Monday, August 25, 2014

The US and Canada differ on many aspects of health care delivery, but one area in which they have a common approach is inadequate care for mental health.  I was reminded of this when I met with a colleague who works at the British Columbia Division of the Canadian Mental Health Association.  She related several stories about slow and inappropriate treatment of patients--both in crisis and in chronic states--in the provincial health system.

Meanwhile, Modern Healthcare reported that south of the border a court ruled that, "hospitals in Washington state will be prohibited from boarding psychiatric patients in emergency departments while they wait for inpatient beds to open up."

This creates a terrible Catch-22:

“While we respect the state court's decision, federal law still prevents hospital emergency departments from discharging unstable patients, for example, suicidal or homicidal patients, back into environments where they could cause harm to themselves or to others,” Dr. Alex Rosenau, president of the American College of Emergency Physicians, said in a statement. “This ruling does not provide guidance for hospitals and physicians regarding resolution of the conflicts among federal law, this state ruling, and the medical liability risk of discharging patients based on a time limit rather than based on reaching a stable condition.”

These debates often focus on funding, but the human costs are high.  Marijke takes the recent death of Robin Williams to note on her blog:

Williams's death hit too close to home to many and it opened up a conversation that many people are afraid to have. Williams graced us with his humour and his talent, and seemed to have it all. Yet he didn't. He missed something incredibly important - good mental health. It reminds us that we are all vulnerable.

Virtually every family in these two countries has had or will have a member with mental illness.  I'd love to see some politicians who bravely break through the stereotypes and force political action that raises diseases of the brain to the level of diseases of the kidney, lungs, and liver.


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