Recent reports suggest that McCready, dead at age 37 from an apparent self inflicted gunshot wound, was recently admitted to a local psychiatric hospital, was held against her will for 48 hours, and then released.
Whoops.
Imagine you went to a medical hospital with some kind of potentially fatal disease, the hospital clears you and says you are safe to go home, and a couple days later you are dead from the fatal disease. Yep.
This, yet another failure of the US mental health care system, is a shining example of what's wrong with mental healthcare in our country.
To give a little background, here's how going to the psychiatric hospital works:
You initially come in to the lobby and fill out some demographic paperwork with the hopes of being seen promptly. Depending on the night, you could wait up to 10 (sometimes more) hours before anyone will see you. While you wait, you will be in a crammed lobby with other people who have varying types of mental illness. There you will find people actively detoxing from drugs or alcohol for several hours, a clear medical risk by any standard. You will be subject to the safety (or lack thereof) of other patients who may be experiencing auditory command hallucinations to kill people and themselves, security nowhere to be seen. It would not be too uncommon for someone who is actively psychotic to flip out after having to wait for far too long and begin destroying the lobby, putting you and the other patrons of the lobby at risk.
Finally, a member of the understaffed and overwhelmed admissions counselors will do a brief (brief because the corporation that runs the hospital doesn't want them to spend too much time with them, because, you know, the wait time for other patients is already out of control among other reasons) assessment searching for admission criteria. Depending on what is going on with you, you may then (after another couple hours worth of waiting) see a psychiatrist.
If you are admitted you will go to a fairly run down unit manned by more understaffed and overwhelmed nurses who are already dealing with people who are angry and potentially psychotic. If this displeases you and you act out, you will be held down by techs and receive a "cocktail" which is usually an injection of Haldol, Benadryl, and Ativan and then go to the "quiet room" to calm down.
Your therapy will consist of individual therapy with an LPC or LMSW, "rounding" by your psychiatrist, which is a fancy way or saying that they come take a look at you and reccommend medication adjustments, and group therapy, which more often than not involves a group size well past what would be considered therapeutically efficacious. Group therapy often involves watching VHS tapes from the 80's or 90's.
Now, let me offer a disclaimer.
Not all psychiatric hospitals are like this. But the ones that have been bought out by mega corporations are too often helmed by CEO scrooges that are more concerned with the bottom line than whether or not people are actually receiving sufficient help to improve their outlook.
Even when the hospital's intentions are sound, they too often find themselves in a battle with your insurance company over whether or not your continued stay is necessary. So if you were, say, suicidal yesterday but not today, your insurance company may not pay for you to continue to be at the hospital. So your potentially caring and thoughtful psychiatric hospital will be left to choose between keeping you anyway (costing them lots of money and creating the potential for them to go out of business) or follow your insurance company's recommendation of discharging you to outpatient level of care.
Your psychiatrist at the hospital does have the option to issue an OPC which stands for Order of Protective Custody. This will keep you in the hospital whether you or your insurance company likes it or not. The problem is that in order to do an OPC, the doctor must feel like you are in imminent danger of harming yourself, harming others, or have deteriorated to the point that you are unable to make an informed decision about your level of care.
In the case of Mindy McCready, the most likely situation is that she was admitted to a psychiatric hospital voicing complaints of having suicidal thoughts, and the day those subsided her attending psychiatrist wrote discharge orders and the rest is history.
As a society we need to take a hard look at the entirety of our mental healthcare system. Our mental healthcare cannot be beholden to whims of an insurance company who has not laid eyes on you, nor should your care be subject to the desire of a bottom line driven CEO attempting to maximize profits for the mega corporation to which he or she reports.
At the end of the day, the patient-provider relationship should be the primary concern. Your healthcare provider should be able to visit with you and make a decision on what they think is the most appropriate level of care and course of treatment. When their livelihoods are tied to outside influences, namely money or the money to be made by the company signing their paychecks, the best interests of the patient is too often compromised.
RIP Mindy McCready.
