Discussion What Does the government (United States) actually offer for mental health?

[Crimson_Dawn_Mob261]

Looking on tv all I really know the government offers are mental health total institutions where you're given drugs and otherwise ignored. That is to say I really know nothing. In TV it's always portrayed as a fairly worthless place where people are thrown away. I know it's a drama thing and that's about it. What I want to know is what the U.S. government actually offers in form of assistance to those that have issues, but can't afford to seek help.

For example, I had in mind a place I could go for maybe a year, be placed in an isolated room, receive 3 meals a day, and have no contact with the outside world for that set period of time or have to leave my room except to go to the bathroom. When I thought this it seemed fairly reasonable because it's pretty much prison or the mental institutions on tv, but no drugs, isolation, and a clean room. For me it just seems like a lot of the pain I need up feeling comes from the outside world, and having to interact with it and other people. I turned off my phone for a week and felt better (not good, but better) and the isolation overall has had the same affect for me, but I know when it ends I'll have no choice, but to go back in the thick of it if I want to not be broke on the streets. I just want to know if the government has an option in place for someone like me just looking for a little peace and isolation without the drugs

Other than that I just want to know more about what the U.S. Government offers in general. Are there free mental institutions you can walk in and out of, or free therapists? Or something? I tried researching, but realized I really don't know what to google (I tried "silent asylum" and got a video game; not parti helpful in this case). What I did find was pretty much just more "you have a problem; get help", I've seen and heard a million times; not actual outlets to help. Is the suicide helpline and those mental health institutions you see on tv all they do? Are they at least not as bad and inhumane as tv makes them out to be?

 

[Pallf]

That's more of a state level issue and mental health institutions vary wildly from institution to institution. The federal government isn't really set up for that. At the present moment we don't have free healthcare but there's been talk about changing that.

I don't know of anywhere in the world that will put you in an isolated room for a year. I've been in a mental institution in the US before and it was alright for me. We did some painting and played dominos and watched TV, as well as do a little therapy and take some meds.

 

[cant cry]

I'm guessing they probably offer nothing since the government doesn't give a sht about people suffering. I've been called a conspiracy theorist before, and I agree I am one, but it seems that the only help they really want people to have is at church or other religious organizations--- like the twelve step programs popping up everywhere for everything. And anyone who tries to go another route is basically punished. World "leaders" like religion because it makes people brainwashed and easier to control.

 

[GoodPersonEffed]

When I was in grad school, my initial focus of interest was on mental health advocacy, so I did a lot of research into mental health movements. What I'm going to write here is based on memory, I may be a little off on the timeline or some details, but these are things anyone can research if interested.

Institutionalization in the U.S. used to be equivalent to a prison sentence, and the environments were just as abusive. Activists called themselves survivors and demanded an end to psychiatric abuse, and the right to deny medications if they didn't want them.

In the late 1960's, President Kennedy's sister had a lobotomy to ease her psychiatric symptoms. She became non-functioning. So under the leadership of Kennedy, community mental health was instigated so that lower-income people could be in communities and receive treatment rather than be incarcerated in institutions, and institutions became much more focused on short-term treatment with a goal of stabilization rather than the kind of respite you're imagining. The language around mental health also changed; those who received treatment were now called mental health consumers, rather than patients, which was supposed to be empowering, yet also hinted at the capitalistic nature of the new ways. The mental health consumer and survivor movements were popular in the 1970s.

As was mentioned in another comment on this thread, treatment does vary from state to state, as does funding. In general, Medicaid is managed by states, and is for the lowest income, including people who are applying for Social Security disability and cannot work while waiting for approval, otherwise they're not disabled. Medicaid is basically free treatment, though not all providers accept the coverage. Some but not all community mental health centers (CMHCs) and institutions will accept Medicaid.

