I’m not a MH professional, I merely grew up with one mentally ill parent. I can’t pretend I don’t have biases, and you’ll probably be able to figure them out easily.
My mother is currently called Bipolar. Her first episode was in 1960, and from the stories, her treatment was perhaps as bad as the worst movie depiction you ever heard of. They called it Paranoid Schizophrenic at the time. She recounts tales of being given insulin shock treatment, and one of the other people in this therapy cohort died of it. I don’t need someone to confirm the story, mostly because I’m fairly sure that’s old news, and they won’t do it now. I can’t say if she was a voluntary admit or if her parents insisted. I wasn’t there, and her parents were remarkably secretive while alive, and have since passed, with questions unanswered.
In the '70’s, she would generally get a heavy dose of downers if she went to a hospital, and then be released drug-free. They also began to call her Manic/Depressive. I know that seeing her on a dose of Haldol, stiff, shuffling, and drooling down the hallway toward me, with my father and the doctor telling me to go hug the terrifying zombie is a recurring nightmare. I don’t need someone to confirm the story, mostly because I’m fairly sure that’s old news, and they don’t do it that way now. I know she was by then a voluntary admit, to the point that once she “stole” the family car because my father wanted to sleep the night and make the four hour drive to the doctor in the morning, but she wouldn’t wait. Looking at the car, and getting her story later, she was hallucinating all the way, traveled through at least one muddy ditch, and is perhaps lucky she didn’t kill herself or someone else.
I can’t pinpoint the date, but she went on Lithium in the late '70’s/early '80’s, and I think it helped a lot. She also took enough Mellaril to fell a draft horse, just to keep from metaphorically floating around the ceilings. She would still have episodes of mania, with increasingly-brief hospital stays to regain her own equilibrium, but most of the time she was capable of living her life, raising her kids, and in general doing her thing as she saw fit. Generally, after about a week to ramp up into a manic state, she would realize for herself that she needed care, and admit voluntarily. Stress, sleepless nights, or medical illness sufficient to cause her to purge her medicine were the most common “causes” of a manic episode, but they did happen roughly every six months for a while.
This does not mean that she believed she was in the right place for the entire time. More than once she called out to tell me and others she was being held captive. I know she sometimes refused to take her meds. With one exception, I believe she got good care, in spite of her behavior. (The exception is a story all its own, but began with an elderly MD, not a mental health professional.)
By the '90’s, I had moved out, and after one doozy of an episode brought on by the stress of me actually leaving (she literally followed me out to the end of the driveway, insisting that I wasn’t really leaving/would be coming right back, and was in the hospital about a week later) she managed four years before her next episode. I used to joke that was proof we drove each other crazy. She got along quietly with my brother through his high school years without apparent incident.
Brother moved out, and mom had another major episode, including selling her house for a pittance, blowing the engine in her car from pure cussedness, and breaking her wrist, but being too paranoid to allow it to be set. Five years after that, she had another episode, brought on by the pain of rheumatoid arthritis not allowing her to sleep properly, and since then, her increasing numbers of ailments have meant more harmful drug interactions.
Perhaps four years ago, on a summer Sunday, she called to have me take her to a hospital for inpatient care. She told me her doctor had called ahead, and instructed her to go the the ER of the hospital to be passed through to the appropriate ward. Sounded simple, so at 11am, I went to get her. We took her car an hour over the state line, and checked in at the desk. Were sent to wait in chairs. Picked a crummy location, since someone appearing drunk/stoned staggered out at one point, fell just a few inches from landing in our laps, and then trotted out the door to play chicken in traffic. Roughly 3 pm, we finally were admitted to a room in the ER, and told her story again. Waited. Vitals taken, and waited. MD came, seemed to be under the impression that she wanted to have drugs and put out on the street, was surprised and seemed… happy?.. that she actually wanted admittance, but requested to run blood tests. She gave permission, so we waited for another person (nurse? phlebotomist?) and waited some more.
Sitting in the quiet little room, hearing a few cries and noises now and then, was fairly restful, as such things go, but we were both getting hungry, and had managed to miss both lunch and dinner. I apologetically asked if they could scrounge up a snack, and they brought the tiniest microwave dinner I have ever seen. We shared it. My own luck ran out, and whether it was worry, or the lights, or just purely an accident of timing, I felt a migraine taking me over. I wasn’t the patient of record, and I didn’t want to just leave her, especially since I didn’t know if I could come back if I left, so I went to the nurse’s station and begged to buy a tylenol or something of the sort. Was told the hospital couldn’t supply it, but one of the doctors gave me one out of their locker. Finally, at 10 pm, an armed security guard came to escort her up to the locked ward. She gave me her watch, and purse, and keys, and she left me at the elevator door.
I can’t speak to any of the paperwork or phone calls that happened out of sight. I wasn’t happy that we took up a room in the ER for so long, that might have been needed by someone with an actual physical ailment, or perhaps been in need of greater restraint. But if a voluntary admit, with pre-clearance from her regular doctor took that long, I can’t imagine that an involuntary admit would be easier. (Might be faster, if the patient is screaming and clawing at people, but surely that’s not easier.)
I am glad that horrific movie-script torture is no longer the norm. The public’s view of health care lags behind actuality, at least partially because movies take some time to dream up, film, and distribute, and a boring wait in a quiet room isn’t movie-worthy. I feel that mental health care is several orders of magnitude better now than it was in the '60’s. I don’t think it’s perfect, and considering that each patient is different, and may respond best to different treatments and therapies, perfection may not be attainable. But I think it is still improving. Like it or not, I consider my mother to be just one of many who have been, essentially, guinea pigs to expand mental health knowledge over the years.
I’ve seen reports that an increasing number of people in prison are there because they are mentally ill. I am aware that some posters don’t like involuntary commitment, but seems to me that prison would be infinitely worse.
