On Demand
Mental Health Woes
Monday, July 07, 2008
The death of Esmin Green at Kings County psychiatric emergency room sparked controversy over the care patients get in public mental health facilities. We take a look at the state of New York psychiatric mental hospitals, talking with CNN correspondent, Mary Snow.
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Comments
one would think that after the deplorable conditions at the Willowbrook state facility in Staten Island was uncovered over 35 years ago, you'd never hear this type of news story, but some things never change. is there a difference between how one is treated in an emergency program versus being committed for life?
I ran into a similar problem at a major private NYC teaching hospital despite having full insurance etc. I went to empty ER at 5am Friday morning in great pain from my gallbladder. My self diagnosis was dismissed and they tried to persuade me to come back on Monday. At 4pm on Saturday ( 35 hours later) I was having emergency surgery for a gangerous gallbladder and ended up in intensive care for several days. A total lack of care and concern. My tip - forget the stiff upper lip and scream bloody murder.
Sadly, is the treatment of Esmin Green anything more than an extreme, tragic example of what is common in American healthcare.
We had to take our five month old to the emergency room two years ago. First was the interminable wait in the emergency room (in Park Slope). Second was the _two year_ battle with the insurance company to pay _anything_ toward the care of a five month old baby.
It is now -- outrageously -- a cliche in the United States to say that what is surprising about the case of Esmin Green is _not_ that it happened but that it is not happening more often.
I believe that the NYCLU had been fighting the city for better conditions in public hospitals and Bloomberg and company were fighting back. Now the city is changing its tune following the awful case.
Kings County was a snake pit as far back as the 1960s. Continued oversight by watch-dog groups is needed to clean it up and keep it cleaned up.
The only good which will come from this will be the law suit the Esmin Green family will file against the hospital and New York City.
Hopefully it will be hundreds of millions of dollars.
They really should just close the place.
Good luck to them.
with my father recently in the hospital I just thank the goddess that he has good health insurance.
Please do not use my name on air.
As a social worker who has worked in many health care and social service settings, I am sorry to report that this incident is only the tip of an ugly iceberg. I recently worked at a private health care facility and witnessed staff throw a sick homeless woman out into the street -- and she was found dead on the subway only days later. This case had no publicity and the facility was able to hush it up. I fought it internally and my job was "eliminated." The woman was disconnected from her family, so there was no one to fight or sue on her behalf. There are many stories like this.
That was one of the most, if not THE most, horrible stories I've ever heard/seen. But it's not only the case in Mental Health facilities, normal everyday ERs are horrors and there is probably at least on such similar story every day in them. I had a situation where I had sliced off the very tip of my index finger and went to St Vincent's emergency with blood pouring out of my finger. There was no one in Triage and the guard was eyeing women with big breasts and bums so no one helped me until I finally screamed at the guard (who still ignored me and waited sometime before he acted) tellling him I needed to see the triage nurse. They didn't know where he was then finally someone else came out to find out if I had insurance... Need I go on? Got the picture. One day my 80 year old aunt waited in a waiting room for eye exam for over 10 hours while everyone else who came in before and after her was being seen. Why didn't she say anything? She's one of the very kind, meek, sweet people who are dumb enough (sorry AJ) to think everyone is a decent kind human being and that she was letting them do their job because they were pleasant to her! Yes, I guess that was her fault but that's not the point.
I was thinking. if only the 3/4 of the working class with insurance would give 1/4 of the working class without, health care, would the world be a better place?
by the way where was her family?
Such problems are not limited to mental health hospitals. In fact, such psychiatric patients often reside in nursing homes, many of which are privately run. Kindred Healthcare is notorious for this. I was a social worker there at a rehab facility, and many patients, many if not most of whom had psych problems, were frequently ignored, over/under-medicated, stolen from, and god knows what else. The behavior at this recent location is par for the course in this setting.
Luckily, the facility I worked in has since been closed, presumably by the state authorities.
When my wife attempted suicide a decade ago, she was admitted to Bellevue and forced to stay in the psych ward for a night. It was something out of One Flew Over the Cuckoo's nest. She had to wade through an inch of urine on the floor to use the toilet; male patients roamed the halls with their gowns open and genitals on full display; and the staff dismissed any attempt at communication as the rantings of a crazy person. It was shocking.
It wasn't a psychiatric hospital, but a few weeks ago I was taken to the Elmhurst Hospital Center with a shattered cheekbone (around 10pm). As I was getting out of the ambulance, I told the EMT I was nauseous and was going to puke. He didn't respond and I said it again, and then I had no choice but to puke. I was strapped down, so my vomit went straight up and then back down on my face. No one bothered to even wipe my face off or give me a cloth to clean myself up. Throughout the night, in addition to asking for more pain medication (for over two hours I begged the attending nurse to get the doctor to give me more pain killer since the neck brace rubbed the back of my head and felt like an ice pick in my brain), water, clean sheets, etc., I asked for a cloth to clean myself off. I was routinely left alone for an hour or more at a time and it wasn't until after 6 in the morning when the oral surgeon saw me that I was allowed to get up and clean myself off.
In all, it was the worst night of my life and I can't imagine how much worse I could have been treated.
When I was working as a paraprofessional in a homeless services organization, I remember taking a client to Kings County to enroll in an alcohol treatment program and waiting for no less than five hours just to fill out the paperwork. I wonder how long the client would have had to wait if I had not been there to advocate for him.
What is expected for hospital psychiatric care during holiday weekends? My friend was admitted on Thursday and is only seeing a doctor today despite the fact that she was "lucky" enough to be admitted right away after very little ER wait (under an hour).
As a volunteer who regularly delivered meals to the Psych ER at NY Hospital (now officially NYP-Weill), I can't imagine something like this ever happening there. The psych ER was never overcrowded and always had both a nurse and a security guard in the room...
