America’s Broken Mental Health System

Anthony Acampora

America’s Broken Mental Health System

Why is it that all too often those who are suffering with mental health disorders become marginalized and find themselves as outcasts in our society?  Are they not simply dealing with an illness like any other illness? Well, not exactly. The reality is, funding for mental illness is abysmal, the care that is provided is at times flawed and the way in which patients are treated can be inadequate, and demoralizing. Most psychotropic medications take two to three weeks to reveal any results, yet in most cases, the emergency room psychiatric units are set up to hold patients three to six days, if not less.  How can anyone assess the medications effectiveness in that time-frame? I believe this is a major contributor to the revolving psychiatric unit doors that plays out on a daily basis throughout the county. When the patient inevitably returns or survives a suicide attempt, they are now the target of the perceived failure to get better, instead of the system that failed them. Studies prove that those who have a longer stay in treatment have higher success outcomes.

In addition, an enhanced screening process for mental health professionals would have an impact on success rates. Often times, how the patient responds to treatment has a direct correlation with the way they are treated by the mental health professionals. The patient walks in with very low self-esteem, so when treated poorly or disrespected, this only reinforces the feelings of worthlessness and despair. This is not all mental health facilities, nor is it all healthcare workers. I work with amazing mental health and addiction professionals on a daily basis who go above and beyond the call of duty. Enhanced compensation packages for potential employees in the mental health industry would be a good start, if not the wages, perhaps the benefits. Adding incentives to draw in higher caliber individuals or implementing programs to incentivize those who have experienced mental health disorders to pursue a career in this field would also be beneficial. No one would better understand those suffering with mental illness than the people who have gone through it and have come out on the other side.

Let’s focus now on the area of the seriously mentally ill. The source of this topic is from Mental Illness Policy Org.  I have known the founder and executive director, DJ Jaffe for many years and had him as a guest on Banyans- Faith in Recovery radio show to discuss the mental health system. Below are some statistics for reference:

Those with a serious mental illness account for a disproportionate share of suicides, homelessness, violence, and incarceration.

  • 18% of population over 18 (43 million) has ‘any’ mental illness.
  • 4% of population over 18 (10 million) have ‘serious’ mental illness (SMI).

DJ Jaffe made the following profound statement during our interview, “In order to receive mental health treatment in the U.S. our laws require dangerous behavior rather than prevent it”. A case in point is Nicholas Cruz who killed seventeen students and staff at Marjory Stoneman Douglas High school in Parkland, Florida. Records obtained from the Broward Sheriff’s office by CNN show the law enforcement agency received at least 45 calls for service relating to Cruz or his brother from 2008 to 2017 prior to the attack at Marjory Stoneman Douglas High School on 2/14/18. This individual was well known to police and school officials. He had also made threats that he will “shoot up the school.”  It is a tragic story, but one that continues throughout the country to this day. Another major problem with the mental health system is the insurance guidelines including Medicaid. The main issues are the provisions in Medicaid which prevents states from getting reimbursed for mental health issues.

If you have a problem with any organ in the body, Medicaid will reimburse the state 50% of the care, but if it is a mental health issue, they will not! The brain is the most complex organ in the human body. If it malfunctions in any way the patient is penalized, stigmatized, and in some cases demonized. Contrast that reaction with a heart attack, broken leg, or cancer. The support and encouragement is unlimited, yet rarely the case with mental health disorders. It’s policies such as these that keep those suffering with mental illness from receiving the much-needed care they need, and keeps the stigma alive and well.

Let’s focus on the area of Faith as it relates to Mental Illness. Source: McLean Hospital, Dr. David Rosmarin is the Director of Mental Health and Spirituality at McLean Hospital. He is also a psychology professor at Harvard. McLean Hospital is the #1 ranked psychiatric hospital for adults in the country by Helio Psychiatry. I had Dr. Rosmarin on our radio show on June 15, 2018. Of the top ten psychiatric hospitals in the country, McLean is the only one that has a Faith / Spirituality program. Rosmarin and colleagues conducted a study on the significance of spirituality as it relates to mental illness. The study indicated that 58.2 % of patients being admitted to McLean wanted to have a spirituality /faith program in their treatment plan. An April 25, 2013 article in Science Daily News, a Mclean study concluded, “Belief in God is associated with improved treatment outcomes in psychiatric care.”

