayview State Hospital on community based mental health services.

Troubled minds: Discharges creating treatment backlog, experts say

By RANDY GRIFFITH
The Tribune-Democrat

September 20, 2008 11:43 pm

New fences at Torrance State Hospital’s fledgling criminal unit illustrate the official preparations for closing another state hospital, but local mental-health leaders say much more is needed.
Discharged state hospital patients from soon-to-be-closed Mayview State Hospital near Pittsburgh and downsized Torrance are given first priority in community programs.
The situation is creating a backlog, psychiatrists Larry Nulton and Burton Singerman say.
Not only do current facilities need expansion, but new intervention programs and treatment facilities will be required.
While the state is looking into those additions, discharges at both hospitals continue.
“The state is behind,” Nulton said at Nulton Diagnostic and Treatment Center, 214 College Park Plaza, Richland. “They should have had these programs and other supports before they deinstitutionalized.”
Closing Mayview is part of a 40-year program to move mentally ill patients out of institutions and into community settings, Deputy Welfare Secretary Joan Erney said.
Her Office of Mental Health and Substance Abuse Services oversees the closing, working with community-based programs and local hospitals to help continue care.
“The seriously mentally ill can live very successful lives in the community if they have stable housing, support and treatment,” Erney said.
Mayview’s discharges have raised alarms in Allegheny County, where several former patients and others treated for mental illness have been involved in senseless violent crimes.
Shadyside resident Terrence Andrews told police he complained to his doctor that he felt like killing someone before he was arrested in May for the stabbing death of 18-year-old Lisa Maas.
In June, former Mayview patient Andrea Curry-Demus was accused of killing a pregnant teenage girl and cutting an infant boy from the woman’s womb.
It was among at least seven serious incidents involving former Mayview patients that triggered investigations since the state in August 2007 announced plans to close the facility by the end of this year. The investigations led to a temporary moratorium on discharges in November, and a one-month halt to new referrals to Western Psychiatric Institute of UPMC last month. Several of the discharged Mayview patients were assigned to Western Psych for follow-up.
Western Psych was just a scapegoat, Singerman insists.
“They have blamed (Western Psych) for many deaths of outpatients who were put in personal care homes after discharge from years of state hospital care, without acknowledging that closing the state hospital led to people being discharged who were too ill,” Singerman said.
“They either killed themselves or someone else because of the severity of their illness.”
Cambria County mental-health leaders agree that community environments are the least-expensive, most-effective way to treat the mentally ill.
“I think the philosophy and the theory are good,” Nulton said.
“The state has the right model. They have researched it well.”
But it’s too slow in coming, Nulton stressed, characterizing it as a “cart before the horse.”
Local advocates are pushing for more inpatient care facilities and more extensive response teams.
Memorial Medical Center’s psychiatric units often are filled because there is no facility that can accept patients ready for less intensive care, said Singerman, who chairs Memorial’s behavior health program.
Admissions at Cambria County’s long-term structured residence facility on Windy Valley Road outside Ebensburg are now limited to those being discharged from Torrence.
Singerman said what is needed is a step-down unit – a place for those who don’t need constant supervision, but aren’t ready for a group home or personal care home. His cousin, David Cutler, helped develop a step-down, or sub-acute care unit for Salem State Hospital in Oregon.
Those coming out of a short-term psychiatric hospital unit like Memorial’s can be placed in the sub-acute unit for up to three months to see if they are ready for the community or should be admitted to a state hospital. Oregon’s program was able to reduce admissions to the state hospital, Singerman said.
Newly formed Crisis Intervention Team of the Laurel Highlands is a good start, said Wendy Stewart, director of National Alliance on Mental Illness of Cambria County.
Based on the proven Memphis, Tenn., model, Laurel Highlands’ law enforcement officers have been trained to handle mental-health patients in crisis to defuse situations and get needed help.
Stewart and the psychiatrists would like local leaders to expand the program to include a 24-hour crisis stabilization unit like Memphis’, where mentally ill patients can be taken for care and evaluation. The next step would be an assertive community treatment team of professionals available 24 hours to help mentally ill people stay out of crises. The team would monitor medication and other life issues, getting help as needed.
“It’s a very expensive program to start up, but well worth sparing people the hospitalization,” Stewart said. “It’s cost effective in the end. You are keeping people out of the hospital.”

Copyright © 1999-2008 cnhi, inc.

2 Responses

  1. Does anyone know if the records exist of the patients that died in that hospital in the 1950’s? Where would they have been buried? I’m trying to find a distant family member for my genealogy research. She died in the Torrence Hospital in 1957.

