Before you read any further, let me suggest you read last week’s post about the failures of the healthcare system. It is a lead up to this post. Here is the link: how-did-the-healthcare-system-fail-us.html
Also, my wife is once again a guest blogger this week and that makes everything I do way better! ;-) We write this post together just as we did the previous two.
Our opinions on the healthcare system and the criminal justice system are strong. We stand by them. We are not saying that those who work in those areas are failures. We have plenty of friends who are nurses, doctors, psychologists, counselors, and lawyers. They are passionate about their jobs and do what they can to help take care of others. If anything, we speak on their behalf because, can you imagine doing something you love while also trying to advocate for positive change? It’s not easy. We stand up for what’s right and for those who want to make things right, but may need help along the way.
To start our discussion for this week, on the failures of the criminal justice system, let me fill you in on what happened after I was released from the Wake County Jail. You read my conversation with my wife on our drive home right?? It’s hilarious. Here is the link: prison-changed-me.html
The charges that were pressed against me were dropped. After several court visits, dates being postponed because the charging parties did not show, and $800, I was a free woman. Sort of. I then had to wait for my record to be expunged. I had been out of work and was not actively searching for a job. Applying for one with a record was not a good idea. It took almost 6 months for that to happen. Turns out the nurse who I kicked in the face didn’t even know of these charges. He never wanted to press them in the first place. It was the police officer that had done so. After the 3rd attempt at a court decision, the judge finally requested that someone call this nurse so that a decision could be made. We were there when it happened. It took less than a minute to call this guy and then tell me the charges were dropped. It was...ridiculous. All that time wasted, money wasted, for an arrest that never should’ve happened in the first place. Let me add that my wife was with me for every single visit, which means she was away from work. I am so grateful that she was there for me.
Sometimes I just want to look that police officer in the eyes and say, "HELLOOOOO sir, do you realize I was brought to the emergency room in serious distress from major depression and anxiety. Did you really feel it was necessary to file a simple assault charge against me?"
My psychiatrist has referred to my diagnosis as Biopolar II, but I’m sort of on the fence. It’s tricky, but I say this because it can help to further define what I experience. Google it if you need to. I was experimenting with different psychiatric drugs, still trying to figure out which one was going to work, and just feeling like nothing was going to. As I’ve said before, I do not consider myself suicidal, but rather Biopolar II with suicidal ideation. You can also Google that. My point is that I needed help and the process of finally getting there was crap. Then, to slap a criminal charge on someone who was there to seek help and unintentionally kicked a nurse!!! Not how our criminal justice system should function.
After my last post, I had a friend from college message me. She said that if I didn’t think I deserved to be arrested and charged, then how do we determine what happens to people who suffer from mental illness and commit crimes? She was wonderful in her approach and wanted to learn more. I really appreciated the conversation we had and her bravery to ask questions. That’s exactly what I want. My response was, “I don’t know that I have the ultimate answer to that, or that there is one solution, but I know putting people behind bars who suffer from mental illness will not help them manage their illness, nor attempt to live a better life.”
In a mental health crisis, people are more likely to encounter police than get medical help. As a result, 2 million people with mental illness are booked into jails each year. Nearly 15% of men and 30% of women booked into jails have a serious mental health condition.
The vast majority of the individuals are not violent criminals—most people in jails have not yet gone to trial, so they are not yet convicted of a crime. The rest are serving short sentences for minor crimes.
Once in jail, many individuals don't receive the treatment they need and end up getting worse, not better. They stay longer than their counterparts without mental illness. They are at risk of victimization and often their mental health conditions get worse.
After leaving jail, many no longer have access to needed healthcare and benefits. A criminal record often makes it hard for individuals to get a job or housing. Many individuals, especially without access to mental health services and supports, wind up homeless, in emergency rooms and often re-arrested. At least 80% of jail inmates with a mental illness d0 not have access to needed treatment.
Jailing people with mental illness creates huge burdens on law enforcement, corrections and state and local budgets. It does not protect public safety. And people who could be helped are being ignored. (Courtesy of NAMI, National Alliance on Mental Illness)
And it doesn’t stop there. We have other frustrations over our criminal justice system such as prison privatization and the treatment of minorities.
From my arrest to my record being expunged, I was fortunate enough to have the means to pay for a lawyer. I am also white. This matters. While we sat in court, there were tons of other cases being heard. Many of those people did not have lawyers. They would never be able to afford one. It was obvious that some were suffering from a mental illness and in some cases were sharing this with the judge. Being arrested and sitting there in court was not making their situation any better. Some were pleading with the judge to not postpone their court date again because they couldn’t afford to miss anymore work. There were younger adults there who had no idea what they were supposed to say or what a plea deal was. Many thought they were getting the better deal, but they weren’t. No one was helping them! We just sat there and witnessed this monstrosity. It angered us so much. Which is another reason we are here with you today, attempting to educate others about what the hell is going on right under our noses!
It shouldn’t take hundreds of dollars to afford fair and professional advice. It shouldn’t matter what color your skin is, what socio-economic class you fall into, and your mental health should not be ignored.
