From the wise words of the late Anthony Bourdain regarding one’s ideal pace in the city of Rome: “take it slow and as it comes.”
In Italy, it’s often expected that a group of people will remain at a restaurant’s table for the entire night. Such is not the case in the United States: a family orders, the kitchen delivers, the family eats, check, go—and the staff immediately cleans the table in preparation for the next customer.
The dining cultures of both countries are understandable, particularly in the case of the U.S.—a country solidified on a quick pace and turning a profit.
For food, such ideas may be acceptable, but should those maxims of speedy service and turnover apply to the care of the mentally ill? Such a concept may seem outrageous, yet it remains to be the case.
First, let me be frank. Modern day mental health facilities are far better now than they were half a century ago. Still, the image of the outdated insane asylums are so powerful that the common stereotype of the psychiatric ward still exists. You know the one: a person curled in the corner of a padded room rocking back and forth in forced restraint.
Such an image would have been plausible many years ago. These days, however, the situation is far more progressive, though there’s much left to be desired.
A facility today has likely thought of all the tragic contingencies. Patients must relinquish their belts, any shoes with laces, any other straps, as well as all the treasured objects in their pockets. The tops of most doors are slanted, the curtain bars are replaced with Velcro. Shower handles are instead cone shaped. The door handles are rather lipped. The sheets on the bed can be easily ripped given enough force. The nurses check on patients every 15 minutes (every 5 if the patient is feeling particularly low). The entire time, the staff at the hospital demonstrates their unwavering care for these patients, so what is it that’s ineffective about the system?
It seems to be the case that these facilities are intended to prevent a bad outcome rather than treat the problem itself.
Still, when one of the largest complaints by patients is that they are not allowed to bring a blanket to group, it’s clear that there’s progress. The underlying issues, though, are subtle, hardly noticeable, and yet they are devastating. The staff is well intentioned, but the system behind it all lacks a key component: compassion.
Mental healthcare does not appear to be about fully tackling the problem but rather to suppress it to a measurable degree of satisfaction. Many hospitals are focused on quick turnover.
Even in a case I’ve witnessed that one may find severe, the brevity in which it was handled is nothing short of staggering. A man who hung himself, unsuccessfully, with a fresh scar around his neck, was given a short hospital stay and medication, and he left with little follow up care.
That seems to be the U.S. way: here’s the problem, here’s your meds, now off you go.
The care he received was not about taking it slow. The underlying issues were likely not addressed, and for all the shortcomings of this healthcare system, the shortcomings within the mentality of our society regarding such compassion are even more acute.
The image of a middle aged homeless man muttering to himself as he slowly limps his way down the street conjures a rationalization to stay away, preferably as far as possible. Such a person likely has some form of schizophrenia, and when it’s as developed and untreated as it is in the case of the homeless, the prognosis is so poor that one may as well consider the matter hopeless. Nobody with any decent moral compass would have the same thoughts for someone with cancer—regardless of the stage.
The efficacy of medication aside, I’m of firm belief that genuine support and compassion from friends and family have a far better effect than the treatment received at a hospital.
Do not wonder how someone close to you is doing. Do not tip-toe around the issue. Demonstrate care and the willingness to stay with the person, because such demonstration of care works.
One may even find that the issues a friend is going through strikingly resembles their own.