Timmothy Pitzen case.

[TechWife]

14 minutes ago, gardenmom5 said:

Washington state is looking at increasing mandatory holds from 72 hours to five days for those in a crises.  pros and cons on both sides.

https://komonews.com/news/local/new-rules-would-allow-longer-forced-holds-of-people-in-mental-crisis

 

Like you said, pros & cons.

It will only help if there is funding. Otherwise, there will not be enough beds.

https://www.thenewstribune.com/news/local/article225079940.html

https://www.governing.com/topics/health-human-services/gov-washington-boarding-ruling.html

https://washingtonstatewire.com/gov-inslee-announces-675-plan-to-transform-washingtons-behavioral-health-system/

https://crosscut.com/2019/02/seattle-could-get-new-psychiatric-teaching-hospital

[Scarlett]

It is a complicated problem.  My brother has always received what I feel is excellent care.  Even still he has had a few horrific events in his institutionalized life...including witnessing a murder.  He is one of the ones more likely to be a victim than a perpetrator.  

[Katy]

It may be only a scant percentage of crimes are tied to mental health issues but a much larger percentage of people in prison (terms over a year) have mental health issues, and frankly that number will greatly increase once we take people out of prison that are there for nonviolent drug offenses. And arguably many drug offenses are due to a mental health issue too.  If you speak to someone in law enforcement or who works in an emergency room a significant percentage of their time is spent on people with mental health issues. And I really don't understand why we let people with mental health issues be victims of crime either.  Of COURSE we need to increase federal funding to cover this sort of thing.  Across the board. And frankly I really don't think this is particularly partisan either, so I don't understand why it hasn't already been done.  Even the NRA lobbies for more funding for mental health care.  The pendulum really needs to swing back on this one.

[TechWife]

2 hours ago, Katy said:

 If you speak to someone in law enforcement or who works in an emergency room a significant percentage of their time is spent on people with mental health issues.

I recently attended a talk given by the head of behavioral health at a local hospital. I live in a mid-size city. The ED of the hospital had 38,000 encounters last year where a mental/behavioral health issue was the primary reason for the ED visit.

[Janeway]

One huge gap we have in mental healthcare is that people with mental health needs often do not recognize it and the people around them they do have no legal rights to get help for the ones who need help. BUT, with the other huge gap, which is the actual help being available or being helpful, not sure the first huge gap matters terribly much. But it does. Both matter. Even in states with laws that allow someone to taken in and evaluated, it is only done when the person is proven to be a danger to themselves or others and then it is just an inpatient thing. So, until someone is actually ready to kill themselves or others, and it is provable that they are in that condition, nothing can be done. Same with drug abuse, same with human trafficking. 

[Innisfree]

5 hours ago, gardenmom5 said:

 

this guy is bipolar, not in treatment. has developmental disabilities.  he spent much early teens in juvy, later teens in jail.

Using gardenmom's post as a jumping-off point, not directing this to her specifically:

To me, what seems important here is that this young man has multiple disabilities and was clearly exhibiting a need for help while he was a young teen. Obviously I don't know whether he got help beyond being placed in juvenile detention. But equally obviously, I think, children and young teens need emphasis placed on treatment, not punishment. 

I will happily pay more taxes to invest in mental health care, especially for young people. Quality care at an early age can improve outcomes significantly, while parents are still able to legally insist on treatment.

Mental health issues that develop in early adulthood are thornier, but I'd still rather pay for someone to get treatment than simply be incarcerated. Certainly some people should not be on the street.---> We need more, better options.

Edited April 5, 2019 by Innisfree

[unsinkable]

59 minutes ago, TechWife said:

I recently attended a talk given by the head of behavioral health at a local hospital. I live in a mid-size city. The ED of the hospital had 38,000 encounters last year where a mental/behavioral health issue was the primary reason for the ED visit.

so over 100 visits a day just for psychiatric reasons? 

[TechWife]

6 minutes ago, unsinkable said:

so over 100 visits a day just for psychiatric reasons? 

