See Something, Say Something, Then What?

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“If you see something, say something.”

That is meaningful in the prevention of terrorist attacks but, for those suffering from mental illness, it is of little help.

In the 1970’s, under the auspices of, “more humane treatment,” politicians thought it would a great idea to shut down all mental health institutions and relocate patients to small community-based group homes. Obviously, those politicians never saw the inside of those institutions … I did.

Could it be the closing of these institutions became an enormous, “cash cow,” for those politicians? Those funds funneled away to more appealing, vote buying projects?

Using Long Island, N.Y. as an example, there was Pilgrim State, Central Islip, and Kings Park psychiatric hospitals (other states followed suit):

At its peak, Pilgrim State housed 13,875 patients.  Today, it is a pitiful 290-bed facility.
Central Islip Psychiatric Center once housed 10,000 patients.  It closed in Oct. 1996.
Kings Park Hospital at its peak had 9,303 beds. It officially closed in 1996.

This is an example of current demographics:
  • Brookhaven: 64 beds, adults only
  • Sagamore Children’s Psychiatric Hospital: 69 beds (ages 6-17)
  • South Oaks: 258 beds (includes addiction services)
  • Stony Brook Univ. Hosp.: 30-bed unit

Patients are admitted to Stony Brook Hospital via their CPEP unit (Psych ER). Patient stays are very brief and are primarily for evaluation and referral outpatient care.

As you can see, inpatient psychiatric care beds are extremely scarce all over the country. Those fortunate enough to find an available bed for treatment are often evaluated, medicated and released with out-patient recommendations. Caring for mentally ill individuals optimally requires extended hospital stays, intensive therapy with close supervision and oversight.

I did a psychiatric rotation at Kings Park shortly before its closure and had up close and personal observations of the very same patients about to be released into the group, community homes.  With multiple staff members and security guards present, many of these patients still posed a constant, potential threat to staff members… in other words, it was a very scary proposition. Releasing these patients into the community, a terrifying thought.

Sandy Hook shooter, Adam Lanza, had a known history of mental illness.  No doubt this latest Florida shooter, Nikolas Cruz, will also reveal mental health issues.

Lawmakers can no sooner legislate away evil than they can mental illness.  But they certainly can recognize the incomprehensible deficiencies of the mental health care system in this country.  You can see something, you can say something but, without adequate facilities to treat the mentally ill in this country, tragedies of varying numbers will continue to play out unabated.

As it stands now, we wait until tragedies strike, then we put the mentally ill in prison. Currently, prisons have become the substitute for the mentally ill after the fact.  Prisons are not a good substitute for inpatient, psychiatric care.