Treatment Options and Alternatives: A First Person Account

  • As I head into my seventh year of work for HealthCentral:

     

    I will document here my own experiences in the so-called mental health system and offer solutions.

     

    Sadly, the best treatment I received is often atypical.  My mother drove me to the ER within 24 hours of my breakdown.  A day later I was hospitalized and started taking Stelazine.  Three weeks later I was released home and had none of the symptoms I exhibited the night I got sick.

     

    A week after coming out of the hospital, I started to see a private Italian therapist that I continued to see for four years.  She focused on my goals and for me to live as normal a life as possible.  She vetted my philosophy when I told her " all a person needs in life is two friends, pizza and a really great sound system."

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    My mother's guilt paid for the sessions.

     

    From the fall of 1987 after I got out of the hospital until June 1988 I attended two day programs.  The second day program was a joke.  Medicaid paid for these programs.

     

    From the fall of 1988 to January 1991 I lived in a halfway house and then a residence.  SSD and SSI paid for this housing.

     

    All during this time in the mental health system (apart from my sessions with the private therapist) I had to fight to be taken seriously.  I fought my way out of the second day program and into clerical training by OVR: the state agency that trained people with disabilities so they could get jobs.

     

    From March of 1993 to June 1995, I attended group therapy at a center in Manhattan.  My health insurance at work didn't cover the group therapy so I paid $25/per session out of my own pocket.

     

    From the fall of 2005 to June 2006, I saw another talk therapist one-on-one.  He wasn't great however he did focus with compassion on my problems.  I stopped seeing him because I achieved what I set out to address in therapy at that time.  The health insurance co-pay was $15 per visit to see this therapist.

     

    In the fall of 2007, I met for 10 sessions with a therapist who provided cognitive behavior or CBT, also for a specific issue I wanted to resolve.  This was the absolute best use of the $100/per session I paid out of my own pocket.

     

    My first doctor who I saw privately was more of a friend than a professional.  He instituted a drug holiday in April 1992 that failed three months later.

     

    The second guy was a bozo.  He kept asking me at the end of every visit if I was in a relationship.  He kept pressing me to switch to an atypical, and I refused every time.  I saw him from spring 1998 to 2003.

     

    In July 2003, I started to see Dr. A: a true professional I'll stay with until he retires.  I pay him out of my own pocket because he doesn't take insurance.  He engineered the cross-titer from the Stelazine to the Geodon in 2007.  I continue to see him and I do not currently have a therapist of any kind.

     

    I'm going to end here with my observations about traditional mental health treatment, and how each of us can aid in improving the system that is literally a sham for countless people seeking help that is non-existent.

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    Speak up, act up.

     

    We cannot continue to solely blame the staff in the system.  The expression goes: "You can't teach an old dog new tricks."  We can lobby for best practices treatment yet sometimes we have to vote with our pocketbooks if other options exist.

     

    You might have to fire a psychiatrist who is not performing.  You shouldn't have to settle for less than the best possible outcome for yourself in your recovery or your loved one's recovery.  Research a better doctor to see.  I would go so far as to say you might need as I did to challenge advice you don't think is sound.

     

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    If your intuition tells you this professional is not on the level, you might have to go elsewhere.  Notify your state medical board of blatantly unethical treatment.

     

    Expect excellence from your providers.

     

    From my time in the mental health system, I saw firsthand that because the bar was not set at all for the clients or patients, absolutely no kind of basic goal-setting techniques or behavior change or lifestyle management was ever conducted with anyone.

     

    I have written it seems endlessly in my personal blog that sometimes the worst stigma comes from staff working in the system who don't think their clients can recover and have low expectations of what they can do.

     

    A woman working in a mental health clinic stated on the Internet years ago that most people can't recover from schizophrenia.  So you can see I'm not making this up or pulling this information out of a hat like a magician.  It's time to hold the staff accountable for their deficit model attitudes.

     

    A solution would be for those of us able to do so either via formal schooling or via activism to become the kinds of professionals we'd like to see treat people.

     

    I know of one compassionate social worker who contacted me precisely because her client was shunted into the expectation of a menial job by an employment agency.  I told her at least three other options her client had that the woman didn't know about.

     

    Get assertive.

     

    This might be hard to practice and easier to talk about doing yet we owe it to ourselves to assert ourselves.  I was lucky I was always able to initiate getting treatment on my own.

     

    For those of us who lack this kind of ability: I recommend social skills training as a good introduction to embarking on a successful recovery.  I'm more impressed with the services offered at an IPRT or Intensive Psychiatric Rehabilitation Treatment program than with the kind of day program I attended when I was just starting out.

     

    I will detail the focus of an IPRT-and talk about a successful agency in New York City that offers this service-in a future SharePost.  The focus is setting and achieving life goals. 

     

    Alternately, you can use members of your support group and friends and family to practice role-playing situations where you will need to speak up.  You can save up money to buy a portable voice recorder and record yourself talking.  Play the recording back to listen to how you sound.

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    Do whatever you can to live life well outside of your involvement in the mental health system.

     

    The damaging effect of so-called "self-stigma," that is internalized doubt about our worth because we have a diagnosis, is all too real.  We empower ourselves by taking positive action.

     

    In the 1990s, I attended adult education workshops at the Learning Annex in the City.  I studied there color analysis, personality theory, magazine writing and handwriting analysis.

     

    I also read self-help guides and I do not suggest this lightly.  My favorite motivational book was Les Giblin's How to Have Confidence and Power in Dealing with People.  A current favorite I recommend is Karen Casey's Change Your Mind and Your Life Will Follow.

     

    Vote in the ballot booth.

     

    One of my best friends tells me he votes for a candidate based on the person's stance on mental health funding.

     

    The first time Obama was elected: I reported each of the candidates' positions on mental health here during the campaign season.  President Obama was the only one who mentioned NAMI by name on his website.

     

    From my personal blog:

     

    Supportive housing in Seattle and elsewhere for recovering alcoholics and those with mental illness results in "savings . . . specifically, the reduction in overnight visits to hospitals, mental health and substance abuse clinics, jails and shelters . . . more than offset the costs of the housing program."

     

    Total medical costs per year were reduced to $13,440 per person to administer the housing program from $42,964 per person per year.

     

    We can impress on our elected officials these kinds of benefits achieved with best practices treatment.

     

    I'm going to end here with the call out that I would love to hear from you other solutions to the problems of the mental health system.

     

    All comments are welcome.

Published On: February 10, 2013