Tuesday, June 28, 2011

ER care for Mental Health Problems

Last week psychcentral.com posted an article asking the question 'Can You Take Someone to the ER for Mental Health Help?'. To me the answer is obvious: Yes, you can. So the first time we needed to make that decision it was an easy one. I should qualify that by saying that to ME the answer was easy. Convincing L of the same was more difficult.

Like most guys I know (from own experience and through stories shared by friends) he hates going the the doctor/ER anyway. Add in that this is not a physical problem and you have an added layer of resistance. The first trip, however, did nothing to alleviate those feelings in him and made even me more resistant to going. Why? Because none of the times that we have gone have been a good experience.

Part of the problem is that most hospitals, from our experience, only have an on-call psychiatrist during the night/weekend who will have to be called and then drive in to the hospital. The wait time is spend in more agony for L having to answer questions, being left alone for long times, looked at with pity by the nurses and doctors that are there. Since they are so poorly equipped to deal with these types of situations L generally tends to want to leave early instead of waiting for the help he needs at that time.

The one hospital we have been at that was equipped with a mental health ER section was not any better. We had gone because L was feeling extremely suicidal and knew he needed help. Since in the past we had bad experiences with wait time etc we made the longer drive to this other hospital. Once there, I was not able to go with L until his grandparents had come to pick up the girls (this was before Mr K was born). Their mental health section consisted of 4 small rooms within a secure area. He was literally in lock down in his room with just a bed, door open, and video monitored as well. I understand that it was to 'keep him safe' but being treated that way did in no way help him. And even though this was specifically for mental health related patients the wait to see anyone was still almost an hour.

After all these experiences we are both wary of going since all that tends to happen is waiting around for what seems like an eternity to then be told that all beds at the local inpatient treatment centers are full anyway, should he decide to go that route.

What it boils down for us is that we avoid the ER if at all possible. We are fortunate to have other options during the day thanks to the VA. The clinic L goes to has been wonderful at getting emergency appointments for L when he needed them, the same day even if necessary. I know many others do not have that option.

What has your experience been?


Jessa said...

I went to the ER after my suicide attempt. They didn't keep me as I wasn't in imminent danger at the time and had someone to stay with me and prevent me from using fire arms, pills and sharp objects. Just had to sign one of those papers that said I wasn't going to self-harm. They made me an emergency psych eval for the next morning. That was in a pretty small town though so I don't know if it would be different in a larger city/larger hospital.

Kris said...

To me signing something saying you won't harm yourself is really not much help. There is much work and education left to do when it comes to mental health issues

Esther said...

I actually had a good experience both times I went to the ER with PPD after I had Muffin. Well, as good as you can when you're dealing with a situation which requires an ER visit and hospitalization, but you KWIM. This was the hospital on base. When I got there, I told the clerk what was going on, that I was 3 months post-partum and having thoughts of killing/hurting myself. They took me immediately to the back. I was put in a private room right in front of the nurse's station where they could have eyes on me the entire time. They did labwork and an EKG, in addition to vitals and all that stuff. The charge nurse was wonderful, she was active duty and she had actually had a bad experience with PPD herself so she was able to reassure me that this wouldn't adversely affect my husband's career in the military and they wouldn't take my baby away. She was so kind and sympathetic, she just sat there and listened to me and reassured me and hugged me and gave me a shoulder to cry on, literally and figuratively.

The Mental Health ward there at that hospital only takes Active Duty so they transferred me to a civilian psychiatric care facility.

Both of my visits and hospitalizations with the PPD were that way. I never had to wait to be taken to the back and I was always treated with compassion, kindness, and dignity.

And, I actually DO know people for whom signing a paper saying you won't hurt yourself has been helpful. It really depends on the person. I agree that there's still a ton of education and work to do WRT mental health and taking away the stigmas, but things like that can help some people.

jonwilson said...
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