Yes, that’s right. 

[unsinkable]

2 hours ago, TechWife said:

Yes, that’s right. 

it is pretty much a meaningless number. What is the population of the city and surrounding metro area? What is the total ER visits per day? Do they have a dedicated psych program? Are those patients who are also presenting with any other symptoms? Where is the next closest ER?

These are all rhetorical questions. I don't want any answers.

[Ausmumof3]

On 4/5/2019 at 8:25 AM, SquirrellyMama said:

I vaguely remember this case. I think she probably killed him. Maybe she really believed he would be safe that way. I've heard stories of parents killing kids because they are so paranoid and mentally ill. 

Possibly, or he's just a jerk.

Kelly

That’s my thoughts as well.  Too many stories where parents honestly felt their kids would be better off dead due to mental illness.

[TechWife]

44 minutes ago, unsinkable said:

it is pretty much a meaningless number. What is the population of the city and surrounding metro area? What is the total ER visits per day? Do they have a dedicated psych program? Are those patients who are also presenting with any other symptoms? Where is the next closest ER?

These are all rhetorical questions. I don't want any answers.

 

Each of those numbers represents a valuable human being. I don't think the healthcare professionals or the patients think it's meaningless.

I know you said you didn't want answers, but someone else might. Here's some context.

County population (2017): 1,072,203

Hospital statistics:

Total ED Encounters (2018): 287,864

Patient Encounters where the patient has a mental health/behavioral diagnosis (2018): 89,364 (these are patients that are there primarily for mental/behavioral health reasons and people who are in the ED for other reasons (ex. a broken bone or car accident)  and also happen to have a mental/behavioral health diagnosis, but that is not the reason for their ED trip.

Patients Encounters with mental/behavioral health issue as the primary reason for the ED visit (2018): 38,000

There is no dedicated psych program at this hospital. There are 40 behavioral health beds for "short stays." These are the  involuntary commitment patients (3,300 in 2018) on a 72 hour hold, patients who are not medically stable enough to transfer to a behavioral health facility (suicide attempt survivors, complications from eating disorders, self-harm patients, etc.), and those who are waiting for a  psych bed to open up at another facility at the appropriate level of care. Six of these beds are designated as pediatric beds. Overflow, both adults and children, goes to medical units with appropriate supervision  (1:1 mental health aid, private rooms, other appropriate services). The hospital employs 35 clinical social workers that work solely in the ED to assess patients for the appropriate level of care. There is always at least one PsychD and one psychiatrist in the ED. The coverage is 16 hours/day, 7 days/week. Night hours are covered by on-call staff.

The next closest ED is 9.8 miles away.

 

[unsinkable]

6 minutes ago, TechWife said:

 

Each of those numbers represents a valuable human being. I don't think the healthcare professionals or the patients think it's meaningless.

 

 

 

 

Post edited by me to address the first line:

It was pretty much a meaningless number bc you threw it out there with no context. 

 

 

[TechWife]

8 minutes ago, unsinkable said:

Post edited by me to address the first line:

It was pretty much a meaningless number bc you threw it out there with no context. 

 

 

The context was provided by the person I was quoting. The number is very meaningful.

[unsinkable]

5 hours ago, TechWife said:

I recently attended a talk given by the head of behavioral health at a local hospital. I live in a mid-size city. The ED of the hospital had 38,000 encounters last year where a mental/behavioral health issue was the primary reason for the ED visit.

 

33 minutes ago, TechWife said:

The context was provided by the person I was quoting. The number is very meaningful.

 

YOU did not provide context, here, on this board. None of us were at your talk.

A number without context is pretty much a meaningless number. 

