Mental illness makes headlines when tragedies strike. After shots are fired
and people die, tears trail down faces and questions form on the lips
of those across the nation.
How could someone like Adam Lanza fall through the cracks of the system,
and die as a 20-year-old mass murderer who calmly shot down 26 women and
children at an elementary school in Newtown, Conn.?
But for all of the questions, such tragedies do shed light on a topic most
people rarely talk about, let alone experience – mental illness.
Yet, for thousands of Gaston County residents, mental illness is a part
of daily life.
The psych ward at CaroMont Regional Medical Center treated more than 3,000
patients in 2012, although some of that number may have been a repeat
visit. That number only represents the mentally ill who needed emergency
care — some brought in by loved ones, others admitted against their will.
A danger to themselves
To admit someone to the seventh floor of the hospital against their will
is to take away their freedom. Taking such a step isn’t taken lightly,
according to Dr. Donald Klasing, psychiatrist with CaroMont Health.
People often end up in the psych ward voluntarily, knowing something’s
wrong and looking for help.
But if someone poses a danger to themselves or others, action can be taken.
Police and emergency workers can take a suspected mentally ill person directly
to the hospital.
But if your family member, friend or even neighbor is in danger, you can
start the process at the magistrate’s office.
About two to three people visit the Gaston County Magistrate’s Office
daily with such concerns. If that person can prove the individual is in
danger, a magistrate will issue an order.
The appropriate law enforcement agency will send an officer to pick the
person up and take them to
CaroMont Regional Medical Center where a doctor will conduct an evaluation.
Treatment starts almost immediately, according to Klasing.
A second doctor evaluates the patient, and in most cases the person is
treated and sent home within five days.
Involuntary commitments only happen about two or three times a year at
the local hospital, said Klasing.
If two doctors agree that a patient’s mental illness is so severe
that they require commitment, an order is sent to the magistrate judge
and a hearing is scheduled.
The procedure is unique.
“You’re treated against your will. It’s different than
every other aspect of medicine,” said Klasing.
Doctors look at past run-ins with police, prescription history and statements
from relatives and friends.
In most cases the patient responds to treatment and is released. But if
the process goes through to completion, a hearing is held, often at the
hospital, with the patient, doctor, guardian and the magistrate judge.
The decline of the ‘asylum’
In the past, such commitment would land a patient in Broughton Hospital
But asylum type treatment is mostly an antiquated practice, according to Klasing.
Most mentally ill patients at CaroMont Regional Medical Center are treated
at the facility, whether they stay for days, weeks or months.
The goal is the same no matter what the affliction – to get the patient
stable and adhering to prescribed treatment and medications.
“When they’re well enough they’re released, and the commitment
is no longer in effect,” Klasing said, “and they begin out-patient
Off their meds
It’s become common place for people to joke that someone’s
off their meds when they act irrationally. But the saying is rooted in
truth, said Klasing.
Medications have come a long way in treating serious mental illnesses like
bipolar disorder, schizophrenia and severe depression.
Finding the right medication and taking it regularly is critical.
“There’s essentially no medication that cures mental illness.
They all treat the symptoms that can lead someone to a happy and productive
life,” said Klasing.
But that simple daily ritual becomes complex for someone with mental illness.
“It’s very difficult for people to gain insight that they have
the illness and that they need the medication to be well,” said
Klasing. “The illness itself affects the organ that allows insight.
When it’s the brain itself that’s broken, you do not see that
anything is wrong.”
The hospital psychiatric ward helps people get back on track. But often
continued long-term care is needed for mental stability, according to Klasing.
Patients can find such help through counselors and doctors. Partners Behavioral
Health Management in Gastonia serves eight counties – connecting
people to a variety of services.
Once a diagnosis is made, care coordinators can help people stick to their
prescribed regimen, according to Tom Gray with the organization.
People with mental illness need as many support systems in place as possible,
Anyone can have dark thoughts. A mentally ill person stewing in that distress
could break. But if that person has a trusting relationship – with
a counselor or family member – they may confess their disturbing
And that entrusted person should act immediately.
“After the fact it’s too late,” said Klasing.
Parents especially have an obligation to communicate with their children,
he said. Think of the tragedies that could’ve been avoided.
“I’m sure the parents of the Columbine killers didn’t
have a clue. Don’t think, ‘Oh Johnny’s up in his room
he must be fine. You’ve got to go up there and talk,’”
Some patients may need a group home setting, and that could be hard to
come by with the depletion of state funding, said Klasing.
Parents, brothers, sisters and children could become full-time caregivers
out of necessity. That job can be overwhelming.
Just as mentally ill people need support, so do their caregivers, said Gray.
Forming peer support groups is important. Such support can come from friends,
church members, family or formal groups.
Asking for help can be tough whether you’re sick or the family of
someone who’s mentally ill, said Klasing.
“There’s a lot prejudice out there against the mentally ill,” he said.
The majority of mentally ill people are treated in doctors’ offices
and prisons, Klasing said.
Prison may seem an unlikely support system, but the environment provides
that “mom” element – putting a person on a strict schedule
that could include therapy and medication.
For some the emergency department of CaroMont Regional Medical Center remains
a revolving door for crisis treatment. Patients are admitted to the psychiatric
ward and spend a week getting back on track before returning to life.
“We’re not sending them home 100 percent. We’re sending
them home in a stable state,” said Klasing who noted it can take
weeks for a patient to completely stabilize. “The goal is to get
them where they can be treated on an outpatient basis.”
You can reach reporter Diane Turbyfill at 704-869-1817 and twitter.com/GazetteDiane.
Partners Behavior Health Management has a 24-hour customer service line
called Access to Care.
Services are available in emergency situations and for scheduling appointments
or provide information on community resources.
Pregnant women who are abusing substances and persons injecting drugs receive
Anyone with a life-threatening situation should call 911.
To reach Access to Care, call at 888-235-HOPE.