The mental-health system will only be effective when it becomes a true partnership between consumers and their families and those who provide treatment and services, according to a noted authority on mental-health issues.
The treatment system that works will be the one that is "consumer-driven.""We do things to the mentally ill. We do things for the mentally ill. Are we ready now, maybe, to do things with the mentally ill?" Dr. Pablo Hernandez, administrator at the Las Vegas Medical Center in Las Vegas, N.M., asked a gathering of consumers and professionals at the U-Can-Du "Training for Change" seminar Friday. U-Can-Du is Utah's advocacy network of mental-health service consumers and their families.
Hernandez criticized a philosophy that says the mentally ill should be treated in the least restrictive environment - the community - then doesn't provide adequate services there.
"Our goal should be to reduce the number of people in state hospitals and let them be treated in a more humane arena in the community," he said. "Our system of care is very disjointed. We are still playing turfing games, `This belongs to you; this belongs to me.' "
The first step, he said, is for treatment providers to put themselves in the place of the consumer. Before you place someone in a state hospital, try it yourself.
Janina Chilton, Utah State Hospital, said that new staff members used to be admitted to the facility as patients for 24 hours. But the Division of Risk Management banned that practice.
The mental-health system also lacks continuity, he said. Consumers are sent from doctor to doctor, their medications are changed frequently. But if they don't do everything they're told, consumers are "noncompliant" and punished.
Finally, people need to understand that those who are chronically mentally ill are "grieving all the time," the result of an illness that "is giving me a sense of fear and failure." So getting angry at a relapse is counterproductive. "The person is suffering enough."
The way experts deal with mental health has to change now or it won't be ready to accept the growth expected as baby boomers who are mentally ill become elderly - and have the combined needs of their age and illness.
In response to Hernandez' comments, director of Mental Health Leon PoVey said that Utah is, in fact, working hard to form a partnership between officials, providers and consumers. "And if the system is built on the value of a partnership, we will always be doing things with instead of to or for."
PoVey agreed that communities need more resources, but said the state hospital and community services should not be viewed as "alternatives" to each other, but as important pieces of the mental health picture.