After decades of deconstructing our inpatient psychiatric hospitals and community mental health centers and after decades of insurance companies demanding that they pay only for social workers and nurses to treat even the most extremely mentally ill and potentially violent individuals (rather than including psychologists and psychiatrists) we now have a mental health care system that simply ignores those among us who suffer with incapacitating symptoms of psychiatric illness and whose suffering can—only in a very, very small percentage of cases, thankfully—lead to terrible violence.
What is wrong, exactly?
Here is the truth: Today, even a mentally ill young man with a known propensity for violence, or even a history of serious violence, is likely to receive just an hour a week of counseling (if that) by a social worker.
He is likely have an unclear diagnosis of his condition and to be on a list of constantly changing, very powerful psychoactive medications prescribed by a nurse.
He is also likely to be turned away -- repeatedly --by emergency room social workers who act as gatekeepers for insurance companies to restrict access to inpatient psychiatric treatment.
If admitted to a psychiatric hospital, he will likely be triaged quickly through an often-incompetent “tune up” of medications that might accomplish nothing and then be sent back home as soon as he “contracts for safety”—simply promising a social worker that he won’t kill anyone.