 

[Murphy101]

On 4/5/2019 at 9:57 AM, TechWife said:

It's sad that we criminalize mental health issues. Mental health treatment is less expensive than jail. Sure, jail time for crimes. But, when the crimes are a result of a mental health issue, it is inhumane not to treat the mental illness. Now, we don't know if his crimes are a direct result of his mental health issues, but I can imagine impulse control issues and a host of other symptoms of bi polar and developmental disabilities leading to criminal conduct. I wish, instead of thinking his brother should be "locked up" that he thought his brother should have access to good mental health care. While it's true that some people with mental illnesses need to live in a supervised setting 24/7, it is not true of the vast majority. If his brother does indeed need 24/7 care, then it should be available to him, but it should be appropriate mental health care, not getting "locked up."

 

This presumes his brother thinks he will accept or comply with mental health care if he had it. Not all are willing to do so and they should be locked up for their criminal behavior that results of that choice. Just having mental health issues and disabilities doesn’t mean he should be locked up and it doesn’t mean he should get a pass either for criminal behavior that may have not happened if he had accepted treatment. 

[TechWife]

On 4/6/2019 at 2:49 PM, Murphy101 said:

 

This presumes his brother thinks he will accept or comply with mental health care if he had it. Not all are willing to do so and they should be locked up for their criminal behavior that results of that choice. Just having mental health issues and disabilities doesn’t mean he should be locked up and it doesn’t mean he should get a pass either for criminal behavior that may have not happened if he had accepted treatment. 

Sorry, just saw this.

No, it doesn't presume what his brother thinks he will accept. Someone can want the best for their family members (want them to have access to appropriate mental health care, evaluations, etc.) while at the same time, think that the they won't take advantage of it.  My wanting appropriate mental health care available in my community is not dependent upon whether or not anyone accesses that health care. The good thing is still the good thing.

Did you miss the part where I said jail time for crimes? It seems you did.

[scholastica]

On 4/5/2019 at 6:57 PM, TechWife said:

 

Each of those numbers represents a valuable human being. I don't think the healthcare professionals or the patients think it's meaningless.

I know you said you didn't want answers, but someone else might. Here's some context.

County population (2017): 1,072,203

Hospital statistics:

Total ED Encounters (2018): 287,864

Patient Encounters where the patient has a mental health/behavioral diagnosis (2018): 89,364 (these are patients that are there primarily for mental/behavioral health reasons and people who are in the ED for other reasons (ex. a broken bone or car accident)  and also happen to have a mental/behavioral health diagnosis, but that is not the reason for their ED trip.

Patients Encounters with mental/behavioral health issue as the primary reason for the ED visit (2018): 38,000

There is no dedicated psych program at this hospital. There are 40 behavioral health beds for "short stays." These are the  involuntary commitment patients (3,300 in 2018) on a 72 hour hold, patients who are not medically stable enough to transfer to a behavioral health facility (suicide attempt survivors, complications from eating disorders, self-harm patients, etc.), and those who are waiting for a  psych bed to open up at another facility at the appropriate level of care. Six of these beds are designated as pediatric beds. Overflow, both adults and children, goes to medical units with appropriate supervision  (1:1 mental health aid, private rooms, other appropriate services). The hospital employs 35 clinical social workers that work solely in the ED to assess patients for the appropriate level of care. There is always at least one PsychD and one psychiatrist in the ED. The coverage is 16 hours/day, 7 days/week. Night hours are covered by on-call staff.

The next closest ED is 9.8 miles away.

 

Do they lump substance use disorders in with that mental health number? Some reports put it all together in one bucket. Just wondering if they separate them out at your hospital.

[TechWife]

22 minutes ago, scholastica said:

Do they lump substance use disorders in with that mental health number? Some reports put it all together in one bucket. Just wondering if they separate them out at your hospital.

That’s a good question & I don’t know the answer. 

[unsinkable]

1 hour ago, scholastica said:

Do they lump substance use disorders in with that mental health number? Some reports put it all together in one bucket. Just wondering if they separate them out at your hospital.

TechWife also didn't specify that the numbers are from a hospital system, that includes 6 separate and distinct ERs at different locations.

 

[TechWife]

1 hour ago, unsinkable said:TechWife also didn't specify that the numbers are from a hospital system, that includes 6 separate and distinct ERs at different locations.

