There are moments in time or things we
experience that have the power to change us forever, to define us, and bring
clarity to our callings. Such a moment happened to me two weeks ago while
in the midst of a family crisis. It was one of the most heartbreaking,
shocking, and enervating experiences I have ever had. It broke me in the
best way possible.
write this today because most of you will never have the chance to experience
this moment. Most of you will never see the reality with your own two
eyes. Most of you will only get the sanitized version from the news or a story you
read online. You will never have the privilege of seeing the truth
or having your heart broken and your protective instincts fired. Even
after reading this, most of you will choose to go back to your sheltered
existence. Choosing to believe the experiences and sights I am about to share
with you could not possibly be as bad as what I am going to portray, and even
if they are..... well, those people had it coming.
this little blog post will have little impact on the grand scheme of
things. However, I would betray everything I stood for if I did not speak
out. If I did not use what little voice I have to scream from the rooftops how
broken and dangerous our mental health system is.
Here's my story. I swear to you not a stroke of this
keyboard is an exaggeration or manipulation of what I have witnessed.
Sit back and read this with an open heart and mind. If we don't
make changes immediately, I fear for the future of our most vulnerable children.
During the past month, my youngest son's behaviors had
started to spiral again, and he was experiencing side effects from one of his
medications. His psychiatrist advised that we change his medication under
his supervision; he referred him to the children's hospital for PHP (partial
hospitalization program). He was to go to the program 8 hours a day for
observation during the med changes and therapy. It took two weeks
after the doctor wrote the order for the program to have a slot open for B.
On the first day of the program, we grabbed breakfast and
started bright and early. B was happy and chattering the entire hour and
fifteen-minute drive to the hospital. We arrived and were led to a
private room by a hospital therapist to answer the intake questions. There had
been a breakdown in their system; had they done things correctly, they would
have seen he had been a patient in their facility in September, and PHP was
ordered by one of their doctors. If any of these facts had been
communicated as they should have been, we would not have had to do the entire intake
process again, and the rest of this story would not have happened. But as
is often the case in our healthcare system, there was a breakdown in essential
communication between coordinating facilities.
If you have never done intake for psychiatric
purposes it is a little more time-consuming than intake for your typical ER or
hospital visit. You have to answer many questions concerning your mental
state, thoughts, home life, etc. It can be overwhelming to anyone.
The process is especially challenging for my
youngest son, who struggles to discuss anything emotionally without breaking
down on his best days. Because he was there primarily to change his medication
protocol, I had not given him his medication either. He needed to see the
doctor and start his new regiment. Within two minutes of beginning the
intake process, my son was starting to work up. Within five minutes, he
was in a full-blown meltdown.
For those who don't know what a total
meltdown looks like, imagine a 250-pound, five-foot-nine teenager screaming,
hitting his head on the wall, scratching his arms, trying to run off, and swearing
at the doctors and security officers. To be clear, this is not a choice. He isn't
"acting out." His brain is so over-stimulated that his logical
thinking process has stopped. He doesn't even remember what happens during
these episodes once he has come out of them.
gave him medication, hoping to calm him enough to complete the intake.
Instead, he worked up even further. The therapist apologized because
there was no way to admit him to PHP in this menta; state ( an obvious
conclusion we all agreed upon). He needed to be placed, inpatient.
It took two armed security guards to escort us to the "special" ER (
as I call it). We were in a room with a bed (with restraint hooks) attached
to the floor, a single chair made of the same material as the bed, and
A doctor quickly examined him and ordered the
therapist to find him a pediatric bed at one of the area hospitals.
Though we were already at the hospital, it was the children's hospital.
They do not take children over 12 in their behavioral (psychiatric) ward.
My son melted down for a full two hours, even after being given medication to
calm him. We spent the next eight
hours waiting as the hospital called every behavioral hospital with a teen ward
in the area, looking for a bed for my son. We live between two major
cities (Dallas and Fort Worth). More than a dozen behavioral hospital wards and
hospitals in our area matched the needed criteria (most of which I would not
recommend, but we will get to that later). It still took eight hours to
find a single pediatric bed. This is not unusual. It is normal for people
to be turned away from the hospitals when they seek help for their kids because
there are no beds available. This is also a problem for the adult population. But
for this article, we are focusing on the pediatric aspects of the mental health
waiting hours, they found him a bed at Dallas Behavioral Health in DeSoto,
Texas. We have been dealing with our kids' mental health issues for a while now,
meaning we have a working knowledge of the hospitals in our area. I had
heard some questionable things about this particular hospital. When I
told my husband where they wanted to send B, his initial reaction was the same
as mine, no way! But we had already spent eight hours in
the ER with the therapist calling and re-calling every hospital looking for a
bed. This bed was literally the ONLY bed available in all of North Texas.
