A Broken Mental Health System: Medicate, Release, Repeat

The mental healthcare crisis in America demands our immediate attention. We're witnessing a disturbing pattern where individuals with documented histories of serious mental illness cycle through brief institutional stays, only to be released back into society without adequate support systems—often with devastating consequences.

Common reasons for institutionalization (multiple sources): 

– Severe depression

– Suicidal behavior, thoughts, or threats

– Schizophrenia

– Hallucinations or delusions

– Lack of sleep or food intake for several days

– Severe substance abuse issues

– Inability to meet basic needs like eating or bathing

– Ineffective response to previous medications and therapies

Source 1: 

https://pmc.ncbi.nlm.nih.gov/articles/PMC10338701/pdf/10.1177_00207640221143282.pdf

In summary, this article explores the recent change (over last several decades) in treatment pf psychiatric patients from long term hospitalization to short-terms stays and/or outpatient services. 

Noteworthy points/findings:

-"Revolving door" (RD) treatments tend to impact a patient group that is younger, single, unemployed, of low education level (less than a high school degree), and with diagnosis of a psychotic disorder.  Many of these characteristics would mark a patient "at risk" and yet they're receiving inadequate revolving door treatment. 

-This shift to revolving door treatment is partially attributed to improvement in community-based/outpatient services. 

-Definition of revolving door patients: those patients requiring a large amount of mental health derived resources (20-30%), thought they represent less than 10% of the total number of patients (small populations requiring a sizable amount of service)

-The research efforts to specifically identify the factors leading to multiple hospitalizations has been controversial, but these authors offer a systematic review to analyze existing research on the topic and forecast the types of patients who will likely receive RD treatments and risk ongoing rehospitalization.  

-The studies reviewed in this article have some different and conflicting findings, but there were some common observations:

*RD phenomenon is greater in younger age groups (esp among those between 15-45 years old)

*No particular gender is associated with RD phenomenon.

*No particular ethnicity is associated with RD phenpmeon. 

*RD treatments seems to occur more frequently in urban areas, as opposed to suburban or rural areas. 

*RD seems to occur more in single or unmarried patients as opposed to married patients. 

*It has been commonly noted that family plays a significant role in RD treatments; patients with family conflict often fall into the RD population, where patients with supportive family are more likely to require non-heavy use of psychiatric services. 

*RD seems to be heavily associated with patients who are unemployed or receiving disability pension. 

*RD patients were significantly likely to have been diagnosed with schizophrenia, personality disorder, or alcohol/substance abuse 

Source 2:

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Episode Transcript

Speaker 1 (00:05):
okay, great to be back again.
Guys.
I have a topic here today I'vebeen waiting to bring forward to
you.
This topic is a need andnobody's really addressing on it

(00:34):
we're about to talk about.
But someone needs to dosomething and say something,
because people are takingadvantage Businesses are taking
advantage for the sake of money,for the illnesses and

(00:58):
weaknesses of others.
So to clarify where we're goingwith this today, I want to be
glad to be here, glad you arehere and from this point on
let's hop right into it.
Today's topic we're going tocover mental illness.

(01:23):
Mental illness and we have someissues with mental illness and I
want to bring it to light.
First off, when we have someonewho's mentally ill, we have to

(01:50):
analyze them a certain way.
We just can't look at everymentally ill person the same way
because there's levels of them.
There's levels of mentally ill.
In somebody's book, I might beclassified as mentally ill, but

(02:13):
the point still remains there'sdifferent levels of mental
illness.
I might be classified as afunctional mentally ill person,
but once again, there aredifferent levels of mental
illness.
I bring that to you becauselately, in the past several

(02:41):
years, we've been having alotbing people in broad daylight
, right in front of other peopleNot to say that the way to do

(03:09):
it is in the dark, but I'm justsaying there's no.
You know there's no.
How do I put it?
It's just reckless behavior.
I guess that's the best way tosay it.
It's just a lot of recklessbehavior.

(03:32):
And then, once the person getscaught if they're caught what do
we hear next?
Oh, this person has a historyof mental illness, which now
leads me to the next point.
You know, the person has ahistory of mental illness, has a

(04:03):
history of mental illness.
That means they have alreadybeen seen by some form of
psychologist or doctor, or evenbeen inside of a mental
institution already.
So my question is now why isthis person back on the street

(04:25):
if they're mentally ill?
Mental institutions are notcuring the problem.
You're not fixing anything.
What do you do?
You dope them up with some sortof medication which somebody's

(04:46):
making a fortune on on the backend that in society today we
find that, hey, whatever works,you're going to even try and
make money off of someone thatcan't fend for themselves,

(05:08):
someone that is actuallymentally ill.
You're going to dope them up,keep them in a mental
institution.
For what?
30, 60 days, depending onwhether or not it's a voluntary

(05:29):
situation or involuntarysituation, and then you need
some form of court order toextend that.
But after it's all said anddone, what happens?
You release this person who hasbeen diagnosed as having some

(05:55):
form of mental illness and yourelease them back to the street
and then they commit anothercrime or do something heinous
and somebody else's life is lost.
You put them in a mentalinstitution.
They're unable to stand trialbecause they've been diagnosed

(06:19):
as schizophrenia or whatever thecase might be and then you put
them back on the street.
It's a revolving door, told me.

(06:59):
Never present a problem withoutpresenting some form of a
solution.
Okay, my idea of a solution weneed ongoing lifelong monitoring

(07:20):
of someone who is diagnosed ashaving some form of mental
illness that is not able tofunction in society.
This is what is needed.
I have some work, some research, I looked up, and also I have
additional assistance from afriend of mine who also did a

(07:46):
lot of research on this topic,because it's a touching topic
and I think other people can seewhere we're coming from when we
discuss this, so give me asecond here and I'll be right

(08:08):
back at you.
Let me hit you with somefactual data on this mental
illness.
Stand by, we'll be right back.