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A failure of the mental-health system

BY GUEST OPINION | JULY 25, 2011 7:20 AM

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After seven months of being without five medications — a cocktail mixture consisting of antidepressants and anti-psychotics — I arrived at the University of Iowa Hospitals and Clinics emergency room at 11 p.m. on July 18. I expressed exhaustion, depression, and urges to commit bodily harm repeatedly to the attendees, including the psychiatrist on staff for that evening. I was without a job, insurance, a dollar in wallet, or a home of any kind. In the system of mental health, one's name goes around the small neighborhood of services very quickly. If you see counselor or a psychiatrist on the taxpayer's dime, your name is logged into the system; mine was.

I stayed in the counseling room for a total of three hours and spoke with a medical doctor, the psychiatrist, and a social worker. Their conclusion was to release me without any admittance to the psych ward or hospital in general. There were no medications offered, very little to no counseling was given; just a scratch: Put a Band-Aid on it and move on. I was told a bed at Shelter House was open for me while being handed an application for Iowa Care, health-care coverage for the under-employed, the unemployed, people on disability, and others. I was told to fill out the application for help with the cost of the emergency room visit. So, without any blood drawn, no medications dispensed, just a simple, "Good luck," granted and a bed at the shelter, billing would take place.

Was I outraged? Yes. Did the social worker hear and see my wrath? Absolutely, but, at 2 a.m. the fight gets weak. All I could do was drive to Shelter House and fall fast, fast asleep. This is a simple process: You are homeless, tired, and in need of shelter on one of the hottest nights of the year. A phone call was made by the hospital on your behalf. This should be a slam-dunk. One would think so.

I was approached by a staff member wearing a baseball cap and carrying a large flashlight. I've worked at homeless shelters in Chicago and Joplin, Mo., in the past; I know the routine. I told the man who I was, giving him the hospital information, and he walked back inside to check my story. Within seconds, he said, "Come on in."

I was grateful. I went to open my back door, grabbed my bag and asked if I should leave it in the car overnight, at which I was told by the man with the flashlight to bring it inside for the clothes to be washed. This is a common procedure in shelter life; it is used to help prevent the spread of lice and germs. I began to tell him that I had washed my clothes earlier that day and was cut off several times in mid-sentence like a Chicago street thug trying to get his point across. The staff member made it clear that he was in charge. It was apparent at this juncture, that my night at the shelter would be less comforting than the streets. So, I told him to keep the bed. The door to Shelter House was closed and I drove away; crying, kicking, screaming at the system.

I made enraged phone calls to the UIHC's social worker. I called Shelter House where the staff member from earlier told me that I "drove away like a little girl." Giving up all hope, I parked my car in the lot at Walmart and wept. A former inner-city school teacher, and a former journalist, screaming out for some kind of salvation at 4 a.m. in a Walmart parking lot — that is the state of our current mental-health system. As the economy gets worse and worse, many will eventually experience a night like this here in Iowa City and across America. The audacity of hope.

D.M. Seay is a nonfiction writer. He writes about classism in America.


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