  2. Biography:

    A combined total of thirty-two years in the healthcare field. In recent years he has been involved in consulting with hospitals to show them how to reduce procedure costs anad how to operate more “green.” Additionally, he has been a consultant to physicians, and small to mid-size companies. He has received his businedss education from Robert Morris University and his medical studies from University of Texas Medical Center and Indiana University Medical Center

    While I agree with much of what Mr. Griffith’s article points out I must respond. Deinstitutionalization in the 1960’s and 1970’s have sewn the seed of a new form of treatment for persons diagnosed with severe mental illness, that being the “Recovery Vision”. Some of the limiting factors that were revealed with institutionalization were the matters significantly important to the recovery of the patient, client, or the term being used more commonly to describe a person who has been diagnosed with severe mental illness who is participating in the 1990’s form of treatment, that being a “consumer” those factors being that the consumer wanted more than just symptom relief, which was pretty much the goal of “institutionalization”. The consumer may have a multitude of needs necessary for recovery, i.e. education, social interaction, vocational, and housing, to mention but a few. We must recognize that persons who have been diagnosed with severe mental illness want what persons who have not been diagnosed with severe mental illness. They want to have a sense of self-worth, feel a part of society contributing to the betterment of themselves and something beyond themselves. Statistics support that the more active role a consumer plays in his/her recovery, the better the chances are for the recovery to occur. In the mid 1070’s The National Institute of Mental Health created the Community Support System (CSS) defined by (Turner & Schfrin) in a publication of 1979 as “A network of caring and responsible people comitted to assisting a vulnerable piopulation meet their needs and develop their potentials without being unnecessarilyisolated or excluded from the community. That is not to say that deinstitutionalization, in and of itself will be the magic bullet to lead all consumers to their full recovery.

    In fact, just as with the energy crisis which is facing our country, a combination of methods for energy is necessary, i.e. clean coal, wind, nuclear, oil, gas, and other methods. Consumers will require as many different methods of treatment, just as there are consumers. Mental illness doesn’t define a person any more than paraplegic defines a person. A person who has been diagnosed with sever mental illness, such as bipolar, schizophrenia, mania, etc. may requiee acombination of treatment modalities, to include medication, electroshock, treatment by a psychologist, psychiatrist, and/or PEER mentor. William Anthony, PhD, Executive Director for the Center for Psychiatric Rehabilitation at Boston University in an abstract titled: Recovery From Mental Illness: The Guiding Vision of the Mental Health Service System in the 1990’s stated, “Deistitutionalization radically changed how the service system attempts to meet these wants and needs.”

    Clearly, there has been a shift of treating the consequences of the illnesses rather than just the illness. While there is a stigma among society about those with mental illness, the fact is that there are no statistics to support the belief held by many that those with mental illness ae a danger and/or a threat to society. Education is a necessary ingredient if patients are being released from long-term facilities into a societal setting. The education is necessary for the public. The public must be made aware of the fact that institutionaization of persons who have been diagnosed with severe mental illness does very little, if nothing to help these persons recover from their illness or illnesses. From a humanitarian, and economocal standpoint, it makes good sense to continue in the positive direction which has been taken, that being to undertake a multifaceted approach to helping the person diagnosed with severe mental illness on the road to recovery, but more importantly provide the tools for the person to help themselves recover. The most brilliant diamond is the diamond with the most brilliant clarity and number of facets.

    I have suffered from anxiety since I was eleven years old as a ressult of being bullied after school. I then suffered a panic attack while on active duty in the Army Reserves. My anxiety disrupted my life, negatively affecting my relationships with my family, friends, fellow workers, and supervisors. My anxiety then coupled up with depression. To look at me you would have thought I was perfectly normal. I quietly suffered with it, losing job after job, and wife after wife. I did see psychiatriats and began taking psychotropic medications and eventually misused them, becoming addicted to them. It was only last week after accepting an entry-level position with an organization which provides Peer Mentors for people suffering from severe mental illness that I came to the realization that I am mentally ill. I reached that conclusion after sitting around the table for only two days with other consumers suffering with their own form of mental illness. If after forty years I can in only two days accept I am mentally ill and have been given a job and more importantly, an opportunity, and most importantly “hope’, then I feel, with that “hope” I can take that road to recovery wth a feeling of self-worth, and dignity. So, for myself, I believe such programs as PEER Support and Advocacy Network in Pittsburgh and AMI located in washington, PA are very viable treatment programs for people who want help to recover and really want to rebuild their lives.

    I still can’t believe I wasn’t really ready to accept those words to describe my condition. I just wanted to accept that I was suffering from anxiety, depression, post-traumatic stress disorder, and Adult Attention Deficit Disorder.

    Now that I realize I am sufferring from mental illness, I can accept much easier those who are sufferring from mental illness. Severe Mental Illness is not something we should be ashamed of, particularly when we consider that approximately one in five suffers from some type of mental illness. We must realize, also, that the body is connected to the brain by something called the spinal cord. They cannot be separated. So, a problem with one often causes a correespondind problem with the other. Physicians are beginning to realize this and pharmaceutical manufacturers are coming out with psychotropic drugs for depression and the pharmaceutical sales representatives are telling the physicians to ask their patients if gthey are experiencing any pain, as research has shown that depression manifests itself with body pain.

    I couldn’t agree more with Ms. Stewart’, Director of National Alliance on Mental Illness of Cambria County, who stated in the above article, “It’s a very expensive program to start up but well worth sparing people the hospitalization.” To that, I might add, that the initial costs may be recouped in the long run through outcomes of patient’s recovery.

    Copyright 2008

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