Abby: Navigating the Mental Healthcare System
Since the car accident occurred in another state, Mandy was required to go to a hospital in that state. Fortunately, the hospital had access to her health records since it was in the same system where she had received treatment for breast cancer a year ago. Medications that she received as part of breast cancer treatment likely affected her response to psychiatric medications. Mandy had felt “super-off” for the last eight months and was trying different combinations of her medications because she felt she was not getting help. At the hospital, Mandy was taken off all medications for a while to determine next steps for treatment. Abby noted, “That was really rough to see her there [in the hospital].”
I felt like the environment there was not set up to help people with mental illness. She couldn’t go outside. She really wanted fresh air and they couldn’t take her outside to get fresh air. There was a balcony. We kept asking the nurses, can she go on this balcony. [The nurses said],“We have four patients each. Only if all the other patients are fine, can we take her on this balcony.” It ended up never happening.
Initially, Mandy’s family did not visit her at the hospital, because one of Abby’s brothers was getting married at the same time. In her “emotionally removed” state, Mandy did not realize the wedding was happening. Later when Abby was able to visit, she became dismayed at her mother’s condition.
They tried a bunch of drugs. Nothing was working. She wasn’t eating. She wasn’t sleeping. She was scared of her bed because the name on the bed reminded her of the devil. She wouldn’t go in the bed. She would only sit in this chair. Her calves were swollen. It was really hard to see her like that.
Mental health staff stopped explaining the side effects of medications to Mandy because she “would take on the symptoms.” As a result, it was difficult to determine which medication was effective. Abby explained, “She was on Haldol for a long time and super shaky. It looked like she was 90 years old.”
After several delays of the court date for a possible civil commitment to enforce treatment, Mandy’s psychiatrist determined that “she wasn’t harmful to self or others.” She agreed to voluntarily stay in the hospital, but soon Julie, Abby’s sister, received a call that her mother was being released from the hospital, confusing the family. Since their father was out of town for work, her sister received the call.
We don’t know why she got released from the hospital, because she was not in a state to come home. The nurse had even said, “Make sure your house is entirely childproof. Make sure medication is locked up.” We’re like what? This is our mom.
Note: Civil commitment involves the legal system. A court order mandates treatment for mental illness when individuals are unable or unwilling to seek treatment and are a danger to themselves or others.
Management of medications is an ongoing challenge in Mandy’s treatment. Abby’s father, Ken, wishes to respect Mandy as an adult who can take control of her own health. He does not want to force her to take medication. However, her inconsistency in taking medications, made treatment decisions complex. In addition, Mandy did not always tell her therapist how she was feeling because she did not want to go back to inpatient care. Abby lamented about the challenges of treatment for mental illness—“Mental illness is so hard. You can’t scan the brain. Only if you could—oh here’s the magic mix that you need.”