IDEMA: Should we be building more state mental hospitals?

Most clergy in their training get clinical pastoral education, or CPE, in either a general hospital or a mental hospital.
Apr 24, 2013

I did my CPE at Boston State Mental Hospital during my theological training; and in 1976 I did a year of CPE at the same hospital, living in the hospital itself and eating my meals with the patients. The hospital gave me a room overlooking the morgue.

Churches are on the front lines of the battle against mental illness. We are the poor person's psychiatrist. CPE enables the clergyperson to understand what he or she can deal with and when to refer to a social worker, psychologist or psychiatrist. 

Sometimes clergy are even involved with commitments to mental hospitals — sometimes with an involuntary commitment, a very messy business I can attest to.

The most agreed-upon point in the whole debate about gun control and whether to expand background checks is that people with mental problems should not be able to purchase a gun. Here is the rub. There are no specifics being offered that I am aware of concerning how we can improve or increase our treatment of the mentally ill.

How about building more state hospitals?

While I was working as a chaplain and a student at Boston State Hospital, I saw the beginning of what became the shutting down of the state hospitals, including Boston State, and the move to community mental health programs. The problem was that this was often a ploy to save state money, and the resources were never adequate for excellent community mental health in many cities.

The 5,000 acres of Boston State are now condos! And our state hospital in Traverse City is a shopping mall.

Some of my patients were released from the state hospital into community treatment and ended up being murdered on the streets of Boston.

After my year of CPE, I returned to parish ministry in the Grand Rapids area. I started working one night a week in the soup line at the Guiding Light Mission on Division Avenue. More and more of our customers were released patients from Michigan's state hospitals, which were being closed. 

The Roman Catholic nun I worked alongside said to me, "Let me break up the fights."  They would not slug a nun!

Movies like "One Flew Over the Cuckoo's Nest," "The Snake Pit" and "Girl Interrupted" reinforced stereotypes of mental hospitals. I saw at Boston State some awful things — people who had lobotomies (no longer being done when I was living there), patients overmedicated, people who should have been in prison instead of a state hospital, criminals mixed in with defenseless patients, and victims of unspeakable sexual abuse, sometimes by parents.

Today, however, due to a lack of beds in our state hospitals, many mental patients populate our prisons, and many criminals wander our streets, often victimizing the homeless.

By the way, the "homeless problem" accelerated when the wards of our state hospitals were emptied. Few connected the dots back then or even now. Actually, forget the dots — there is a direct correlation between mental illness and homelessness if we as a society are willing to see the truth.

Here are some of the positives I saw at Boston State: There was community, the building of which was part of my job. The food was excellent (great scallops on Fridays). The patients had clean sheets and were safe. Yes, they lived on locked wards with bars on the windows, which movies constantly remind us, but they were not murdered as homeless people. And they had us chaplains to talk to! For the most part, the attendants were kind and compassionate.

The drug problem in our society escalated in the 1970s, at the same time the mental hospitals were shutting down. There was thus less opportunity for treatment — and when you combine the use of drugs with mental illness, you have a lethal combination.

As a society, we have put vast resources into our wars: Vietnam, Iraq, Desert Storm and Afghanistan. We have put a small fraction of that price into mental health treatment. Now many of our vets cannot get adequate mental health treatment, and many are committing suicide. This is an outrageous example of immoral priorities.

So, our politicians are fiddling in Washington as our mental health crisis literally burns, as seen in mass shootings, suicides by vets, a growing drug addiction problem and homelessness.

In 2014 and 2016, I will be paying close attention to how our politicians voted on background checks for purchasing guns, but I will be paying even closer attention to where they stand on putting more money into mental health programs.

We could do worse as a society than opening more hospitals for treatment of the mentally ill, hospitals that have the resources to be effective and humane.

— By the Rev. Henry Idema, Tribune religion columnist

Comments

SignalMaintainer

Video I shot several years ago of the state hospital in TC http://vimeo.com/4671173

gordbzz231

this is the best column i have seen in a long time, someone directly involved in the mentally ill and state ways of saving money, its also done with our prisons, are our streets really that safe ?

rainbowjoe

This is a good piece of writing, and Rev. Idema raises some excellent points. Expanded mental health services are sorely needed in our society, but how are we to pay for them in our current climate of hyper competition for dwindling state and federal resources? Confinement and/or treatment of those deserving of mental health services is costly, but ignoring them may be even more costly as we're learning via headlines virtually every day. I once worked in a maximum security prison for several years, and it was said about 30 percent of incarcerated offenders suffered mental health issues. For the most part, they generally behaved while they were medicated and supervised, but they often returned to prison (sometimes quite quickly) for new offenses once direct management of them ended following their exit from jail. There is a lot of professional attention and a significant amount of resources already being devoted to the mentally ill but, thus far, it doesn't seem to be accomplishing enough. A substantial amount of criminal behavior and much of our national homeless problem is attributable to the mentally ill. I wish we could figure out and afford some sort of solution to this issue.