 

 

What makes you think that? And, why would that be relevant?

If you think you  know personally identifiable information about me, I’d appreciate it if you would keep that to yourself and PM me. It is highly inappropriate to use personal information on a message board. 

I will say this regarding statistics. Whether or not substance abuse is “lumped in”with mental health disorders doesn’t change the number of people in our area needing access to mental health care, The size of the hospital doesn’t change the number of people in the area needing mental health care. None of these statistics change the fact that mental health care is under funded and that there is a severe shortage of mental health providers & beds. These problems are nationwide. My area is not unique. 

What is also not unique is the stigma mental illness still carries in our nation. What is not unique is that there are people who would rather lock up people with mental illness than provide appropriate care and integrate them into the community, when appropriate. The primary reasons for this, IMO, are a combination of fear, lack of awareness & appropriate information as well an unwillingness to spend money on meeting the needs of others. 

Unsinkable, I have no idea why you are fixating so much on the numbers I provided - do you doubt the fact that so many people in one area that need mental health care? That’s the only thing I can think of.  If you doubt it, there’s really nothing I can say to change your mind if facts don’t do it. If there’s something else you’d like to discuss, feel free to PM me and I’ll consider it, but I’ve provided all of the numbers I have available to me. Many hospitals, states and advocacy organizations make census statistics & provider information available, feel free to do additional research on your own. 

Mental health is an area where I have done a reasonable amount of research and have taken care to find out what is happening in my community, state and the nation at large. I advocate, I donate and I am in favor of higher taxes, if necessary,  in order to pay for mental health access because I think it’s important. 

[scholastica]

12 hours ago, TechWife said:

That’s a good question & I don’t know the answer. 

Ok. Not a big deal. I’m just curious. I hope I didn’t offend. 

[unsinkable]

8 hours ago, TechWife said:

 

What makes you think that? And, why would that be relevant?

If you think you  know personally identifiable information about me, I’d appreciate it if you would keep that to yourself and PM me. It is highly inappropriate to use personal information on a message board. 

I will say this regarding statistics. Whether or not substance abuse is “lumped in”with mental health disorders doesn’t change the number of people in our area needing access to mental health care, The size of the hospital doesn’t change the number of people in the area needing mental health care. None of these statistics change the fact that mental health care is under funded and that there is a severe shortage of mental health providers & beds. These problems are nationwide. My area is not unique. 

What is also not unique is the stigma mental illness still carries in our nation. What is not unique is that there are people who would rather lock up people with mental illness than provide appropriate care and integrate them into the community, when appropriate. The primary reasons for this, IMO, are a combination of fear, lack of awareness & appropriate information as well an unwillingness to spend money on meeting the needs of others. 

Unsinkable, I have no idea why you are fixating so much on the numbers I provided - do you doubt the fact that so many people in one area that need mental health care? That’s the only thing I can think of.  If you doubt it, there’s really nothing I can say to change your mind if facts don’t do it. If there’s something else you’d like to discuss, feel free to PM me and I’ll consider it, but I’ve provided all of the numbers I have available to me. Many hospitals, states and advocacy organizations make census statistics & provider information available, feel free to do additional research on your own. 

Mental health is an area where I have done a reasonable amount of research and have taken care to find out what is happening in my community, state and the nation at large. I advocate, I donate and I am in favor of higher taxes, if necessary,  in order to pay for mental health access because I think it’s important. 

Firstly, YOU put the personal identifying information out there. I said "These are all rhetorical questions. I don't want any answers."

I googled your numbers and found the hospital SYSTEM in about 30 seconds. 

Secondly, I know a lot more about mental health, emergency mental health, and emergency room statistics than you give me credit for. I knew the odds of one single hospital seeing that many people for mental health reasons in a year (38,000) would be rare in a single hospital. The percentages I've heard based on personal conversations range from 10% to 20% (depending on area and particular days) of patients who go to ERs are there for mental health reasons. Mental health orgs say 1 in 8 people who go to ER are there for mental health reasons.

