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Crisis / Mental Health Facilities - need feedback please
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melly2210 posted:
Been thinking about why it is we all hesitate so much in checking ourselves into these places when deep down we know we need the help. For me, I know the answer is that I feel like I don't get the help I need when I get there. It's a humiliating experience for me from the get-go. The whole stripping and tagging every bug bite, pimple and mark on your body thing just, well, irritates me. Especially being clumsy and having to explain bruises that I sometimes don't even realize I've had. Then you add in the limited time you get with the doctor's. The change in meds. And don't get me started on group therapy, lock down and outside time...or lack thereof. I've also found myself looking in from the outside in as a caretaker too and having to advocate for someone else. And I am finding the system isn't very supportive in that respect either. So within all of that, I started to ask myself....if I could be in an ideal center, what would it have available? And some of the things I came up with went from crafts to equine therapy to fitness activities to spiritual support and activities. I realized that they dope us up and send us off to cope...in the very same world we had issues with coming in...and meds are not always the answer alone. So....I've been researching what it would take to put together a center that did all of that....that even brought family/significant others/caretakers in to help them to understand MI and how it impacts not just the patient but those around them. Think NAMI on a therapeutic scale. Or The Cancer Centers of America and their care model except applied to Mental Illness. Lots of things to consider, but I've found that to even start it all...there's a lot of work to go into it...like doing not for profit status, creating a board...etc etc...but the base is the plan or idea.

So my question to you all is:

If you could have a center available to you that addressed your needs in the time of a crisis....besides the obvious initial need of stabilizing you with medication, what else do you need? Is it prayer sessions? Access to music of your liking? Craft sessions? What would you wish for in the most perfect place that would help you to begin fixing what went wrong? What has worked or not worked for you? What would make you more willing to get the help you need when you first needed it instead of delaying it until it was absolutely necessary to get it? And of course, do you think that such a place is feasible?

Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all.  ~Emily Dickinson
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slik_kitty responded:
to be able to get in and get a room without sitting in the er for hours on end. being allowed mp3 or cd players would be nice. also computer access. one on one therapy instead of group therapy. a smoking area you can use whenever you need it, not on their time schedule. and i hate occupational therapy, so crafts are out. he he he

most things are money driven, so that's why they are set up the way they are. if money wasn't an object, then making these changes would be feasible.

oh, and don't wake me up at 5 or 6 in the morning to take my meds. grrrrrrrrrrrrrr
 
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ddnos responded:
Melly, good questions and thoughts.

Without sounding totally pesimistic, I don't believe that it's feasible for our current psych hospitals to make such drastic changes because the bottom line is money. It take money to make a hospital stay more theraputic. From my understanding, all or the majority of mental hospitals are there to keep people safe who are currently suicidal or homicidal. Little to no actual treatment is involved -the patient is just housed for a certain amount of time and then released no better than when they came in. Sure, they may (and hopefully are) past that point of crisis, but they will continue to need repeat visits to the hospital if they can't deal with the underlying issues that brought them there in the first place. That's not the role of the hospital.

Mental hospitals need to be treatment centers with qualified therapist and programs and trainings that can help the patient be better equiped for going back into the outside world. I do NOT beilieve the patient should be drugged up or thier meds drastically changed.

There is one thing, a contract of sorts, that everyone can have written up that says what you want and don't want at your hospital stay. Example, if you odn't want certain drugs, tehy can't give them to you - legally. If you want certain people to visit, but not others, then your wishes must be complied. It's called a Mental Health Advanced Directive. It's a legal document that you fill out re what YOU want and don't want re your treatment while at the hospital. Doctors must comply unless it goes again safety standards.

The following is a good link http://www.nrc-pad.org/content/view/16/39/ It's the National Resource Center of Psychiatric Advance Directives.

If you click "Get Started" on the main menue on the left side of page, there are webcasts and pdf's that explain how to fill out the form. Note, when you click , "Get Started" you won't see anything on the screen - you have to scroll down.