Sarah@TCMCounseling

Rev. Idema, Thank you for writing about the issues surrounding mental health. This is an issue that is not getting better, as services keep getting cut. I would like to remind people, however, that Tri-Cities Ministries Counseling has 23 therapists and is completely community supported. If a person lives, works or worships in the Tri-Cities (Grand Haven, Spring Lake or Ferrysburg) they will not be turned away and will receive counseling services. 842-9160
www.tcmcounseling.org
Thank you,
Sarah Lewakowski
Executive Director

LuditeHunter

Some humans are simply broken. While cost was/is certainly part of the reasoning behind the mental hospitals spewing human tragedy into the streets, so is Politically Correct psychobabble.

"Seung-Hui Cho, who committed the Virginia Tech massacre in 2007, had been diagnosed with severe anxiety disorder as a child and placed under treatment.

But Virginia Tech was prohibited from being told about Cho's mental health problems because of federal privacy laws.
Innumerable studies have found a correlation between severe mental illness and violent behavior. Thirty-one to 61 percent of all homicides committed by disturbed individuals occur during their first psychotic episode -- which is why mass murderers often have no criminal record. There's no time to wait with the mentally ill.

James Holmes, the accused Aurora, Colo., shooter, was under psychiatric care at the University of Colorado long before he shot up a movie theater. According to news reports and court filings, Holmes told his psychiatrist, Dr. Lynne Fenton, that he fantasized about killing "a lot of people," but she refused law enforcement's offer to place Holmes under confinement for 72 hours."

Excerpts from Ann Coulter's Jan 16th 2013 Column:
Guns Don't Kill People, the Mentally Ill Do
http://townhall.com/columnists/a...

Wingmaster

Now there you gone and done it you linked to an article that is.........right. I hear a "van" that is getting ready to "lan"d in your face.

pattio

Thank you, Rev. Idema for your insightful comments. Yes, we need to get more attentive and more creative in how we treat our brothers and sisters with mental illness. I attended the National Alliance for the Mentally Ill - Michigan Conference (NAMI-MI) last week to hear Patrick Kennedy speak about the passion he and his family have had for improved and refined treatment for the mentally ill. It was he and his father, Ted Kennedy, who constructed and were able to get passed the mental health parity act in 2008 so that mental illness would be treated on the same plain as any other physical illness. As he said over and over - mental illness is a disease, a brain disease, and we should have the same research and treatment that other diseases have.

We also need as a people to try to remove the stigma of mental illness, starting with ourselves. I have to wonder how all the exclusion, avoidance, ridicule, disenfranchisement and rejection affect the mood of someone who is mentally ill. Do you suppose some might get angry? Are we helping to create the problem, then blaming the victim? As a person with a family member who is mentally ill, I have watched this painful process occur. The stigma that is so damaging keeps the mentally ill person from acknowledging and accepting their own mental illness, thereby often precluding sufficient treatment. Each year I go on a walk in Grand Rapids called the Stomp Out Stigma Walk. We raise funds for the Mental Health Foundation of West Michigan who employ many people with diagnoses and who have constructed videos and talks that are delivered to schools, helping to educate future generations about mental illness. Perhaps they will begin to view this population differently.
I am certainly not alone in having a family member who is mentally ill - I know because as I have shared my experiences with others, many, many come forward with their experiences of having a mentally ill family member. It's something we never used to talk about. Let's begin to talk about it in a humanizing, dignifying, and respectful way for those who suffer from these brain disorders. And, let's see if we can begin to implement some different ways of thinking about mental illness and the people who have it. Many of these ways do not cost any money - they simply involve a greater understanding, a change in attitude and opening our compassion. Perhaps then we will find more sophisticated solutions for our brothers and sisters than leaving them homeless, or putting them in jails and prisons. If we continue to ignore their existence and entitlement as human beings, we will not have the passion to create the solutions needed. If we can spend hours figuring out our newest piece of electronics, I think we have the time and ability to understand and address this problem in a different, more creative, humane and satisfying way.

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