A logical question that may come to mind is, if more than half of patients entering a psychiatric hospital are requesting faith programming, and recent studies are determining it is effective, why do we only see one of the top psychiatric hospitals employing faith programming? Perhaps it’s due to the increased politically correct environment, or maybe leadership is reluctant to implement a different treatment approach. Whatever the rationalization may be, the reality is, faith plays an enormous role in many people’s lives. If it can be a source of hope and healing for those in emotional pain, it should be incorporated into patient’s treatment for those seeking it.

Finally, I also had the privilege to have Dr. Keith Ablow (Fox News Mental Health Team) on the radio show June 30, 2018. His comments were shocking! Quote from Dr. Keith Ablow, “People go to the emergency room for help and they don’t get the help they need. They go there feeling as though they are going to hurt themselves or someone else and they are asked if they could ‘contract for safety’ Translation- to say that they will not harm themselves or others.  Wait a second, what happened to the fact that they just came in and said they were going to do that! That question is designed to show them the door. Somehow third-party insurers have been able to get the therapist to do the bidding of the insurance company or they will get the third degree.”

That is a very sad and disturbing commentary on a truly broken system.  I could not think of anything worse than a person who is suicidal and have their lives be in the hands of greedy motivated insurance companies. Are you starting to get the idea as to why it is a broken system? The Recommendation: There must be federal mandates on insurance companies, particularly when someone is suicidal and or homicidal. The mental health professional must have autonomy to make sound ethical decisions on patient’s treatment. They no longer can be influenced by insurance companies.

Having insurance companies play a part in treatment regimens for the mentally ill cost lives and will continue to cost lives until something truly changes. The bottom line is mental illness and mental health disorders are a vicious cycle of tremendous pain, despair, anger, shame and hopelessness. It destroys relationships with family and friends. It undermines confidence and makes the individual question who they are and who they have become. The Recommendation: Revamp the emergency room systems to provide more time for the patient to heal. Stop chasing people away who are suffering and seeking help. Refer patients to other facilities that are more equipped to handle what the person is suffering from. We do it with other injuries and illnesses all the time. Patients are air lifted to higher levels of care that specializes in what the patient needs. Enhance the pre-employment screening of mental health workers. They must have basic attributes of compassion and patience. They are on the front lines of this battle.

Throughout the research and writing of this article, I realized the title “America’s Broken Mental Health System” implies that it was once functioning effectively, however the reality is that is simply not the case. There may have been periods of time where mental illness received more attention and federal funding but it never functioned properly. Big pharmaceutical companies became rich, but the average person who is suffering from mental illness understands all too well that this system is failing them, not the other way around.

We must stop shaming people who are tormented through no fault of their own. People with mental illness can and will recover with proper treatment and compassion. They deserve the chance to receive legitimate care, they deserve a fighting chance to overcome, or, at the very least, experience relief from this horrible illness. A word of encouragement can also go a long way especially when someone is in desperate need of hope. When in a dark place, just a little light can make a huge difference. Let’s be that light in the darkness for those who are suffering from mental illness.

Anthony Acampora is the Faith Program Director & Chaplain at Banyan Treatment Centers. He is a published author, writer and speaker. He earned a Master’s degree in ministry from Vision International University and received a Master’s Diploma in Biblical Studies from the Int’l School of Ministry. He is a former board member of the Henderson Behavioral Health, FACT and the National Alliance Mental Illness, Broward County. In 2019 Anthony was selected “Professional of the Year” by Broward National Recovery Month Organization. In 2018, he was selected as Global Goodwill Ambassador representing the USA. In 2015, he received the “Volunteer Recognition Award” from National Alliance Mental Illness, Broward County In 2014 – Selected “Public Citizen of the Year by: National Association of Social Workers, Broward County. He is the host of the Faith in Recovery Show.