If you watnt to skip that, click "State by State info" again, scroll down and click on your state. Scroll down until you see "forms" adn then click on it. Scroll down again (they need to fix this site!) and it will tell you what forms your state has. Select the Psychiatric Advance Form.

Taken from

http://www.disabilityrightsca.org/pubs/508801.pdf

"A person with a psychiatric disability can benefit from having an Advance Directive in a number of ways:

"022 An Advance Directive can empower the person to make mental health treatment choices ahead of time in the event the person is found incapable of making the decision when in crisis.

"022 An Advance Directive can improve communication between patient and doctor. It's a good way to open up discussion with providers about treatment plans and the full spectrum of choices in treatment.

"022 An Advance Directive can help the person prevent clashes with family members and/or healthcare providers over treatment during a crisis by allowing those discussions to take place when a person is filling out her Advance Directive.

"022 Completing an Advance Directive creates an opportunity for the person to discuss her wishes in detail with family and/or friends. This may help family and/or friends more effectively advocate for the person when she is unable to advocate for herself and to advocate in ways that reflect the person's wishes.

"022 An Advance Directive may prevent forced treatment.

"022 An Advance Directive may reduce the need for long hospital stays"

I'd encourage everyone to have one of these filled out.

Debbie
Forgiveness is letting go of the hope that the past could have been any different --Unknown
 
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melly2210 replied to slik_kitty's response:
@ Slik....So what would you suggest for substitutes about the cords for the earbuds on the mp3 players or cd players? Been thinking on that one cause I miss my "therapy" music like crazy when I go in myself. But my music isn't everyone's and the MP3's solve that problem.

I agree 100% on 1 to 1 therapy. Most people cannot identify their triggers on their own let alone in a group setting.

Smoking? You're lucky you can smoke in your centers. Last one gave everyone a nicotine patch and said "not on campus."

As for the OT...what I am hearing is you don't want not attending a session to count against you as non-compliance with the "program." Right?
Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
 
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melly2210 replied to ddnos's response:
@ Deb...wasn't thinking of revamping an existing program but re-creating. The area I am in has 1 center which serves 3 separate counties. It's large, but what happens when they're at capacity. This is also the center that upon discharge even for voluntaries that if you don't make your follow up med appt (which is nothing but showing up to make another appt) they send the sheriff out to your home and fails to tell you the number at the top of your script is for MAJOR discounted medication at a local pharmacy in town.

I'm thinking this area could use a 2nd facility. Maybe not today, next year or the year after as it's going to take a LONG time to put together something viable and fund it and staff it. Like I said research phase. Just seeing that in order to do anything, there must first be a conceptual idea. And who better to ask what is needed/desired/wished for in a center than those who might one day need such a place?

The info on the Advanced Directives is awesome. Thanks! Added all those links to my resource file. Need to do some revamping of my own personal one with the new dx's, but I am getting to it. One thing at a time.
Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
 
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ddnos replied to melly2210's response:
Way cool, Melly! Another resource you may want to check out is a good place to model some of what you're wanting to do after them, the ICCD (International Center for Clubhouse Development) www.iccd.org

Here's a quote from their page, "ICCD is a global resource for communities creating solutions for people with mental illness. We help communities around the world create ICCD Clubhouses, which are community centers that give people with mental illness hope and opportunities to reach their full potential.
ICCD Clubhouses, now over 300 worldwide, are founded on the realization that recovery from serious mental illness must involve the whole person in a vital and culturally sensitive community. An ICCD Clubhouse community offers respect, hope, mutuality and unlimited opportunity to access the same worlds of friendship, housing, education, healthcare and employment as the rest of society.

ICCD promotes the development and strengthening of ICCD Clubhouses; oversees the creation and evolution of standards; facilitates and assures the quality of training, consultation, certification, research and advocacy; and provides effective communication and dissemination of vital research and information.

Established in 1994, ICCD is a non-profit and non-governmental organization"

Not suggesting you model what you want to do after them, but rather glean some ideas from what they have done since 1948, when the first clubhouse was formed BY PEERS!