My husband did what research he could online. He found that the hospital had improved
its facilities and recently won a few awards for its behavioral unit. So
with reluctance and no other options, B was assigned the bed. It was a
voluntary admission, but they would have admitted him under the Baker Act
(non-voluntary admission) if I had not cooperated. That would have
severely limited the amount of control I would have to make medical decisions
for my son. So though we had a choice, we didn't really have a choice.
We waited for the ambulance to arrive to take us
the hour and a half to Dallas Behavioral in DFW rush hour traffic. The
entire ride, B was chatting away, asking questions about all the equipment in
the ambulance. The paramedic asked me twice if he had received the correct
transfer paperwork? Was B actually supposed to be transferred to DBH?
Yes, I assured him, the paperwork was correct.
We exited the ambulance into a different
world from the one we left. Because B had been labeled a flight risk during
his earlier attempts while melting down, we were sent to the locked flight risk
intake ward. Before I begin, let me say I have gone through intake with
my kids on many occasions. I have visited the behavioral ward of
different hospitals in many states as a missionary and parent. This was
not my first rodeo, and I am not easily shocked. However, this intake
waiting area managed to shock and horrify even me. I will try to capture
what the experience was like, but I don't think even I can do justice to the
absolute chaos that assaulted us as we were ushered through the large locked
The first thing I noticed when walking in was the
smell. The pungent odor is not new to me. I spent years doing
homeless ministry. I lived above a homeless mission and worked there full-time
for my college internship. The smell of un-bathed, inebriated individuals
with dirty clothes and no access to hygiene products is not new to me. It
was, however, new to my son. He immediately asked why it stank. Milling
around the narrow halls were adults waiting to be admitted. Some were rocking,
others were screaming, and one lady kept trying to take off her shirt and have
everyone feel her stomach and her "baby." She would start
screeching and yelling if you did not acknowledge her imaginary baby. She was
demanding to leave so she could have her "baby."
Around five police officers crowded the narrow
hallway as they brought in two patients. One patient was a young teen
girl ( I later learned she was 12 years old). She had handcuffs over
bandages where she had attempted to cut her wrists and was held between two large,
muscular officers. Several of the male patients tried to touch her or engage
her. I was grateful to one officer for keeping them at bay while he was
there. Of course, he left as soon as he signed the admission papers.
right was a large waiting room with more adult patients waiting to be
admitted. They were sprawled across chairs and on the floor. Some
had blankets; others just sat on the floor talking to themselves. They
wandered the halls freely, with no visible supervision.
To our left was a room with teenagers.
Adult patients kept wandering in and out, even though the nurse would kick them
out of the room the few times she walked past the door. Most of the teens were
unaccompanied, having been brought in by law enforcement. B and I were
instructed to stay in the cramped, loud, and poorly monitored hallway until the
staff could "get to us." They dealt with the patients brought
in by the police. B kept pushing himself between the wall and me, scared.
He didn't know what to make of the chaos that surrounded us.
they called his name. It was our turn to meet with the admission nurse. Our
belongings were locked in a locker (standard procedure at every psychiatric
hospital), and we were patted down and scanned with a metal detector
wand. I was surprised when they told me to bring B to the teen room.
After standing in the hallway for over an hour, I thought we would be doing the
admissions paperwork. But instead, we were being shuffled off to yet another
waiting area. When I asked what was going on, I was told I could leave if I
wanted. I did not want to leave. At this point, I wasn't sure if I would
be leaving him at the hospital at all, the Baker Act be damned!
As we waited for several hours, more
patients were brought in by the police or nurses. Some were loud. Some
looked high; others looked utterly beat down by life. Some were
violent. One began beating on the doors with so much strength he shook the
entire ward. The teens were terrified. One girl looked at me and asked if
he would be able to break the glass windows of the room we were in. I
assured her we were safe and that security would deal with him. After twenty
minutes of the nurses ignoring him and his behavior, they finally called
security. However, security took nearly 10 minutes to show up after they were
adult patient kept stripping naked, over and over again. They would barely get
clothes back on him, and he would take them off again. Having autistic kids, I
understood his behavior. But it made the teen girls very uncomfortable to
have a large adult male wandering around completely nude.
of this was happening, the teens were unprotected in an unlocked room with
adult patients wandering in and out. When the nurse returned, I asked that the
door be locked to protect the kids. She only complied after demanding to
know who I was. I explained I was a parent and knew that teens should be
seperated and protected from the general adult population by law.
During our wait, I talked with the kids who were there. They
were dying to be listened to. Most of them had been inpatient before and
began comparing the facilities, which had good food, the best staff, and places
with the best therapist.