So an ER that sees 38,000 out of 288,000 patients for mental health reasons would be seeing a statistically number of people consistent with numbers I am familiar with.

However, there is not one single ER in this country (that I know of, NOT a hospital system) that can handle 789 patients a day. 288,000/365. 

When you wrote 38,000 people at one hospital, I knew something wasn't right. Because 38,000 ÷ .125 = 304,000. I didn't need any more stats to know that. But you provided them even when I said it wasn't necessary.

[Murphy101]

Personally I don't care if substance abuse is lumped with mental health illness.  It's often a chicken vs egg as to which came first scenario.  Self medication is often the only treatment or the first treatment many people get for their problems.

[unsinkable]

3 minutes ago, Murphy101 said:

Personally I don't care if substance abuse is lumped with mental health illness.  It's often a chicken vs egg as to which came first scenario.  Self medication is often the only treatment or the first treatment many people get for their problems.

Agree. Cosigned. This. +1,000,000.

[Murphy101]

13 hours ago, TechWife said:

Sorry, just saw this.

No, it doesn't presume what his brother thinks he will accept. Someone can want the best for their family members (want them to have access to appropriate mental health care, evaluations, etc.) while at the same time, think that the they won't take advantage of it.  My wanting appropriate mental health care available in my community is not dependent upon whether or not anyone accesses that health care. The good thing is still the good thing.

Did you miss the part where I said jail time for crimes? It seems you did.

 

My response was to you saying it was a shame he wanted jail time.  If you've got no problem with that, then why shame his brother? His brother may very well be pro mental health care and also think his brother deserves to be jailed.  So if you aren't presuming otherwise, why shame his brother for thinking this deserves jail? 

[Scarlett]

I have what feels to me an unusually high number of friends who are foster parents and or have adopted through the foster care system.  Drugs are involved in every single case. It is really quite astounding what drugs have done to the lives of people and especially to innocent children.  I do agree that many times people are self medicating pre existing mental health problems.....and/ or the drugs exacerbate those mental health issues that may have been fairly easily treated if the care had been available.  

People do get clean and get help in prison so there is that option.  But how much better it would be to help people before they get to that point.  

[scholastica]

28 minutes ago, Murphy101 said:

Personally I don't care if substance abuse is lumped with mental health illness.  It's often a chicken vs egg as to which came first scenario.  Self medication is often the only treatment or the first treatment many people get for their problems.

I agree that it is often co-morbid. It's just that not every mentally ill person is abusing substances and not every substance abuser is or was mentally ill when they started. Mental illness and substance abuse require different treatment modalities so why lump them in together?  It seems to be a continued bifurcation of the idea that disorders of the brain that aren't visibly physical, i.e. tumor, tbi, are all the same and not another physical illness. I personally think that is an artificial separation. 

[TechWife]

24 minutes ago, Murphy101 said:

 

My response was to you saying it was a shame he wanted jail time.  If you've got no problem with that, then why shame his brother? His brother may very well be pro mental health care and also think his brother deserves to be jailed.  So if you aren't presuming otherwise, why shame his brother for thinking this deserves jail? 

I didn’t say any such thing. Don’t put words into my mouth. 

[Murphy101]

36 minutes ago, Scarlett said:

I have what feels to me an unusually high number of friends who are foster parents and or have adopted through the foster care system.  Drugs are involved in every single case. It is really quite astounding what drugs have done to the lives of people and especially to innocent children.  I do agree that many times people are self medicating pre existing mental health problems.....and/ or the drugs exacerbate those mental health issues that may have been fairly easily treated if the care had been available.  

People do get clean and get help in prison so there is that option.  But how much better it would be to help people before they get to that point.  

 

Absolutely.  The entire premise of genuine mental health care is that we should offer preventative and on going healthcare so that self medication isn't necessary.