They have a lot of good ideas that have worked, and some not so great ideas. I worked at a clubhouse for 5 years, and it's very rewarding, and it kept a lot of our members out of the hospital!

Check it out. Maybe there will be something you can use there.

Debbie
Forgiveness is letting go of the hope that the past could have been any different --Unknown
 
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Supa_Kay responded:
There were a lot of responses here and I didn't read through all of them, but I must say the treatment centers and hospitals here, do all those things. Crafts (painting, drawing, writing, puzzles), radio for down time (that the patients get to control), prayer circles (not mandatory, but available... they will even bring your spiritual leader in if you ask), relaxation techniques such as Chakra Tibetan song bowls I learned how to use one while admitted.

One thing that really gets to me is that I'm a smoker and personally I don't feel that it is appropriate to force someone to quit smoking while in mental illness crisis. But There is one Adult treatment center that allows scheduled smoke breaks if you comply with group therapy, that's not where you go if forcibly admitted though.

Still, for me, I think I feel like I'm admitting that I'm weak when I admit myself. I feel like everyone else is better than me, which in times of stability I know is not true, that's just what plays most in my head I guess.... Just that I lost the fight , again. Which is really hard for me to admit cause I'm hardly ever wrong and I win everything LOL
To the power higher above... Please keep your arm around my shoulder, and your hand around my mouth, Amen!
 
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Dyanne48jj replied to melly2210's response:
Hi Mel

That is something my thoughts have played around with for years. I have always thought that if I hit a huge lottery lol I would want to purchase a couple of those buildings left wasted in downtown. (thats always so sad) Then utilize them for homeless who WANT help. not just a place to sleep before another binge. In this thought I had given emphasis to MI and emotional help.

What you are speaking of, imo, is what the rich already get to enjoy under cover of a treatment spa, so to speak.
I love the ideas you have and ltos of the others on here. You would want it to be easily assessible, but there should be a 'tight' initial one on one w a psychiatrist to be sure this is what a person needs.
As said, group sessions are not always good, but I think at least 1 week should be mandatory as well as some group activities such as yoga. Locking ourselves away only hinders complete recovery. We all know MI needs 'total body' health so yoga or something along those lines is very important.
Out door group activities are wonderful, in this electronicly owned world. ex: a group of 10 in a circle, close your eyes, what do you hear? feel? smell? and other types of things like that.
Another big expense would be food because you would want to be sure peeps had fruits and veggies and not just powdered eggs and beans.
I do think though, if a person was to utilize this offer they would need to contract to a certain amount of time. NOt only to be sure it is a benefit to them, but to maintain a proper environment, staff and organization.
say, they contract to a week, then after a review, they agree to stay another week if so deemed necessary. popping in for 3 days leaving, and then just returning a month later for a couple of days helps no one.
so mandatories: a commitment; meals; yoga; 1-1; 1 group session; 1 outdoor group session.
Also available should be a smoking area, a hike or bike ride, and even a garden area for those that find that relaxing. Plant the veggies and let the patients help maintain it, helps them therapeutically and helps the food budget.
A chapel of sorts is a must w at least 1 service per week for those who wish to attend and a minister available when requested by a patient.
Crafts and other items should be offfered and strongly encouraged but with a sign up list for those interested.

also, bring in volunteers to talk or teach on popular items that may help the person in other areas of life. Money management, adult education, addiction, dissability and other government options re their health, healthy eating on a low budget, on and on and on.
I KNOW I am crazy....THAT is what keeps me from going INSANE!!! Oceans and Stars- Dyanne
 
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melly2210 replied to Dyanne48jj's response:
Excellent idea Dy. The garden is a fantastic one. There is already a group here functioning I read about in a community magazine that is going community gardens and small gardens in homes. She comes out, evals the area, helps set it up with the proper soils and stuff...and what is picked, a percent of it gets donated in return for her time to local food banks. I could probably link resources there, since she's connected into the homeless/poverty stricken and oftentimes MI people.