That said, I would regularly see patients who would curl up on their beds and face the wall or hide under their blankets. I imagine this would make it more challenging to realize if one had lost consciousness. But this is a challenge with psych patients generally...
I have to credit the NYH ER for its standard of care. If I ever had the misfortune to find myself in a psych ER, I would want to be taken there...
Thanksgiving week around 10 years ago, a friend of mine was admitted to a psych ward. She was having a bad reaction to some anti-depressants, and was told that this is where she could detox.
There were no doctors there until the following Monday, and so she could not get out. Not a single doctor to evaluate her, all weekend. And this was for a voluntary admission. Five days before she got out, and this stay did enormous emotional damage.
What other wing of a hospital would lack doctors for five days?
I am so glad we live in the greatest country in the world with the best health care system in the world. Thats what I am told ad nauseum by my politicians and media and why shouldn't I believe them?
So are the ER's over crowded or is it poor management or both?
I witnessed a very similar scene in the psych ER of an upstate public hospital. A patient collapsed to the foor in a locked waiting room. At first staff did nothing, then the semi-conscious patient ws restrained in four point restraints as he lay convulsing and groaning, and was screamed at while he was in restraints. At the same time, many staff members stood around discussing their plans for the weekend, The man struggled and moaned for an hour before eventually passing out, apparently from an injection he was given.
Are people desensitized to this? What has happened to compasion in our societies?
De institutionalization has left the mental health care system in a shameful state. Hospitals that were opened 100 years ago as an alternative to alms houses (basically homeless shelters), and prison, so people could receive treatment.
Brooklyn state Hospital, next to Kings County, when opened was the pride of the community. the Brooklyn Garden Club provided the plantings and landscaping to make a restful place for healing.
Yes things got out of hand and by the 70s underfunding and twisteed treatments turned the situation from bad to worse.
The downsizing of public hospitals and state facilities has led us the the shameful situation that we are in. KCH is overwhelmed with the number of chronically mentally ill, and nowhere to send them for long term treatment....
It is important, no matter how stressful, not to abandon our children once they reach 18 with mental illness, although they are adults, we need to watch and be vigilant they get the care they need.
This is horrible that this happened and that it happens all the time. I am happy those people not doing their jobs are getting fired and the city is under pressure.
These are human beings that have problems and need care not lay on the floor dying while those animals check their e-mail and look at the internet.
I am a psychiatric nurse practitioner in Ct. This is not dissimilar to what is going on everywhere. There are not enough psychiatric inpatient beds. Every time there is an event which involves a psychiatric patient, there is a huge outpouring of outrage. Nothing else really changes. It's like rearranging the deck chairs on the Titanic. In this economic downturn I don't anticipate any money being poured into this system. Until this country changes it's approach to health care and get the middle man (who is sucking up the profits and hampering the practitioners from doing their job) out of the picture, I don't think there will be real reform. This is true in all areas of medical treatment, but the psychiatrtic patient is always on the bottom of the list.
I took my husband to the emergency psych. ward at out local hospital due to extreme depression from PTSD he sustains after a horrendous car accident 2 years ag
fyi-We are "white college educated professionals" -I was appalled at the way we were treated. we were ushered into a crowded tiny corridor to sit side by side on hard chairs with drugged out teenage girls A nasty guard was staring at us, and would yell menacing threats- a woman was knocking her head against a wall and no one did anything, there was no privacy at all-we heard why everyone was there. no one spoke to us at all, except to get insurance info. a screaming woman came in and everyone was ushered into the hall right next to the door for the trauma entry, it was winter and blasts of cold air hit us. 3 hours later we were escorted to the locked psych ward, another "intimate"corridor. I knew the name and condiion of the others in our group. We witnessed a weeping girl who was manhandled by one of the security guards because she didnt want to be admitted. It actually took the paranoid schizophrenic patient to calm her down-no one else seemed interested. 8 hours after we arrived my husbnd was seen by a psychiatrist and our ordeal was over.
It was a miserable and insulting experience, and we are still fighting to get our insurance to cover it(my husband works for NYC)I can only imagine the hidden horrors people in the most fragile of states are subjected to elsewhere!
I recently had 2 experiences in two different emergency rooms for my aged mother each one was equally unpleasant.
I recently spoke to a hospital professional who informed me that emergency rooms are no longer run by the hospital but by private corporations any one know anything about this--from my personal experience I would say this is true there is a distinct feeling that the staff are dealing with numbers instead of patients I guess this is the real world.
CHECK THE STATISTICS FOR THIS HOSPITAL.
Beds: 627
Clinic Visits: 539,894
ER Visits: 116,689
Births: 2,423
I'd like to know how many doctors and nurses per patient. The sad thing is that this is one of many stories ...Remember last year in California when Ms. Rodriguez had to call 911 from the Emergency Room and 911 never responded and she died.
The truth is our government is more concerned with ATTACK and DEFEND rather than LOVE and CARE.
The first federally-run mental institution in this country, St. Elizabeth's, in Washington DC is a prime example. Most of the facility's vast campus and grounds are being turned into the Department of Homeland Security. AND just this year a woman was found in her house with 4 decomposing children under the age of 18.
I also wouldn't be surprised if the woman died from an overdose. We are living in the Age of Medication..the Era of New Science. I'm not sure if we've made any advancement from the Asylum Era. Pharmaceutical Drug Companies are now in charge of research, training, diagnosing and treating. In that equation there is little room for actual CARE, RESPECT and true CONCERN.
There are more than a few problems with the present system. And the majority of people are too busy working to pay the mortgage or the rent or shopping and watching TV to do something about.
This thread is closed.
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