[acb-hsp] A Glimpse into our Mental Health System

[peter altschul]

A Personal Glimpse into Our Woefully Inadequate Mental Health 
System
  Mary Ann Swissler December 20, 2012
  Manhattan filmmaker Lucy Winer can recall when mental health 
care was a chaotic system designed to punish instead of providing 
service now required of U.S.  insurance plans under ObamaCare.  
It was the age when warehousing warm bodies was too often as good 
as it got.
  Winer's new documentary, "Kings Park: Stories from an American 
Mental Institution," which debuted on Long Island in December, 
chronicles her improbable journey beginning in 1967, from a 
17-year-old suicidal patient padlocked behind the hospital walls 
of the "women's violent ward," to a 30-year veteran of 
movie-making.  Her latest creation casts a wide lens on the 
continuing neglect of people with serious mental illnesses, while 
applauding the progress that's been made in awareness and 
insurance coverage of medical treatment.
  Off-camera, Winer also lauds various legislative mandates 
including ObamaCare.  "The Affordable Care Act can really make a 
difference for people with mental illness and specifically for 
women with mental illness," Winer said of the mandated mental 
health coverage for people insured privately or publicly through 
Medicaid and Medicare.
  Women are more likely to suffer from depression and anxiety 
than men and are more likely to attempt suicide, she said.  "And 
those disorders are much more likely to persist in women."
  Luckily, Winer didn't succeed at suicide, and now at 62 she is 
adding public speaker to her long resume of feminist projects.  
At Kings Park as a girl of 17, she was misdiagnosed as 
schizophrenic after several suicide attempts and isolated without 
benefit of talk or group therapy, much less any compassion for 
her situation.  Her experience was part of the massive 
"warehousing" of people living with mental illness which ended 
with deinstitutionalization in the 1970's-one massive failure 
replaced with a string of broken promises to provide community 
and family support.  Instead, patients were unceremoniously 
discharged out into a society that was unprepared for their 
medical and social needs.
  "Saying the hospital was closed down because the bulk of the 
patients found other alternatives gives quite an idealized 
version of how these people fared," Winer said.  Today, at least 
25 percent of incarcerated people have serious mental health 
issues, she said, and similar numbers show up in the homeless 
population.
  A 2008 federal law requires equality for mental health under 
private insurers but not for public insurance.  It's an important 
distinction, she said, since two-thirds of adults on Medicaid are 
women and more than half of Medicare recipients are women, 
according to government statistics.  "Women rely more on public 
programs like Medicaid and Medicare and those programs are being 
threatened by federal and state budget cuts," Winer said.
  Numerous risk factors are present for women that aren't there 
for men-gender-based violence, domestic violence, socio-economic 
disadvantage, income inequality, lower social status, and 
"unremitting responsibilities for the care of others," according 
to a United Nations report.  Women also make up the largest group 
of people affected by post-traumatic stress disorder (PTSAID).
  Winer added that under mental health treatment, women are 
frequently charged more for the same condition and service, and 
are routinely charged higher premiums than men.  The Affordable 
Care Act now bans this practice.
  Winer is used to mulling over these issues.  "A part of me has 
never left," she states in the movie, while exploring the 
dilapidated interiors of the now-shuttered Kings Park State 
Hospital during the first moments of the documentary.  Surrounded 
by paint chips on walls and floors, Winer sits down on the floor.  
"This is what you did," she says, laughing.  But at 17, there was 
nothing funny for Winer or other patients.  Languishing in open 
rooms and being pumped with powerful anti-psychotic drugs 
comprised "treatment." The patients, who were clothed in gray 
uniforms called "state dresses," were unable to use a restroom 
without permission and banned from going outdoors.
  In the film, Winer recalls being told by another patient, `Do 
not cry.  They'll hurt you.` And I stopped, for 25 years."
  There are also strong no-talk rules-still-about mental health, 
which she hopes her film, which is to screen at the American 
Psychopathological Association next March, will break through.
  She said, "Our movie provides a wonderful catalyst for much 
needed dialogue about the stresses exerted on women by a sexist 
society, which play a role in undermining women's mental health.  
Whether we are talking about poverty, sexual violence, lack of 
family support, or the myriad demands of confining gender roles, 
these external pressures continue to compromise our safety and 
well being despite all the progress we have made in the last 30 
years."
  She has high hopes for the next 30 years through new promises 
made via ObamaCare, with its guarantees of insurance coverage for 
mental health treatment and other programs that sound like the 
unfulfilled promises of deinstitutionalization: support, 
education and research for post-partum depression, Centers of 
Excellence for depression, a Medicaid Emergency Psychiatric 
Demonstration Project, and community mental health centers.