DALLAS, TEXAS–It had already been a long, emotionally draining week. I was tired, bone tired. The kind of tired that made me want to crawl into a corner and stay mute for a few hours. The kind of tired that made me question if there is enough wine in the world to get me through.
But I didn’t have a choice on that recent Friday evening. A client of mine who is young, attractive and smart is also quite sick. His diagnosis is bipolar I with psychotic features, anxiety, schitzopal personality disorder and obsessive-compulsive disorder. He was on his second stay at this hospital and his third psychotic break in the past few months. The last break culminated with the police arresting him for running through the streets waving a spoon.
His mother was desperately trying to get him to enter private treatment and that was my role that evening: to convince this young man that his life could be better, that accepting the help his mother is offering was the only way out of this cycle. She had tried for years to get him to accept that help. So, it was my job to see if I could get him to accept what his mother could not.
Not an easy task. The mother was on her own here; the father battling his own mental health issues, and who bailed years ago. Like many mothers throughout the globe, she had been left behind, making the tough calls. She was the lifeline for her son: literally and figuratively.
Going to a state-run mental health facility was not for the faint of heart. The entire place felt a bit more like jail than a treatment center, with locked doors everywhere and police presence at each turn. Even the televisions are under shatterproof glass boxes. The waiting room was also a sobering place, with mothers bringing children as young as 13 through the doors— helpless, hopeless and terrified. “Yes, she has been cutting, again,” I heard one mom say. The young girl stood numb, ashamed and frightened, as fat tears slowly dripped down her face.
Once allowed into the main area, I am struck by the age and condition of the patients. Most are older, at least 45, many wearing paper clothing, and some were wheeling themselves around in chairs. They were heavily medicated, watching the Lifetime network, an interesting choice of programming. These are the people we have left behind, the throwaways. That man in the corner, rocking, was someone’s child, brother, friend. The woman sitting alone at an empty table was someone’s daughter or mother. Where was their lifeline? Their support?
The staff, mostly women, do their best to keep the mood light. Many of these angels– for lack of a better term–have spent decades caring for America’s most helpless. Women historically have always been the caregivers, the support, the soft place to fall in our world. That seems to be the same in this facility as well. These women were kind, friendly and frankly, pillars of strength.
Mental illness is terrifying. It remains a mystery to most, even to those of us in the profession. Treatment has gotten better over the years, however, access to that treatment has not. Of course, a person could go to the hospital, however then they would will be shuffled off to a different facility. Then, once deemed that they were no longer a danger to themselves or others the insurance payments usually stop. (If you are lucky enough to have insurance) This is not treatment, but rather stabilization. Private treatment, such as residential treatment programs or short-term interventions are often successful, but again, U.S. insurance does not cover the complete costs. Bottom line: there are simply not enough affordable hospitals, treatment programs and housing options for those battling mental illness.
For example, many of the top programs I recommend on a regular basis cost upwards of $550 to $2000 a day, with an average stay between two to 12 months. How can the average family afford that care? So, these people are often left to flounder. And then terrible things happen like Sandy Hook, Columbine and Las Vegas. But it is not just shootings and gun violence. It is easy to make that argument with shock-inducing headlines. It is also homelessness, broken families, rape, drug addiction and crime. It’s the loss of potential. We are losing children, mothers, fathers, families to mental illness.
One of my past clients used to say to me, while choking back tears, “When your child is diagnosed mentally ill, no one brings you a casserole, no one calls, no one cares.” And she was right. We rally around those with cancer, Parkinson’s and diabetes. But mental illness? Too scary. And again, that fear keeps us silent and that terror provides nothing but shame. There is an inherent shame that accompanies those with mental illness and their caregivers as well. It as though there is a belief that this could have been stopped or was somehow self-induced.
Most, if not all, of the programs I recommend on a regular basis do not accept insurance for the simple fact that they cannot run a quality program on what the insurance companies will reimburse. Americans are quite aware that many of our incarcerated individuals are mentally ill. In fact, according to an article published by The Atlantic in 2015, over 55% of incarcerated men and over 73% of women are mentally ill. Our jails have become our hospitals. Furthermore, good treatment for mental health can cost anywhere from $75,000-$150,000 – steep yes, but while in New York City, it can cost upwards of $168,000 to house an inmate for one year. More often than not that does not include mental health care, education or job training.
And why are so many of those mentally ill, incarcerated individuals women? It’s a complex question and one that must also factor in their families and children. Another group of those left behind.
My client signed the necessary paperwork and was headed to treatment next week. It took coaxing, tough love and frankly, brutal honesty. I informed him that he was a lucky one. He had someone that gave a damn about him. His single mother drained her retirement savings to make that happen. I also advised her to take care of herself and with that, her finances.
Her son’s mental illness did not treat cheap and keeping in mind her age and her earning time left before retirement, I warned her outcome could be like it had been in the past. Treatment and then a return home for him to only abandon his medication protocol soon after. There is no safety net for those most vulnerable. She understood and quietly replied, “I am his mother. I cannot give up.”
When I called to relay the good news, she quietly wept and said, “Thank you, Kelly. Tonight, for the first time in years, maybe I can get some sleep.”
Kelly Raclin Miller is a lead therapeutic and educational consultant where she helps families with educational and therapeutic placement needs. She holds an MA in psychology, majoring in child and family psychology, from the Chicago School of Professional Psychology.
photos courtesy Shutterstock