Wednesday, April 27, 2011

Sick (and poor) in America

Picture yourself in this situation:

You are strapped to a gurney and rolled into a locked hospital ward. You may be left in a room without any human contact for up to 12 hours. No matter what your life history is, you are suspected of being a drug addict or alcoholic, and must be tested for evidence of this and HIV. You are not examined or tested for any other illnesses, so if you are actually sick and it is not plainly obvious, you will not be treated. Even if you are sick, unless you are in a immediate life threatening situation, treatment of your condition will be postponed.

A person comes into the room. If you are wearing street clothes, you are asked to remove them, and given hospital clothes to wear. Most of the time these are made of blue paper. If you have a belt, shoes with laces, earrings, or anything that is considered dangerous to yourself or others, it is taken away from you and locked up. If you have any personal care items that contain alcohol (which means just about anything) on your person, those are taken away. You are not allowed a shaving razor, a comb, nail clippers, nail files, or a blow dryer (it has a potentially lethal cord). Toothbrushes that are electric, battery operated, or just plain hard are considered "contraband."

You may be observed for up to three days without access to any books, magazines, papers, pencils, pen, or contact with the outside world. You must sign away your normal rights in order to receive medical care.

You, wearing the above "safe" clothing, and probably not as well groomed as the average person, meet with a doctor, a nurse, and possibly other adjunct professionals who are all wearing whatever they want. They sit behind computer screens and desks in large comfortable armchairs. You are given a small armless chair that faces them and asked to give an accounting of your entire life history in the shortest time span possible.

You are given a diet of overprocessed foods, high in fat and sugar. No food from the outside world is allowed to be brought to you, for it is considered "contraband."

You will be forced to attend meetings that have nothing to do with your condition. If you claim you do not have a condition that is being discussed, you are told you are in denial. Conversely, if you want treatment, or want to talk to someone about anything that you consider a problem, and you are not a danger to yourself or others, you will be given nothing to do and no one to talk to.

If you find this situation distressing, you are given a pill to make you more comfortable. However, if you ask for said pill, you will not receive medication. Those who are detoxing from drugs are given substitute drugs that are more expensive and more physically dangerous than the ones they were originally on. If you say you do not want to take them, they may be administered to you against your will at the discretion of a doctor. If you do not have a drug history, drugs are suggested, and if you do not take them, you are told you are resisting treatment.

As you probably suspected from the beginning, this is what goes on in an average psychiatric ward in an American hospital. I could go on, but I suspect you have heard enough to wonder if this possibly could be therapeutic.

Generally speaking, the only therapeutic value in going through this Kafka-esque experience is discovering one's inner strength. People who are in dangerous life situations may be helped to find places where they can live when they leave the hospital. People who are on drugs or are alcoholic are in a fairly safe place to detox, though certainly the experience is pretty dehumanizing. People who are able to socialize will find solace and help by talking to others, but it's a sad state of affairs that one has to go to a psych ward to experience community. In spite of all the attempts to de-stigmatize "mental health problems," we still are told to be ashamed if we are struggling, sad, angry, or self-medicating ourselves. There is only one option for help in most communities, and that is the 12-step program.

Of course, for those with good financial resources, there are better solutions. There are many healthier options, but these are not covered by insurance. A good example would be the Kripalu Center for Yoga and Health: There you can do yoga (of course), eat healthy food, and engage in a myriad of life affirming and positive activities, listen to music, dance, laugh, and even cry. If you cry, you might get a hug. Hugs are not allowed in psychiatric wards.

Photo note: © Jarek Tuszynski
I feel like I'm stating more of the obvious here, but. . .liability issues prevent the majority of psychiatric wards from allowing patients (or "clients") to engage in exercise or be in the outdoors, both of which are proven to be better mood elevators than any medication.

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