Family’s struggle to get care for manic father highlights philosophical and practical struggles of mental health system

New York Times Magazine coverIn this thoughtful and riveting article, Jeneen Interlandi chronicles the fear, helplessness, frustration, and double binds that relatives face in a mental health system struggling to navigate civil liberties, public safety, and beneficence. She brings in stories from other families to support the picture of a system so concerned with patients’ rights to be free of detention that other important rights are neglected. I consider two of the most important of these to be:

  • the right to be in one’s sane state, in which one’s actions are governed by his or her true self–not by symptoms; and
  • the right to be taken care of when in an altered state–a state in which one might be victimized, destroy one’s relationships, lose one’s job/housing/savings, and, in extreme circumstances, die or kill someone else

The short hospital stays of today carry a far smaller risk for harm to a patient than decisions not to hospitalize. Putting theoretical concerns about individual liberty above the actual safety and wellbeing of patients will lead to continued suffering, especially as lack of funding for outpatient services continues to drive more patients into crises.