Whoops.
Imagine you went to a medical hospital with some kind of potentially fatal disease, the hospital clears you and says you are safe to go home, and a couple days later you are dead from the fatal disease. Yep.
This, yet another failure of the US mental health care system, is a shining example of what's wrong with mental healthcare in our country.
To give a little background, here's how going to the psychiatric hospital works:
You initially come in to the lobby and fill out some demographic paperwork with the hopes of being seen promptly. Depending on the night, you could wait up to 10 (sometimes more) hours before anyone will see you. While you wait, you will be in a crammed lobby with other people who have varying types of mental illness. There you will find people actively detoxing from drugs or alcohol for several hours, a clear medical risk by any standard. You will be subject to the safety (or lack thereof) of other patients who may be experiencing auditory command hallucinations to kill people and themselves, security nowhere to be seen. It would not be too uncommon for someone who is actively psychotic to flip out after having to wait for far too long and begin destroying the lobby, putting you and the other patrons of the lobby at risk.
Finally, a member of the understaffed and overwhelmed admissions counselors will do a brief (brief because the corporation that runs the hospital doesn't want them to spend too much time with them, because, you know, the wait time for other patients is already out of control among other reasons) assessment searching for admission criteria. Depending on what is going on with you, you may then (after another couple hours worth of waiting) see a psychiatrist.
If you are admitted you will go to a fairly run down unit manned by more understaffed and overwhelmed nurses who are already dealing with people who are angry and potentially psychotic. If this displeases you and you act out, you will be held down by techs and receive a "cocktail" which is usually an injection of Haldol, Benadryl, and Ativan and then go to the "quiet room" to calm down.
Your therapy will consist of individual therapy with an LPC or LMSW, "rounding" by your psychiatrist, which is a fancy way or saying that they come take a look at you and reccommend medication adjustments, and group therapy, which more often than not involves a group size well past what would be considered therapeutically efficacious. Group therapy often involves watching VHS tapes from the 80's or 90's.
Now, let me offer a disclaimer.
Not all psychiatric hospitals are like this. But the ones that have been bought out by mega corporations are too often helmed by CEO scrooges that are more concerned with the bottom line than whether or not people are actually receiving sufficient help to improve their outlook.
Even when the hospital's intentions are sound, they too often find themselves in a battle with your insurance company over whether or not your continued stay is necessary. So if you were, say, suicidal yesterday but not today, your insurance company may not pay for you to continue to be at the hospital. So your potentially caring and thoughtful psychiatric hospital will be left to choose between keeping you anyway (costing them lots of money and creating the potential for them to go out of business) or follow your insurance company's recommendation of discharging you to outpatient level of care.
Your psychiatrist at the hospital does have the option to issue an OPC which stands for Order of Protective Custody. This will keep you in the hospital whether you or your insurance company likes it or not. The problem is that in order to do an OPC, the doctor must feel like you are in imminent danger of harming yourself, harming others, or have deteriorated to the point that you are unable to make an informed decision about your level of care.
In the case of Mindy McCready, the most likely situation is that she was admitted to a psychiatric hospital voicing complaints of having suicidal thoughts, and the day those subsided her attending psychiatrist wrote discharge orders and the rest is history.
As a society we need to take a hard look at the entirety of our mental healthcare system. Our mental healthcare cannot be beholden to whims of an insurance company who has not laid eyes on you, nor should your care be subject to the desire of a bottom line driven CEO attempting to maximize profits for the mega corporation to which he or she reports.
At the end of the day, the patient-provider relationship should be the primary concern. Your healthcare provider should be able to visit with you and make a decision on what they think is the most appropriate level of care and course of treatment. When their livelihoods are tied to outside influences, namely money or the money to be made by the company signing their paychecks, the best interests of the patient is too often compromised.
RIP Mindy McCready.
Chase Chick MPA LPC is CEO and co-founder of Beyond the Gray Sky, whose brands include Pursuit of Happiness, Dallas Psychology Review, and Luxe Media Productions.
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