With the privatization of prisons, people who are mentally ill sitting in jails and prisons only suffer more. Staff are paid less, there’s less funding for staff training, and the rates of assault and suicide are higher. The companies that build and run private prisons have a financial interest in the continued growth of mass incarceration. That is why the two major players in this game—the Corrections Corporation of America and the GEO Group—invest heavily in lobbying for punitive criminal justice policies and make hefty contributions to political campaigns that will increase reliance on prisons. They want you to get arrested and to remain behind bars.
Worldwide, there are more than 10 million individuals in prison at any given time with more than 30 million circulating through each year. Research has consistently shown that prisoners have high rates of psychiatric disorders, and in some countries there are more people with severe mental illness in prisons than psychiatric hospitals. Despite the high level of need, these disorders are frequently under-diagnosed and poorly treated.
A neighbor of ours told us he was happy to leave his job at a women’s prison because they were not providing rehabilitation for life outside of prison, only ways to help them continue to live inside. Many of these women were suffering from severe mental illness.
Mental illness does not belong in the criminal justice system and it certainly does not belong behind bars.
Last week my wife and I collaborated on my blog post, ‘Prison Changed Me’. We are doing the same thing for the next two posts. Our goal is to address the failures of our healthcare system and our criminal justice system, as they relate to mental health.
The concerns we’re addressing are based on our experience in the last year and a half. Please note that everyone has their own experiences and opinions to share. We are fairly confident however, that our experience is like millions of others around the world. We need to change this and make it better for everyone.
There are four main ways that we feel the healthcare system was less than adequate when addressing my mental health needs:
1. Access to Mental Health Treatment Options
Most people are not aware of the federal law (The Paul Wellstone and Pete Domenici Health Parity and Addiction Equity Act of 2008) that helps to prevent disparities between mental health and physical health insurance practices. AKA, if your insurance policy states that you can have unlimited visits to a doctor for physical wellness then they must also provide you insurance for unlimited visits for mental wellness. Sounds like this would make things easy for people seeking treatment for mental illness. Unfortunately, the statistics on people who have health insurance are unfavorable. And even if you do have health insurance, it’s still not as easy as you think.
When I first realized I needed professional help my only option was to make an appointment with my general practitioner. I couldn’t just go to a psychiatrist of my choosing and start there. When I met with my GP we discussed what I was experiencing. He first suggested depression and I shared my medical history with him. I also made a point to express my concerns with medications and being open to alternative medicine. His only answer to my needs was medication. So, as someone in desperate need of help, having just started a new job, I took the meds and went home. I felt hopeless. I tried the meds for a couple months and things only got worse. I was then referred to a psychotherapist by my GP. That didn’t work either. Finally, after visiting the ER twice, I was handed a stack of papers with a daunting list of psychiatrists to choose from. Maybe I was finally on my way to proper treatment. How long do people suffering with a mental illness have to wait for proper care?
2. Lack of emergency mental health providers
If we think about mental health as being completely differentiated from physical health (sarah absolutely hates this approach and thinks that it is the fundamental flaw in treatment of brain disorders) then why is it we do not have the same emergency care for mental health? Specific to our location, we have one Level 1 Trauma Center nearby, and if you have read my previous posts then you know they are not equipped to handle mental health emergencies. In fact, they do not even have a psychiatrist on staff.
3. Lack of training in emergency room staff
There is an incredible shortage of acute mental healthcare facilities right now. A recent report shows a 14 percent decline in available psychiatric beds. At this point in time, there are approximately 14 beds available per 100,000 people. At the same time, the number of adults who present with mental illness has increased. This results in people flooding emergency rooms for treatment, or worse, not seeking treatment. Nationwide, hospitals are reporting significant increases in patients seeking treatment for mental health crisis. Unfortunately, hospitals are not providing the appropriate staff trained to handle these situations.
4. General Stigma
One in four adults is diagnosed with a mental illness. One half of Americans live with a diagnosable mental illness at some point in their life. To put this in perspective, you are 11 times more likely to know someone with a mental illness than to know someone who identifies as LGBTQ, 1.3 times more likely than someone who has had cancer in their lifetime, and 6 times more likely than someone with blue eyes.
Our healthcare system influences the way society views mental health. If the healthcare professionals we trust are placing less of an emphasis on mental health, than we fail to believe that BRAIN HEALTH IS PHYSICAL HEALTH! MENTAL HEALTH IS MEDICAL HEALTH. Currently, we cannot replace or transplant a brain. Therefore, our healthcare system needs to put this at the top of the list.
If this is just my story, one story, than imagine what others are going through, who don’t have support, or insurance, or the financial means. In addition, how would being wronged by our criminal justice system affect their access to mental health resources and treatment? This is the second failure that we will address next week.
After seeing the Magistrate and being released from the Wake County Prison, I could finally go home. Sarah came to pick me up and met me inside. We exchanged a few words with the women working there, including how ridiculous it was that I was even arrested. Then we walked out and drove home. This was our first time seeing each other since she watched me get handcuffed and put into the back of a police car. Here’s a bit of our conversation:
(Getting into car)
Sarah: Hey Andy from Shawshank. Or would you rather be Piper from Orange is the New Black?
