I am sure that this particular post will anger some, make some uncomfortable, and maybe it will prompt some to action.
THESE STATEMENTS HAVE ONLY TO DO WITH MY OPINIONS, OBSERVATIONS AND CONCLUSIONS AND DOES IN NO WAY REFLECT THE POSITION THE STATES MENTIONED, OF JCAHO OR MENTAL HEALTH PROFESSIONALS ANYWHERE.
First, I want to tell you that I am sure I do not have all or even some of the answers. But I know there are wonderful professionals out there that do have the answers. I just want to share with you some experiences that are anecdotal. I agree with Gloria Steinem who said in a speech at NC State ...that antidotes are the only way we can fully understand the human condition. I have always gotten quite angry in meetings when people would say well we don't deal in personal experiences, where is the data. Well data depends on who collects it, how it is set up, and on and on...Data has taken this country down the tubes more than once. Personal experience stories have as well. We need to consider both carefully. In the area of mental health is certainly one of these areas.
I worked for Joint Commission in the early 90's and as luck would have it I was just married to Ralph. I told the scheduling department that I had a traveling buddy and if they wanted to assign me to doing alone surveys that I would be up to it. I was assigned to doing those surveys that must be done when the. organization doesn't meet requirements at their regular survey. I had been cross trained to do hospital, medical staff, environment, mental health and ambulatory surveys (one of the first and few nurses that could survey medical staff), so I was a good pick to do these surveys.
Ralph and I were excited about our time together and traveling . We started out from Raleigh and moved up the coast through Virginia, Maryland, Delaware, New ,Jersey, New York, Mass., and back across northern New York, to Ohio, Indiana, Kentucky, and home through Tennessee. This took an entire year. We were visiting primarily three kinds of organizations: Mental Health Hospitals, Prison Hospitals(forensic care) and more rarely, small isolated hospitals and clinics.
By the time I got to Hyde Park, NY, I was in quite a state. On this particular day I arrived at a Psychiatric Hospital where the offices were in a beautiful old turn of the century building, on a hill, with many additional modern dormitories and workshops. The grounds were beautiful, although a little unkempt. The beautiful area was like a ghost town. Only and occasional person would walk by. The state was closing this facility. The issue was: Psychiatric patients had been mainstreamed by law. The new drugs had proven that many symptoms could be subdued and controlled and that people who had been institutionalized could be treated with drugs. So many hundreds of thousands of patients were discharged, funds cut, and admissions cut down as patients were seen on outpatient basis. Only one big problem. Left to their own, many mental health patients will not take their drugs. So they would get back into destructive behaviors with no way for readmission. Where do they end up?
The rest of the story is equally interesting. My next stop was in Fishkill, NY at a prison. They were madly building beds for patients. The very same patients who had enjoyed the beautiful grounds, the work in the sheltered workshops, the manufacture of simple products and the self esteem that comes from those programs.... were now in prisons. They had been discharged. Many had become homeless. Those in prison had committed crimes that brought them there. Now they were in rooms with a small window. little outside activity, and the terrible impact of self esteem. I talked with a number of these people. They could articulate this cycle with heartbreaking detail. Not enough food, no where to be when it was so bitterly cold, very unsafe conditions and inability to trust anyone. Some ended up in Attica, and as I visited there, the same stories but the offenses were more severe. Since the 90's I have watched this continue with no intervention to change the outcomes for the mentally ill. I have only watched funds cut year after year because of the words mentally ill. We would never consider cutting funds in the same percentage for premature babies and other programs.
There is no doubt that many people had in good faith supported the rights of these individuals, believing that it was in the best interest. The vision was lacking. How could a country that took care of their people so well be so unfeeling, thinking that they were feeling? My grandfather who had a third grade education in his limited language used to say to me," Rusti, a country or a family that does not take care of their babies, old people, sick people and crazy people will not survive. That is why we pay tax. That and making sure our army is in good shape." He was obviously not politically correct.
What does this have to do with TALK. Any mental health worker who has had experience with a certain population of patients will tell you that what is heard is often misinterpreted. For example, airplanes flying over, cars braking, and things on TV. With that misinterpretation comes action. Sometimes these actions require staff in hospitals to subdue patients because of their reaction. If anyone argues that talk radio, news programs, crime programs, etc... do not influence the thinking is grossly ignorant. Therefore, yes the vitriolic voices win or loose depending on what you are trying to do.
If you are winning, you are getting more people to listen, higher ratings, promotions and more money. Because I periodically listen to Rush and others, doesn't mean that I agree and has nothing to do with ratings.. I just need to know what they are saying. I was shocked when Ms. Palin talked of putting individuals in the cross hairs. But I wrote that off to ignorance, and in the back of my mind I wondered how it had affected the impressionable and the delusional. I do not think that individuals who do voice anger and hate really expect that their words have such a negative effect.
Why cant we as a country step back just a few years and learn to argue effectively. In my sophomore year at Duke I had a wonderful Sociology professor. His words were something like this.... "As you study here and as you go about your life, take a vow to expose and oppose ignorance. Get your facts right. Argue them well. Understand that others have a right to their opinions and do not be afraid to let oppositional arguments become your own, if the facts are better than yours. If it is an issue of importance, do not be afraid to take action.Because you are educated and action is a requirement." This is certainly paraphrased because I cannot remember the exact words some fifty years later. This idea was repeated over and over throughout my four years at Duke. What has happened to us is that we cannot debate issues using civility and come to a compromise. We must be careful not to criticize compromise it is how we can survive as individuals and as a nation.
Again, I want to leave you my most important quote:
Dante once said that the hottest places in hell are reserved for those who in a period of moral crisis maintain their neutrality”
No comments:
Post a Comment