Recently, I found the journals I kept while a patient at Richmond State Hospital in Richmond, Indiana.  The entry for August 13, 2008, contains this tidbit:

[The service line manager] is now aware of my occupation. I probably overplayed my hand when I told her my paper’s, shall we say, reputation. I let my judgment lapse in an attempt to appear sympathetic. She is not happy to know I want to write about the hospital’s budget cuts.

Brace yourself–the following information is something the State of Indiana–and possibly your state–doesn’t want you to know.

Low budget = inhumane conditions

Everywhere you looked at Richmond State Hospital, you could see signs of inadequate funding. For example, the bed linen didn’t fit the beds. Much of it was also stained or torn. The mattresses were hard, and I never received the soft mattress pad the doctor ordered.Making phone calls was difficult; we used pay phones that charged an exorbitant amount of phone card minutes. The pay phones often malfunctioned.

There were not enough chairs to seat everyone at the same time, which made group therapy difficult.  One day there was a leak in the women’s bathroom. The water covered the entire floor, and remained there for three days.

Exactly how was all this “therapeutic”?

Low budget = poorly trained, overworked staff

Staff members at Richmond often worked double-shifts. In a profession requiring patience with sometimes difficult people, as well as constant alertness, this is not good. One staff member, during a double, started yelling at a disruptive patient. Another staff member would sarcastically offer suggestions on how to solve our problems. One staff member was fired after telling a patient with borderline personality disorder (BPD) “Why don’t you just f****** do it?!” when the patient said she wanted to die. And no, it wasn’t me, but I was cursed at by staff as well.

There were not enough staff, especially those with medical training. We often went without medical treatment; one patient flat-out told staff “We shouldn’t have to beg to see the doctor.” I agreed, saying “Just because we’re psych patients doesn’t mean we don’t get sick.” I went for four months without medical treatment that I received within four days of my transfer to LaRue D. Carter Memorial Hospital. The major difference between the two state hospitals is that LaRue receives some private funding–which made for better conditions.

The problem of funding

It all comes down to money. People as a general rule want to pay for as little as possible and get as much for their money as possible. Funding for the state hospital system is not on the radar of most people. Stigma is part of the problem; to some people it’s like arguing for more humane conditions in jails. However, another part of the problem is the simple “It’s not my problem” mentality.

But it is our problem. One in four Americans will be diagnosed with a mental illness at some point in their lives. While very few of these cases end up in the state hospital system, the sheer number of people with a mental health diagnosis should serve as a reminder that it can happen to anyone. It’s like Medicare and Medicaid–it’s intended to be a safety net for the disadvantaged, but rich politicians get votes from rich people by blaming the victim.

How do we solve that? Education. We need to raise awareness that mental illness is common and treatable. We need to remove the stigma not only of mental illness, but also of hospitalization. We need to educate people that going to a long-term psychiatric facility is no different than going into long-term treatment for a more visible illness. When people understand this as a medical issue and one that could possibly affect them, they’ll be more willing to talk about paying for treatment that sick human beings deserve.