One thin boy with the saddest eyes I've ever
seen told how he had been a patient at a different facility over the Easter
holiday. The nurses had sneaked patients Easter candy, and a kind doctor
had ordered the entire teen ward pizzas for dinner that night. He said he
had asked to be brought back to that facility when he had been removed from school
by police in handcuffs because he had been overheard threatening to hurt
himself. The sad boy explained that was the only facility where he had
made progress because the staff cared. But the officers said it was too
far and they could only bring him to DBH.
As I sat there listening, my heart was broken
over and over. The beautiful girl brought in by law enforcement in cuffs
with her wrists bandaged began to talk to me. She had just been released
from inpatient two days before. She had tried to slit her wrists again,
so she was brought back in handcuffs after they bandaged up her wrists.
It is just standard procedure to handcuff our youth. So common, in fact,
the kids were all comparing their cuff bruises while we waited. Most of
the teens had been waiting 6-8 hours for a bed. They were not given food
or even water the entire time they waited. To get to the bathroom, they
had to wade through the sea of adult patients wandering the halls without
After three more hours, we were finally admitted. So for
those of you keeping count, we drove an hour to the PHP program, waited eight hours
for a bed to become available, and drove an hour and a half to the hospital.
Then we stayed in the hallway for an hour and waited three more hours to be
admitted. And we were "rushed" because he was transferred from
another hospital and I was making waves about the lack of proper security or
supervision for the kids who were alone with adult mental patients.
Once I looked over the ward B would be on (well, what I could
see of it from the place I was told to stand), I was reassured that he would be
completely separate from the adult population while on the teen floor. I
signed the last of the paperwork. They did a complete physical exam of B (again
standard procedure for psychiatric wards), documenting any scratches, rashes,
bruises, etc. They skipped any more intrusive exams because of his
autism. I am grateful for that. He would have been even more traumatized
if they had done a rectal exam.
B was there for eight days with limited visitation and phone
calls. Their doctors were able to balance his meds, which with B is no
small feat. However, the teens were allowed to put whatever they wanted
on the TV after therapy. They chose horror movies. My son had never been
exposed to graphic horror movies before his time there and has had nightmares
since returning. I don't understand how it is healthy for teens in a
mental facility for self-harm or violence to be exposed to violent, gory, rated
R movies with full nudity at the hospital that is supposed to be treating
them. The people on duty would watch the movies with the kids, so they
knew what was being played.
Eight days later, B came home. The doctors had been
able to balance his medications, but the hospital experience was traumatizing
I go to sleep haunted by the faces of the
kids I waited in the intake waiting room with. So many of these kids were
traumatized by things and situations in their lives. They are crying out
for help. As a society, our solution to that trauma is to slap cuffs on
them, and stick them in an unsafe and traumatizing waiting area, alone.
Then we admit them to hospitals with little supervision, drug them and send
them back to the very environments that traumatized them, to begin with, in
many cases. Kids have died in mental hospitals in our area.
We have a national mental health crisis with our young people
today. You only have to turn on the news to know I speak the truth. How
can we help them if the very institutions meant to help are so overcrowded that
it takes nine hours to find one bed in a vast metropolitan area ( and we were
lucky to find that one, I was told repeatedly)? How can we help them when
they are dropped into traumatizing situations like I described, with no one to
advocate for them while they are waiting? How can we help them if, while
they are in the hospital, they are exposed to more violence, gore, and
Some of you are reading this thinking that this does not
affect you, so why should you care? Or maybe you think those kids have it
coming to them because they wouldn't be in this situation had they not earned
it. You are wrong. How many school shootings and mass public
attacks will it take before we as a nation wake up to the mental health crisis
we are facing?
to be clear that most people who suffer mental health problems are not violent
(someone with a diagnosed mental illness commits only 3% of violent crimes).
You may be lucky. Maybe you or someone you love are not affected by
mental illness. However insulated you think you are, let me assure you that you
know someone that struggles with mental health issues. According to NIMH
(National Institute of Mental Health), 1 in 5 adults has a mental
illness. That is 20% of the adult population. Of those, only half receive
ANY treatment at all. Here, I included a link to NAMI's
statistics on pediatric mental health issues here.
I encourage you to click the link. There is a lot of important information
I know this is a very long article, but I needed to share our
experiences with you. We need to change our mental health care system in this
country. The only way those changes will happen is if we demand
them. The only way we can demand them is if we know the actual state of
the mental health care system in our country. Unfortunately, many people
in our society who need things to change the most are unable to advocate for
themselves. So we must be their voices.
reported our experiences to the hospital and, more importantly, to our
insurance company. I am writing this blog. I purposely did not obfuscate
the institution we visited because I want to see changes. I demand better
for the most vulnerable members of our society.