Monday, March 19, 2012

Mercy Hospital; Selling the Sizzle!

     In both public relations and sales, individuals are taught, “Sell the Sizzle, not the Steak!” This process is to entice the public to focus on the positive traits of what is being promoted, while glossing over or totally ignoring the negative. In some cases, it is a way to evade the reality of what that person is trying to sell. Large companies, politicians, and even hospitals become masters of manipulating the perception of many situations.
     This spin, as it is referred to as, is the public relations departments of these groups put out press releases, and if they get published, a vast deal of positive press can replace expensive advertising. With that, it inhibits scrutiny, and when follow-up questions are asked; the conventional answer is the infamous, “We will get back to you!” Few ever do, especially if it invites analysis. This brings us to the various headlines inspired this time by Mercy Hospital of Lorain over the last couple of months. Specifically, the focus is on the sizzle from the one dealing with a “new” mental health unit they are promoting.
     Back in December, this hospital gathered some positive press and the article headline read, “Mercy opens unique behavioral unit in Lorain”. This was followed with the information of this “new” mental health unit with 24 beds and that it would “Compliment the quality care delivered by our dedicated staff.” With the current mental health crisis, the result of massive budgets cuts throughout all levels of government, and with the police becoming the de-facto mental health workers, this article immediately caught my attention. In essence, the sizzle was an eye opener!
     Once the reader gets past that sizzle they see the steak, and with it, the ever present gristle, the fat, which is the distasteful part of the meal. It is at this stage that the headline, which was the likely result from a press release, was more repugnant then the steak could overcome, and does not stand up to inquisition.
     Soon after, I contacted the individuals mentioned in the article to find out if this truly is an improvement over what had been done in the past. I was instructed, via voicemail, to leave my questions, and they would, “Get back to me.”
     My questions are; “Is this an increase or decrease in the number of beds? What did they (Mercy Hospital) do prior in their evaluation process that is so different? How many emergency room contacts does Mercy experience with the mentally ill and what percentages are admitted for treatment?” They are simple, straightforward questions, and two months later, I am still awaiting the return phone calls.
     It is clear that beyond the headlines, this unit will be nothing more the same, and that has not been working. There will not be a substantial increase in the number of beds available, or an improvement in the quality of care.  People are brought into hospital ER’s at an ever increasing rate, by local law enforcement, and after sitting around, they are quickly released with instructions to seek help. Forgive my ignorance, but isn’t that what hospitals are for?
     To be fair, I must say that given the choices in Mercy or Elyria Memorial, I still encourage people in Lorain County to bring their loved ones to Mercy, the lesser of the two evils. That is from a personal experience twelve years ago, when I spent some time at EMH. The resulting treatment nearly killed me, but that is a story for another time.
     To better illustrate Mercy Hospital’s spin at its bests, I must refer to a sentence in that article about this unit. The sizzle said, “The unit provides a collaborative care environment for patients with innovative safety features to address risks associated with behavioral health patients and a multi-sensory environment for behavioral management.” In other words, the gristle is like all mental health units; it is a lock down area, and they can restrain the patients. It must be pointed out that this is standard operating procedure from all mental health units, so where is this improvement?
     Eight years ago, I began my work as an advocate, and decided that I would never just be a critic, but would always add to my assessment the needed changes. I was critical of police work and have strived to work hard to help them understand the needs of the mentally ill. Overall, they have responded admirably. I recently called on law enforcement officials to follow the lead of Summit County Sheriff Drew Alexander, who refused to accept psychotic patients in his jail until they are properly stabilized, rather than treat them and street them, which is what hospitals routinely do. Mercy Hospital is no exception to that rule.
     My message to Mercy Hospital is clear and to the point. Please stop the cheap public relations spin to demonstrate phony compassion and understanding of those with one of these socially unacceptable diseases and make real changes. Rather than dehumanize the individual and send them on their way, admit them and treat them. Give them the opportunity to recover and live the life that all of us are entitled to live. With more treatment, fewer requests will be made of the police, and they can begin to spend more time being police officers. Because of the current state of affairs, they are the ones being called to intervene with a patient that had been denied admission to a hospital.
     I know my answers appear to be visceral, and in many ways, they are. The system is broken and in dire need of repair. I do not have all the answers, but neither is it appropriate to promote something that only masquerades as legitimate change. If hospitals are truly determined to make real changes, be transparent about them; do not hide behind press releases.  Also, invite scrutiny, because if it is real change, it will stand on its own. The taxpayers, who pay an immense deal for health care, demand the reality of what they are getting for their money.  Everyone deserves to be treated with humanity and dignity, even those who suffer with an invisible illness.
     I reiterate; Mercy Hospital is no worse than most medical providers, but maybe they have better public relations then most. However, these actions by Mercy remind me of another old saying. No matter what you do, you cannot make a sheepdog out of a Chihuahua! Sadly, it appears that Mercy hospital is attempting to do just that! Oh, by the way; I am still waiting for that returned call with answers, but I believe I already answered for them. That is nothing for that hospital to be proud of!

