What I Would Change About the Mental Healthcare System

I want to bring attention to the most broken part of the mental healthcare system in the US. I know there are many broken pieces, but I’m basing my comment on my personal experience, as someone who was fortunate enough to get care inside of a psychiatric hospital setting. You know, where one who is sick is supposed to be treated to get better.

As someone who has served others receiving these services, and as one who has been served within the mental healthcare system, I’ve come to my own conclusions about the most broken part of the mental healthcare system.

The treatment I received inside different secured units screamed one common denominator: no standards of quality care.

Five to Stay Alive

Maslow’s hierarchy of needs lays out the most basic needs to provide quality of life. They are: 1) physiological provisions, 2) safety, 3) love and belonging, 4) esteem and respect, and 5) lastly what he calls self-actualization (to desire to be your best self).

I think the hospitals I’ve stayed in got the first out of those five needs right.

What happens if the rest of those needs are neglected?

What we see and have been seeing the last 60 years: The revolving doors, the untreated cases of brain disorders, the complete irresponsibility toward our most acute cases that need more time. Severity ought to determine treatment duration. And treatment ought to have standards of care that meet all five basic human needs.

Simple enough, so why don’t we have and enforce standards of treatment?

Changes I’d Make to the System

Here are a few practical suggestions to implement:

1. Hold a standard orientation with each patient, one on one, if possible, open to families. Every time I was admitted I was in a confused state of mind and didn’t understand why I was there and what I needed to get better, or the facility’s expectations. No one broke it down for me!
2. Require staff to have compassion toward the patients. There should be no room for condemnation or ignorance.
3. Make talk therapy available and encouraged in the secured units. Why this was not implemented and how crucial it is to our treatment is unacceptable.
4. Require a structured schedule that does not change. Week to week or biweekly schedules that change isn’t healthy for someone in a chaotic state of mind who needs consistency, including visiting hours.
5. Have a suggestion box where patients can submit comments and concerns and be addressed in a weekly resident council.
6. Incorporate and encourage Bible studies, prayer, and chaplains. Spiritual growth facilitates healing and sews seeds of hope.
7. Permit and don’t punish appropriate gestures of physical touch in the forms of hugs (side hugs for the opposite sex), handshakes, high fives, elbow bumps, fist bumps, brushing hair, makeup application, etc. Physical touch is crucial to humanity and our sense of belonging, safety, and security. We flounder without it.
8. Create homey, comfortable, aesthetically pleasing décor and pieces of livable comfort instead of sterile walls, blank halls, and abstract art (which is trip-inducing).

Your Thoughts

What are some things you would change in the inpatient mental healthcare settings? Tell me about it in the comments if you or someone you know has been there.

About this post: This post is taken from a letter I’m submitting to a meeting of the Interdepartmental Serious Mental Illness Coordinating Committee, a group of federal and non-federal departments and members established in 2017 to help those with SMI in our country. They meet twice a year and their upcoming meeting at the end of October will convene on ways to help the mental healthcare system and those with Serious Mental Illness and youth with Serious Emotional Disturbances. The NSSC (National Shattering Silence Coalition) I serve on has drafted a comment which I’ll try to read at the end of the ISMICC meeting that day. This post reflects the individual comment I’m submitting, not the NSSC’s.