Stephanie: Hey, you could just say ‘Hey Shawshank, or Hey Orange is the New Black.’ You don’t have to reference the specific actor.
Sarah: Damn. Prison changed you. (I should add that Sarah was so happy to be able to reenact this scene from pitch perfect.)
Stephanie: (Sighs. Hangs her head). Speaking of Orange is the New Black...
Sarah: You met someone on the inside didn't you?
Stephanie: That's funny, but no. They wouldn’t let me keep the cool orange sandals as a souvenir.
Sarah: Oh that's gross, they made you wear communal shoes? You were only there for like 45 minutes.
Stephanie: What am I going to do with my life? I’m ruined.
Sarah: Don’t be silly. We can get you some athletes foot spray or something.
Stephanie: But seriously....
Sarah: This whole thing is ridiculous. You should’ve never been arrested. On a side note, I am pretty sure your mom and sisters are ready to yell profanities at this guy. I kind of want to know what your sisters would do right now. I imagine Katie stalking him on social media and then sending him an email telling him what a jerk he is and why he made a mistake. Samantha on the other hand, would most likely tag him in her status on Facebook telling him to 'Suck a D'.
Stephanie: Bahaha, that's about right. Their hearts are in the right place.
Sarah: They always stick up for you. You Gaal sisters are scary. I wouldn't mess with you.
Stephanie: Will you be my lawyer?
Sarah: Hells yeah. Especially if it means I get a new Brooks Brothers outfit.
Stephanie: Oh man, I don't know, you might be a little too pricey for me.
Sarah: I’m glad we can laugh at this. I was worried you’d be super angry and, well, emotional. I wasn’t sure what was happening while you were in there, so naturally I was so worried. And of course I had no clue that when they arrest someone they don't actually take them to the police station so I went to like 5 different places before I was finally told to go to the Wake County Detention Center, which can I just say makes 'jail' sound like an after school special.
Stephanie: Honestly, I surprised myself. It certainly could’ve been worse, but I was so clueless as to why someone I didn't know was pressing charges against me for something that I didn’t remember, and certainly would never intentionally do. I’m a nice lady. I’m going through a hard time. The emergency room was where I needed to be. And now my mugshot is out there. They didn’t even let me look at the picture to make sure I was happy with it.
Sarah: I'm just glad you weren't wearing something ridiculous when they took your picture.
Stephanie: Like a UNC shirt?
Sarah: EXACTLY! If only people could hear our conversation.
Stephanie: They can. I’ll write about it.
Sarah: Ok, but first I think we are supposed to go to a crappy diner and your supposed to scarf down a bunch of food really quickly like you haven't eaten in days.
Stephanie: Soooooo we go to a crappy diner and all I have to do is eat exactly how I always eat?
Sarah: (nods her head emphatically).
So, that’s kind of how our conversation went. Why? Because Sarah handles everything with humor and it was exactly what was needed at the time. I know it’s hard to imagine when you’re not actually there, but we laugh A LOT, about everything! It’s one of our strengths as a couple, among many. What we’ve both learned from this, however, is very serious. Our views on mental health and the criminal justice system have changed. Individually and collectively.
You have to really imagine this situation. While we joke and laugh, it was very much a serious one. For several months I was struggling. I had no clue what was happening with me. I had experienced depression before, but this was different. More severe. The anxiety was new. Sarah had no clue what I was going through and she wasn’t sure how to help. I go to the emergency room twice, within two weeks. I hoped with all my might, that the sadness I felt, the worthlessness, and the guilt, would all just disappear. I didn’t want to die, but i certainly didn’t want to wake up another day and feel the way I was feeling. And that my friends is not okay. So Sarah did what every caretaker in this situation should do--she sought emergency medical attention for me.
We rely on healthcare professionals to care for us and expect emergency healthcare professionals to be trained to handle anything. This is where I feel our healthcare and criminal justice systems fail. Not all policies and laws make sense. North Carolina, for example, passed a law a couple years ago that makes it a felony to assault any provider on hospital property. This is one of those laws that Sarah has become so frustrated with. Admittedly, it sounds like something that would be good, right? Hospital workers deserve to be safe at work, but their jobs do have risks. And punishing people who are not able to control their actions because of behaviors resulting from brain disorders is not going to deter them or others from acting out in the future. It is only going to punish them more severely for something they can’t control. In situations where people are clearly hurting, these policies and laws only make things worse. People who need emergency medical attention for mental health emergencies (or those seeking treatment on their behalf ) should not have to worry that seeking the necessary medical attention could result in felony charges. In my situation, Sarah took me in for emergency help. My treatment consisted solely of Haldol and Ketamine. Less than 12 hours after pleading with a police officer to take my life, I was released from the emergency room without them even notifying my psychiatrist. This is the first failure...the failure of our Healthcare System.
I just want all people to learn and grow together.