Then there is Medicare, for people on Social Security due to disability or retirement. They still have to pay many expenses out of pocket. In some states, Medicaid or other programs will supplement the costs. Some but not all CMHCs and institutions will accept Medicare. Some institutions will keep people for as long as possible to keep getting Medicare funds. Most CMHCs in my experience accept only Medicare, some also accept Medicaid.

Finally, there is private health insurance or paying out of pocket. Some institutions take private health insurance, and some private health insurance policies set limits regarding treatment. Most if not all institutions will take cash. Therapists and psychiatrists generally but not always take health insurance, some will give you a superbill to submit to your insurance company, and they do this so that insurance companies cannot dictate the treatment they provide or the standard of care.

Private treatment programs are the most likely to allow long-term treatment such as you seek. Most of them do not accept Medicare or Medicaid, but there are rare exceptions. Most want private health insurance or cash.

In order to deal with suicidal symptoms, I voluntarily went into multiple hospitalizations. The quality of treatment varied from hospital to hospital and state to state. Some ERs did not put me in a hospital, but private facilities that existed to milk Medicare and Medicaid. The groups were a joke, drugs were pushed, and there was no sense of any staff giving a shit about individuals or their recoveries. In hospital programs, most did not allow computer access, the groups were primarily focused on CBT and occupational/art therapy, and sometimes some DBT or AA. Drugs were pushed. The goal was rapid stabilization, release, and follow-up with psychiatrists and therapists in the community, either in community mental health or private practice. I will note that I have worked in community mental health, as well as tried the services, and they basically function to get Medicaid and Medicare dollars; they do not accept private health insurance; and many will not allow a client ("consumer") to see a therapist unless they also see a psychiatrist.

Finally, I was in a PTSD-focused program that did provide more practical support than typical hospitalizations, but there was still a push for drugs, and there was not nearly enough one-on-one therapy for the type of program they claimed to provide.

In summary, the point of hospitalizations is not support, rest, or recovery. The goal is rapid stabilization, a strong push for drugs, and release back into the community to be supported by psychiatrists and therapists while remaining in the ostensible comfort of one's own home rather than in an institution. Some hospitalizations are abusive environments, and the worst in my experience are those "behavioral treatment facilities" that are not located inside hospitals, they exist for the cash, not to provide beneficial treatment. The second worse were hospital units where the doctors pushed meds, and pushed patients out the door if they did not agree to meds. The best I do not know from experience, only from anecdotal accounts, and those are the expensive private facilities.

On a side note, something I saw happen in the behavior treatment facilities and that also happened to me was coercion to stay in the program. Folks were subtly threatened that if they were there voluntarily and didn't "agree" to stay longer, then they would see a mental health court judge who would likely have them involuntarily committed. In such environments, I saw staff intentionally mind fuck patients, and there were patient-to-patient physical and sexual assaults that the staff turned a blind eye to. One of those environments was utter hell, scary as fuck, torturous, and abusive.

From the worst environment to the best, I have seen trained nurses fuck up on dosages when meds are handed out, and adjust the records to cover their own asses. There is no oversight as in a pharmacy.

I wish I could tell you that what you seek exists. I used to hope for something similar. I have worked in the system in one state in a CMHC, and been a "consumer" in the system in two states, and I will never again trust it, have any hope in it, or recommend it to anyone. Unless one has a lot of money to supplement excellent insurance or to pay totally out of pocket, I would not recommend hospitalization except for highly specialized and expensive programs, and if one had the resources, I would still be highly suspicious. Once you walk into an institution, you give up a lot of freedom. You can't just walk out when you want to, even if you're there voluntarily. You give up the right to privacy and autonomy. The best programs will support autonomy, but the the best is, imo, rare and expensive.

 

[Final Escape]

It is no sign of mental health to be well adjusted in a sick society. Therefore, they give the mentally healthy but likely traumatized, drugs so u can deal with the insanity but they won't give u actual therapy because that might wake u up and help u to actually thrive. The mentally ill might actually be the sanest people, because they see society more accurately and it makes us miserable.