23 minutes ago, scholastica said:

I agree that it is often co-morbid. It's just that not every mentally ill person is abusing substances and not every substance abuser is or was mentally ill when they started. Mental illness and substance abuse require different treatment modalities so why lump them in together?  It seems to be a continued bifurcation of the idea that disorders of the brain that aren't visibly physical, i.e. tumor, tbi, are all the same and not another physical illness. I personally think that is an artificial separation. 

 

I don't know that I agree that mental illnesss and substance abuse require entirely different treatments.  In fact, I think separating them as though they aren't as closely related as lots of data suggests they are is part of the problem.  I think that's just a continuum of an artificial separation of illnesses.

It's not unsimiliar to the problem of physical pain management.  Many people end up addicted to pain pills not because the pain doesn't exist, but because it is real and is mismanaged or not manageable.  And honestly, there's very little we understand about the science of pain, physical or mental.

[TechWife]

38 minutes ago, unsinkable said:

Firstly, YOU put the personal identifying information out there. I said "These are all rhetorical questions. I don't want any answers."

I googled your numbers and found the hospital SYSTEM in about 30 seconds. 

Secondly, I know a lot more about mental health, emergency mental health, and emergency room statistics than you give me credit for. I knew the odds of one single hospital seeing that many people for mental health reasons in a year (38,000) would be rare in a single hospital. The percentages I've heard based on personal conversations range from 10% to 20% (depending on area and particular days) of patients who go to ERs are there for mental health reasons. Mental health orgs say 1 in 8 people who go to ER are there for mental health reasons.

So an ER that sees 38,000 out of 288,000 patients for mental health reasons would be seeing a statistically number of people consistent with numbers I am familiar with.

However, there is not one single ER in this country (that I know of, NOT a hospital system) that can handle 789 patients a day. 288,000/365. 

When you wrote 38,000 people at one hospital, I knew something wasn't right. Because 38,000 ÷ .125 = 304,000. I didn't need any more stats to know that. But you provided them even when I said it wasn't necessary.

 

I have no idea why I’m engaging with this. I guess I’m a glutton. Do you know that when numbers are added together, they are still statistically valid? All you have proven is that the hospital I have statistics for isn’t “average.” Do you know what an average is? Some fall above it, some below it -thats what makes it an average. 

Do you know some days ED’s are so busy they have people lining the hallways and they close to everything but trauma? Other days they are mild and relatively quiet. They don’t see the same number of patients every day. 

Do you know numbers are only one piece of information? They are widely used because they are understood. They don’t tell the whole story though. When we know the whole story, we realize numbers are only one descriptor of a complex issue. 

Do you know any of the wider context? Like hospital procedure? Staffing? How many charity patients are seen in a particular hospital as compared to other hospitals in the area? That’s an important thing when it comes to mental health. How close a hospital is to an at risk community? Whether or not the hospital provides other services to that at risk community?  The availability of affordable mental health care in the area? How well the county and state fund mental health care? The location of the mental health beds in the state? The quality of care a hospital provides? The compassion extended to mental heath patients? The ability of a hospital to find appropriate care for those who need to be admitted? Do you know how the local police department manages mental health care encounters? 

All of that information, and probably much more that I’m  to thinking of at the moment, impacts the hard numbers. Context does matter, even if you don’t want it. 

I never drew any conclusions about how much or how little you know about mental health. You aren’t engaging on the subject, only attacking one example which you don’t have a full grasp of and so it seems odd to you. I am not lying. I have no reason to believe the behavioral health team at that particular hospital is lying when they provide numbers in a formal setting. If you think I’m lying, you don’t know me. 

Have a good day.

 

[TechWife]

2 hours ago, scholastica said:

Ok. Not a big deal. I’m just curious. I hope I didn’t offend. 

Not at all, no worries. 

[Catwoman]

42 minutes ago, Dotwithaperiod said:

This obsessive type hounding and questioning is something I’ve observed here for years. Not sure if it’s personal or just a discussion style.