Since it's also horse territory here. Farm after farm. Stable after stable. I thought equine therapy too. Resources in the area, ya know? Teach people to care for a big animal who is extremely sensitive to emotions of the people around them. They've used that with handicapped, disabled, autistic spectrum, substance abuse, and so on and so forth. Got to be a program out here.
Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
 
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melly2210 replied to Supa_Kay's response:
Thanks for your ideas, and yes, I agree...a crisis is not the time to start talking sudden smoking cessation.

You have had it very lucky because I've only ever been in one hospital/mental health center that offered the whole health criteria. Unfortunately, it was a faith based hospital and I didn't follow their belief criteria. I had a hard time accepting their form of prayer and laying on of hands and such. Survived it because of all the other stuff though.

And like you I always have a major sense of failure when I go in. Been asking myself what would make me feel less like that though? Any thoughts?
Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
 
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Dyanne48jj replied to melly2210's response:
THRU THESE DOORS,
WALK THOSE WHO ARE STRIVING TO BE THEIR BEST.
I KNOW I am crazy....THAT is what keeps me from going INSANE!!! Oceans and Stars- Dyanne
 
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melly2210 replied to Dyanne48jj's response:
A mission statement for the patients!! General enough to fit all Mental Health issues and very much clear of the base expectation.

Not sure though if as a licensed mental health facility I could refuse an involuntary or not. Never compliant at first. More to think about. And research.
Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
 
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HeidiSue3 responded:
I would just appreciate not feeling like such a prisioner when you arrive where you are told to take everything off while they go thru all your possessions. Last time they made me sit in a gown out in front of everyone that was horrible and horrific to me/it brought back memories of the group rape that I had gone thru.

Sometimes I feel like the people working there really do not give a crap about you. I know that they have heard it all different day but I am an individual struggling.

I would love a chance to go outside, other then smoking time in a little tiny courtyard and since I do not smoke I would prefer not to be there. Do they not think that fresh air would help.

How about hot meals and real coffee.

Heidi
 
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Supa_Kay replied to Dyanne48jj's response:
I love the gardening idea.... LET US OUTSIDE!!!!!!! and it's so therapeutic anyway
To the power higher above... Please keep your arm around my shoulder, and your hand around my mouth, Amen!
 
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Supa_Kay replied to melly2210's response:
Through other posts too, I have come to realize that maybe because I'm in a small but bigger town our hospitals offer more than some others. The way it has been explained to me every time I go though is that it is basically to give a break from life and to stabilize, not to treat per se. Though on that same note I have always had at least 2 1 on 1 with pdoc every time I'm admitted.

I don't like mandatory lights out or blood pressure checks at 3 a.m. but i.m.o some of those not so pleasant aspects of crisis centers keep their services from being abused, you know what I mean? Who truly wants to share a room with a stranger or have some cranky old nag watch while we shave our legs... blah. And I have seen more than once, people that say they are suicidal just to have a place to sleep while they are there. I have seen a girl come in and say shadows were chasing her after a binge of meth just to walk out when the drug wear off. Idk I love the concept of giving more to the people that need more to help them, but we have to keep in mind the more that can be given the more there is to take. Furthermore, when we offer "more" to someone who doesn't truly need it, by doing so we are taking more from those who arn't getting enough as it is. It's such a fine line....

In my perfect world they would teach psychology or at least some basics of it in middle school. I think it would de~stigmatize a lot of the negative self talk when trying to get help. I actually did a 40 minute presentation for my Eng 202 class on a system that would combine the tactics of 1-800-Dentist and a suicide hotlines in an effort to minimize stigmas and make treatment more accessible to the general public.

If I only had all the money in the world. I love the horse therapy idea too... It truly is amazing how wonderful it is for patients (my son has autism spectrum disorder) and those who support patients. Kudos on the topic though, if only we ruled the world hu? LOL
To the power higher above... Please keep your arm around my shoulder, and your hand around my mouth, Amen!


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