When We Don't Value Psychiatric Care

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

A long-time reader experienced the harmful consequences of low funding for mental-health facilities:

I have had major depressive disorder my whole life >60 years. I’ve been hospitalized 25-30 times—once for three months. And yes, you can get psychiatrists who say “You do what I tell you or I will put you in involuntary admission to the state hospital for a MINIMUM of six months … and there is NOTHING you can do.” What a power trip!

I have watched psych care change from three separate units in the hospitals to one general ward where the psychotic drug abusers, the schizophrenics, and depressives are all put in one large room. Health insurance pays BIG for major trauma—surgeries, ICUs, ER physicians, physical therapy, more surgeries. But for psych? Tiny by comparison.

So they cut staff and room for psych. We used to have art therapy (drawing with crayons), ping pong, basketball—tough to do when they take your shoelaces. But no money! Registered Nurses no longer come onto the ward. They sit behind one-way glass watching us on monitors. Cameras are even in our bathrooms and bedrooms! The nurses sit and watch computers.

Last time, there were 30 of us crammed into one room—just enough room to crowd in 30 stuffed chairs. Many of us are put on major tranquilizers and just want to sleep, but we are gotten out of bed at 0630, marched to the ward room, then stand in lines to get our meds—determined by a doctor who puts you on what THEY want, even if I’ve been on the same meds for decades. The change in meds can result in auditory and visual hallucinations, or the feelings of ants or spiders under your skin. Patients are screaming, crying.

We had HUGE techs—mostly former football players who stand around and yell at us. And if we do something wrong (most of the time we have NO idea what we did!) we can’t go to the cafeteria to eat! I went from 140 pounds to 125 in two weeks. And you cannot go back to your room and sleep! Not until 8:30 pm.

Why is the place is run by huge techs? Because psych patients CAN injure each other and the staff, so the ALL-important thing anymore is staff safety. But when you USED to have many aides, nurses, space, group therapy, patients were caught BEFORE getting violent.

Because of state rules you aren’t allowed to put leather restraints on wrists and ankles and chained to a gurney. Now they just put you in a padded room—mustard yellow-green, like baby shit.  Only a bare mattress on the floor—no blankets, just a paper patient gown, and it’s ALWAYS cold.  

Getting medications? You know how when you buy a ticket at a movie theater, you talk into a microphone and they slide the ticket under the clear plexiglass glass—in the slot? That’s how you get meds. You have a bar code on your wrist band and the LPN scans the bracelet, then her computer opens the drawer and you get your meds. You say, “That’s the wrong meds.” They reply, “Take it up with the doctor.” Sure, a different doctor gives you two minutes a day. Your internist is NEVER called; these are isolated units.  

The last time I was in, I also had breast cancer. The surgeries made my chronic pain syndrome worse and the radiation caused all the ribs on my right side—where the cancer is—and four spinal vertebrae to break. I was placed on opiates. The doctor REFUSED to give me pain meds other than Motrin 800 mg 3x/day! So not only was I dealing with terrible depression—4th anniversary of my husband committing suicide in front of me with a gun, losing our home, being in horrible debt—but NOW I’m going to go into withdrawal. It’s TEN times worse than anything on TV.

As long as those of us with psych problems are seen as “crazy people” or nut cases and told to “cheer up,” PEOPLE WON’T CARE. It would be like telling a person with a brain tumor to “Go running, take up yoga, volunteer to get your mind off yourself—it works for me!” We respectfully treat patients with cancer, heart disease, diabetes. But psych patients? We are a throw-away society, so nobody cares!