Beth A. Leverence
On a sunny August afternoon, I came home from work to find my 17-year-old son, Aaron, lying on the sofa moaning in pain. That night we took him to the Emergency Room where a CT scan revealed he had appendicitis. His appendix needed to be removed. The surgery was scheduled immediately, and gratefully, it went smoothly.
The following morning we came back to the hospital to visit. Knowing what room he was in, we walked through the door and took the elevator to the floor where he was staying. No one stopped us at the hospital entrance and asked who we were visiting. They never called the floor to get permission for us to go to his room, and they most certainly did not request we lock up our personal belongings or go through a metal detector before proceeding to visit him. It seems absurd, doesn’t it, that you should have to pass through metal detectors to visit your loved one in a hospital?
When Aaron was 15, he became very ill with a difficult-to-treat case of schizophrenia. As a result, he has spent a lot of his life passing through different mental health facilities. Every time we visited at the Milwaukee County Mental Health Complex, we were required to stop at the front desk and tell them who we came to see They called the ward where he was staying to get permission. Once confirmed, they had us lock up our belongings. Finally, they took a metal detecting wand and checked us front and back for weapons. This process causes me to shake my head in wonderment. Was my son in a hospital or was he in a prison?
The differences between many mental health facilities and hospitals don’t just stop at the lobby. Most hospital rooms are outfitted with comfortable beds, televisions and walls painted with pleasant colors intended to calm and comfort the patient. Many mental health facilities Aaron was treated at looked like the walls hadn’t been painted for years. The rooms were often shared with one or more patients, and each patient only had a low platform bed. Patients were lucky if there was one working TV in a common room with more than a few channels for them to choose from, let alone having a TV in their room.
I can understand the stark nature of the furnishings and bed linens might be intentional in order to keep people safe from personal harm. Still, shouldn’t the intent also be to create a calm and comforting environment to help the patient heal? I rarely walked into a calm and comforting environment when walking through the halls of a mental health facility.
Is it any wonder that many people with mental illness don’t seek help for their disorders? According to the American Psychiatric Association, more than half of the people with mental illness don’t receive help for their disorders because of stigma. Researchers have identified three types of stigma: public stigma, self-stigma and institutional stigma. It is the institutional stigma that creates significant disparities in the environment and care people receive in mental health facilities versus hospitals for the physically ill. (Find the full study “Stigma, Prejudice and Discrimination against People with Mental Illness” by Jeffrey Borenstein, M.D., Aug. 2020 at Psychiatry.org, www.psychiatry.org/patients-families/stigma-and-discrimination.)
Aaron is now 38. I’ve been observing the institutional care he has been receiving and I have only seen limited positive change if any. Mental illness is, however, getting more visibility due to the impact many have felt from COVID-19. This is unfortunate, but at the same time, I’m hoping it is a blessing in the long run. The more people talk about mental illness and the more people understand it, the likelihood of positive change will finally be realized.
Institutional stigma can be reversed.
Beth A. Leverence is a mental health advocate for families who writes at https://raisinghealthyminds.com/