Kyle Week 5 – Mental Health In Detroit and Wayne County – Detroit Community-Engaged Research Program

Kyle Week 5 – Mental Health In Detroit and Wayne County

For this week’s blog post I wanted to find an article about mental health issues in Detroit. I found the article “Legislature threatens to pour gas on mental health fire”. The focus of my post will not be on how the legislature threatens to make it worse but on the fire that we currently have now how it’s affected me.

It’s difficult to get data on how many people are affected by this just in Detroit so I’m writing from a standpoint of someone in the same county as Detroit (Wayne county).  

The article talks about how “We have an epidemic of people with mental illness imprisoned. Our publicly funded mental health system, run through governmental Community Mental Health (CMH) programs the past several decades, has too much bureaucracy, lacks statewide uniformity, is weak on rights protection, has meager hospital resources, and is not well monitored by the Michigan Department of Health and Human Services (DHHS).”

It goes on to say that “The system is underfunded and overburdened. To provide one local example, Wayne County has just one walk-in crisis program – the COPE facility in Livonia, managed by Hegira Inc. – and that program often deals with a volume of clients far too great for its resources.”

As I revealed in my Kyle Week 3 – Observations from Detroit post, I suffer from anxiety and depression. I’m also on Michigan Medicaid for my insurance along with 195,818 or 11% of the population in Wayne County (MLIVE). This system has and continues to affect us.

 

Stigma, a Barrier to Improving Mental Health Outcomes 

In my experience mental health and helping those with mental health conditions are largely ignored in this country. Everyone seems to ignore it or have strong stigma about it. This leads to shaming the person with the condition for having a “character defect” instead of an actual illness. I’ve actually been told by a family member that “no one would want to be around me or talk to me because I’m too negative and not happy enough”. So you can imagine how much pressure there is to hide what I’m experiencing and feeling.

This is not an isolated case based on others I’ve talked to with a mental health condition. We live split lives. We hide our condition around others in fear of what would happen if they new the real us. But why am I talking about this? In public health we talk about overcoming barriers to people improving their health. The more barriers there are the harder it is to get a better health outcome.

Stigma is a barrier to better mental health outcomes. Especially for those just starting to get treatment. There can be great shame in getting a mental health diagnosis and getting help. That isn’t everyone’s experience but it is common. So the way our society views and treats people with mental health conditions is hurting them and preventing them from getting diagnosed and getting the help that they need.

 

An Exercise in Experiencing Barriers 

This next part will be difficult and difficult for those who have never experienced a mental health crisis to comprehend but bear with me.

Imagine you are in crisis. You may be having suicidal thoughts and you feel that you can’t tell anyone. You fear people won’t want to be around you or will shame you for having these thoughts and feelings which could put you over the edge. You know for sure you can’t go to your family with it. You know you need help but don’t know what to do. You’re passively suicidal (not currently in the process but are having thoughts) and are extremely depressed and out of energy.

You know that since you’re on Medicaid you have to call your insurance to find out where you can go and what would be covered. You agonize over getting the energy to call and admit you are in crisis. It takes you a couple hours just to get yourself to call.  When you do call you have to wait a half hour to talk to someone. You find out that you can’t do a hospitalization program until you have been assessed by a center in Livonia called “COPE”. This is an hour and a half from your house.

You muster up what energy you have left and drive yourself there. After getting there you walk in, a door locks behind you. It’s a dimly lit room with a lot of people in it. You get to the front desk and are told that the wait time to be assessed is at least 8 hours but probably more like 10. You know that even after being assessed nothing may happen because you’re not actively suicidal and that if it does you’ll be transported somewhere else. You’re scared of the uncertainty and make a decision. Feeling that you don’t have the energy to do that and all you want to do is lie down in a dark room and be alone, you say you’ll come back another day and leave.

 

What Went Wrong

This person who was trying to save their life didn’t get the treatment they needed because of several barriers:

  1. They had to do this alone because of the stigma around mental health (If you broke your arm would you have hesitated to call someone or have someone take you to the hospital?)
  2. They are on Medicaid and are limited in where and when they can get treatment and have it covered (had to be assessed before getting treated at a mental health facility)
  3. The only assessment center in the county was 90 minutes away by car (which not everyone has)
  4. After getting to the center the wait was 8+ hours to be seen
  5. They are mentally ill and one of the symptoms of their depression is exhaustion and fatigue

Note that this is not a complete list. The first barrier is from society. The next three are barriers caused by the health system itself. The fifth barrier is caused by the illness itself.There are many barriers to getting the help and this situation is for someone who

  • Already knew they had a mental illness
  • Was working with a therapist
  • Was working with a psychiatrist for medication
  • Was taking their prescribed medication
  • Knew they needed more help and
  • Wanted to get help voluntarily

You may now be starting to see how hard it is to get that help and how much work we have to do to fix it.

Conclusion

1 in 5 adults have a mental health condition (NAMI). Suicide is the 10th leading cause of death in the U.S, the third leading cause of death for 10-14 year olds and the 2nd leading cause of death for 15-34 year olds (CDC). Many people in these groups rely on the system to get help when they are in crisis.

We need to do more to help those with mental health conditions. As a society we are stigmatizing and harming people with mental health conditions. Making it harder for those with a condition to get help. Our health care system is failing people with mental health conditions by making it extremely difficult to get help even when you are in crisis. It’s a complex problem and It’s not as simple as being told to “just get help”. There are many barriers to getting the help you need.

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