Monday, March 12, 2012

Forcing Dignity, a Sheriff draws a line!

     Recently, the Sheriff in Summit County, Drew Alexander, made the startling declaration that he would refuse to accept inmates with severe, untreated mental illness. On the surface, people wondered if this law enforcement officer had lost his mind in his own right, amid the fear that he would allow all the crazy people to wonder the streets. I had a couple of friends insist that this was a discriminatory practice that was once again, adding to the stigma of having one of these disorders.  
     After the initial shock, those comments do not stand up to scrutiny. In fact, after a recent interview I had with him, it is evident that Sheriff Alexander is becoming a champion to end the barbaric “treat them and street them” mentality that permeates the medical profession with their dismissal of those with mental illness. In essence, most medical providers would rather exclude the mentally ill from appropriate treatment, and send them back to the streets without adequate care, which in many cases, leads them to be dumped on the prison system. To more clear, his announcement could be the most merciful actions that the law enforcement community has ever done for this invisible and widely misunderstood group of people!
     This directive stipulates clearly that before the individual is to be placed in the jail system, he or she must first be stabilized. In simple terms, they must be given proper therapeutics, such as diagnosis and medication. After the person is stable, this regiment can continue under the controlled environment of the medical personal of the jail. This is a much safer environment for both the prison guards and the inmate themselves. This could also lead to some court ordered and monitored programs once they leave the prison system. Long term, we would see a decrease in the recidivism rates of these same individuals.
     If you want better understanding as how we are at this stage of a law enforcement official forcing treatment, you just need to understand recent history. Many of us old enough to remember, can find humor in old movies, with their portrayal of those in psychotic crisis, then known as the infamous, nervous breakdown! With that breakdown, two individuals would show up driving the ambulance, and carrying the straightjacket, which was used to restrain the person in question. Add to all the old classic cult song, “The funny Farm” and it would be scenes that would provoke laughter.
     In twenty first century America, those hospitals that people were taken too do not exist, and neither do the individuals arriving with the straightjackets. They have long since been replaced with police officers and with that; the medical community finds virtue in excluding those seeking help. After all, they then become the problem of the jails, not theirs! Thus began the process of the revolving door of those in crisis entering the emergency room and being sent out through those same doors, with instructions to obtain treatment elsewhere. After that, the ping ponging between these same ER’s and jails became commonplace.
     There is ample evidence that a directive such as this should have occurred many years ago. A common misconception is where people are taken when are in need of mental health treatment. Many would be shocked to learn that the number one facility for dispensing care to people in need is the Las Angeles County jail. In the Summit County Jail, it is estimated that about 40% of its prisoners have mental health issues, and along with it, a chemical dependency. Would it not have been much more prudent to treat these people outside of the prison system before they become a financial burden on society? Sheriff Alexander has agreed and decided it is time for action!
     If there is one situation that still amazes me, is the sheer arrogance and ignorance of the medical community with regards to people with mood disorders. I use this example on many occasions of two people being brought in to an ER. One has a broken leg, and the other is in a suicidal psychosis. Which one will be treated? Which one has a more life threatening condition?
     In that scenario, the one with the broken leg will be treated, and will be given after care instructions to make a full recovery. The one with life threatening illness may be held for observation, or may just be sent back to the streets to fend for themselves. Even if kept, that person most likely will eventually be disposed of by the medical community, with instructions to seek help. It is as if seeking help becomes a scandal in the eyes of the medical establishment as a reason to enter the hospital in the first place.
     Unlike the medical community at large, Sheriff Alexander recognized something that has been ignored for many years, and that is mental illness is a real illness. He was quoted in a local paper as saying “If a person had an injury he would be sent to a hospital; this is the same thing.” He is calling out people for practicing this inhumane practice of ignoring those in need and forcing them to put the brakes on this disgusting ritual.
     This is not a cure all for what ails the mental health system, but it is another element to the puzzle. Giving people without hope some hope, those without dignity, some stability, will go a long way to restoring faith into a broken system. I am hoping that law enforcement officers across the country follow Sheriff Alexander’s lead and influence the medical community, and of course our political leaders to begin to restore the system. It will be a mammoth task. However, as the old Buddhist saying goes, “A journey of ten thousand miles begins with a single step”. Sheriff Alexander just forced people to take the first one!