 

I’m not seeing anything obsessive about unsinkable’s posts in this thread. It seemed to me that she was looking for clarification about the statistics that were posted, because the numbers didn’t sound plausible to her.  

I was shocked at those numbers myself, but I am the first one to admit that I’m nowhere near as well-informed on mental health care as many others on this forum, so I didn’t question them. But now that this has turned into a big debate, I just did a quick Google search using a few of the numbers that were posted, and I immediately found what appears to be the same information that unsinkable found, which is that the Emergency Department statistics Tech Wife quoted were for an entire hospital system and not just one individual hospital — and I do think that information is very relevant to the discussion. 

I think we would all agree that those statistics are incredibly alarming, but it does make a difference that those numbers appear to be from multiple hospitals and not from just one single hospital. 

 

 

[scholastica]

3 hours ago, Murphy101 said:

 

Absolutely.  The entire premise of genuine mental health care is that we should offer preventative and on going healthcare so that self medication isn't necessary.

 

I don't know that I agree that mental illnesss and substance abuse require entirely different treatments.  In fact, I think separating them as though they aren't as closely related as lots of data suggests they are is part of the problem.  I think that's just a continuum of an artificial separation of illnesses.

It's not unsimiliar to the problem of physical pain management.  Many people end up addicted to pain pills not because the pain doesn't exist, but because it is real and is mismanaged or not manageable.  And honestly, there's very little we understand about the science of pain, physical or mental.

Well, as things are structured now, you can’t just put someone with only mental illness into drug rehab and expect that to treat the mental illness, nor can you just put a substance user in a psychiatric facility. They wouldn’t get the treatment they really need because they’re not set up that way. Really good substance use rehabs have treatment to deal with the underlying issues when they occur, but not all, and psych hospitals are not all set up to deal with substance use. 

Edited April 10, 2019 by scholastica

[beaners]

20 minutes ago, scholastica said:

Well, as things are structured now, you can’t just put someone with only mental illness into drug rehab and expect that to treat the mental illness, not can you just put a substance user in a psychiatric facility. They wouldn’t get the treatment they really need because they’re not set up that way. Really good substance use rehabs have treatment to deal with the underlying issues when they occur, but not all, and psych hospitals are not all set up to deal with substance use. 

Yes, and in order to be admitted to most psych facilities they will require drug testing before agreeing to a transfer from an ER. One of our kids is autistic and intellectually disabled and always directly supervised. His intakes still require testing to make sure he hasn't been secretly using drugs. Mental health in general is a mess. It's even harder when there are complicating factors like disability, or speaking a language other than English.

[Murphy101]

38 minutes ago, scholastica said:

Well, as things are structured now, you can’t just put someone with only mental illness into drug rehab and expect that to treat the mental illness, not can you just put a substance user in a psychiatric facility. They wouldn’t get the treatment they really need because they’re not set up that way. Really good substance use rehabs have treatment to deal with the underlying issues when they occur, but not all, and psych hospitals are not all set up to deal with substance use. 

 

Which explains why both systems aren’t particularly effective. 

[Scarlett]

On 4/5/2019 at 9:57 AM, TechWife said:

It's sad that we criminalize mental health issues. Mental health treatment is less expensive than jail. Sure, jail time for crimes. But, when the crimes are a result of a mental health issue, it is inhumane not to treat the mental illness. Now, we don't know if his crimes are a direct result of his mental health issues, but I can imagine impulse control issues and a host of other symptoms of bi polar and developmental disabilities leading to criminal conduct. I wish, instead of thinking his brother should be "locked up" that he thought his brother should have access to good mental health care. While it's true that some people with mental illnesses need to live in a supervised setting 24/7, it is not true of the vast majority. If his brother does indeed need 24/7 care, then it should be available to him, but it should be appropriate mental health care, not getting "locked up."

I think this is the post where people felt the brothers reactions were being judged. 

[TechWife]

11 minutes ago, Scarlett said:

I think this is the post where people felt the brothers reactions were being judged. 

They are wrong.