Mental Health Facility And The Emergency Room

In an effort to transform the public mental health system, in 1963, President Kennedy proposed the Community Mental Health Act. It was the first among several federal initiatives to create a community mental health care system. Once the act was ratified, there was an intense deterioration in institutionalization, otherwise known as “deinstitutionalization”, and by 1980 there was a 75% declined of the inpatient population at many public psychiatric hospitals. In 2000, there was less than 10% of the public institutionalized just fifty years earlier. In 2009, there was even a more dramatic shift among children and adolescence whereby there was a 98% decline in

Many years ago, mental illness was viewed as a demonic possession or a religious punishment. In the 18th century, the attitudes towards mental illness were negative and persistent. This negativity leads to the stigmatization and confinement of those who were mentally ill. The mentally ill were sent to mental hospitals that were unhealthy and dangerous. A push in the mid 1950s for deinstitutionalization began because of activists lobbying for change. Dorothea Dix was one of these activists that helped push for change. The change called for more community oriented care rather than asylum based care. The Community Mental Health Centers Act of 1963 closed state psychiatric hospitals throughout the United States. "Only individuals who posed an imminent danger to themselves or someone else could be committed to state psychiatric hospitals" (A Brief History of Mental Illness and the U.S. Mental Health Care System). Deinstitutionalization meant to improve quality of life and treatment for those who are mentally ill. This would hopefully result in the mentally ill receiving treatment so they could live more independently. The hope was that community mental health programs would provide this treatment but sadly there was not sufficient or ongoing funding to meet the growing demand for these programs. Budgets for mental hospitals were reduced but there was no increase for the community based programs. Many mentally ill individuals have been moved to nursing homes or other residential

Because states needed Medicaid reimbursement from the federal government, they had no option but to transfer patients with mental diseases from state hospitals to nursing homes and community psychiatric facilities. It is these alternative

Mental health services in St. Louis have undergone a multitude of changes as stigmas towards mental health issues have begun to change. Traditionally, mentally ill individuals were thought to be lacking religion or in trouble in the eyes of God, and this thought process was believed until after the Middle Ages. These beliefs may have changed, but the attitudes towards the mentally ill were continued into the 18th century and beyond, which caused an increase in the stigmatization of mental illness, and thus subjected these individuals to humiliating and unhealthy conditions found in the original confinement of mentally ill patients, asylums. The government created mental health asylums, which separated these individuals from their societies,

In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the

The history of mental health in the United States show a robust movement towards the mental healthcare system we have today. Prior to the 19th century, individuals with mental health issues were widely considered to be demonically possessed, thus contributing to the stigmatization of mental illness and the proliferation of poor treatment conditions. However, in the 1800s, there was a dramatic change in mental healthcare in the U.S. The government took a proactive role in treating the mentally ill, leading to the dawn of state psychiatric facilities.

The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.

Resources for Human Development (RHD) is a national human services nonprofit founded in 1970. The company currently oversees and supports more than 160 programs in 14 states. The programs fall under the following categories: Intellectual Disabilities, Behavioral Health, Addiction Recovery, Homelessness, Women & Children, Family Health & Counseling, Youth Development, Returning Citizens, Economic Development, Employment & Training, Veterans, Nonprofit Incubator, and Outsider Art. Within the Behavioral Health program, there are two Assertive Community Treatment (ACT) teams. The ACT Program provides community-based services to individuals with severe and persistent mental illness. The mental illness may also be accompanied by a substance abuse disorder and/or a developmental disability. The program is an outpatient agency and each ACT team has about 100 clients.

The mentally ill were cared for at home by their families until the state recognized that it was a problem that was not going to go away. In response, the state built asylums. These asylums were horrendous; people were chained in basements and treated with cruelty. Though it was the asylums that were to blame for the inhumane treatment of the patients, it was perceived that the mentally ill were untamed crazy beasts that needed to be isolated and dealt with accordingly. In the opinion of the average citizen, the mentally ill only had themselves to blame (Surgeon General’s Report on Mental Health, 1999). Unfortunately, that view has haunted society and left a lasting impression on the minds of Americans. In the era of "moral treatment", that view was repetitively attempted to be altered. Asylums became "mental hospitals" in hope of driving away the stigma yet nothing really changed. They still were built for the untreatable chronic patients and due to the extensive stay and seemingly failed treatments of many of the patients, the rest of the society believed that once you went away, you were gone for good. Then the era of "mental hygiene" began late in the nineteenth century. This combined new concepts of public health, scientific medicine, and social awareness. Yet despite these advancements, another change had to be made. The era was called "community mental health" and

In 1965, there was a histrionic change in the method that mental health care was delivered in the United States. The focus went from State Mental Hospitals to outpatient settings for the treatment of mental health issues. With the passing of Medicaid, States were encouraged to move patients out of the hospital setting (Pan, 2013). This process failed miserably due to under funding and understaffing for the amout of patients that were released from the State Mental Hospitals. This resulted in patients, as well as their families, who were in dire need of mental health services. This population turned to either incarceration (jails and/or prisons) or emergency departments as a primary source of care for their loved ones.

In the Provision of Mental Health Services at the Detention Hospital in Guantanamo Bay article, it covers the treatment of detainees and the use of mental health officials in the military setting. The American Psychological Association questions whether it is ethical for psychologists to participate in nontraditional clinical activities. The detainees of Guantanamo Bay are sent to officials through a referral process and are provided with multiple psychological and psychiatric therapies. The purpose of this study, was to address the situation at Guantanamo Bay and show that detainees is treated with the best possible care. The treatment of detainees are an important thing, because these individuals are humans and have rights, despite what they are accused of participating in. In my opinion, I think that it is ethical for psychologists and psychiatrist to work in this nontraditional setting, as long their motives are to the detainee and not the towards the agenda of the military. One thing that was mentioned multiple times in the article was that the mental health officials did not partake in any of the interrogation settings and if a detainee was unfit to be interrogated then they were not interviewed, and I think this concept is for the best. The only problem that I do have with this program is not knowing how much oversight that the military has over the officials and their care, and if it is really possible to keep these two aspects separately. One way that detainees are

Hospitals, long-term care facilities/programs, and mental health efforts in today’s health care system all play a vital role in the delivery and availability of health care and there are key things to understand about each of them. One key point to understand about hospitals, is that they focus on quick cures for diseases, illnesses, and other ailments rather than focusing attention on long-lasting cures and prevention. Hospitals are understood to be a center of advanced technology which, as a result, means they are faced with more complex patients, higher acuity of care, and an increase in costs (Williams & Torrens, 2008). This is a key issue as hospitals also take the brunt force of care to indigent, uninsured, and homeless populations, making payment for services difficult to come by.

During the mid-1800’s the mentally ill were either homeless or locked in a cell under deplorable conditions. Introduction of asylums was a way to get the mentally ill better care and better- living conditions. Over a period of years, the admissions grew, but staff to take care of their needs did not. Asylums became overcrowded and treatments that were thought to cure, were basically medieval and unethical

It is my understanding that hospitals, long-term care centers, and mental health systems are different for a few reasons. The type of care they offer and the patients they serve are quite different. Each system has evolved through the years, but their types of patients remain different.

The average stay in my unit, the psychiatric emergency room, is typically anywhere from four hours to twenty four hours. One patient recently broke the record with her stay being close to two weeks. This was a major concern for our unit as placement for her was difficult to find and staff had never dealt with a stay this long in the past.