I have had a difficult time with the “Behavioral Health” Hospital/ER here. They discharge my son when I can show that he’s still paranoid and deeply delusional and thus a danger to himself and others. They say his difficulties are behavioral rather than mental health, but they don’t really outline the difference. Yet the hospital is called behavioral health, so either way, why discharge him when he is still struggling??
The Differences Among Mental, Developmental, and Behavioral Conditions - Trying Together says:
"Psychiatric conditions are considered to be involuntary while in behavior disorders, choices are essential. " What does “essential” mean?
This is confusingly worded because in medicine essential normally means with no known external stimulus or cause. Otherwise known as idiopathic. Although here I think they mean essential in the sense that it’s a “requirement”.
What they seem to be getting at is a disorder is behavioral if it’s the result of personal choice. For example alcohol or drug abuse can lead to paranoid or delusional episodes and (debatably) the result of a “choice” to abuse substances. ER triage for mental health issues often hinges on whether patients are deemed to be malingering, under the influence of drugs or alcohol or “organic”. They’re often reluctant to give a psychiatric diagnosis when it’s possible other issues are in play, so people with emergent psychiatric disorders who appear to be using drugs and have no prior history of mental illness, tend to fall through the cracks.
Thank you for responding to my frustration and desperation. So as I understand it,
even though my son is diagnosed with bi-polar depressive type, schizoaffective disorder, they will call his delusions, hallucinations and suicidal ideology “behavioral” because he smokes pot?
I would try to pin them down about what they mean about “behavioral”.
How do they know his symptoms aren’t caused by his mental illness? I.e. they are of “of unknown cause” (and might not be an outcome of his MI). Isn’t the more likely answer they are MI-derived.
Here they use a term, drug-induced schizophrenia for people who enter the system through the use of recreational drugs. Personally I am skeptical that they can tell the difference between schizophrenia symptoms induced by recreational drugs and the ones perpetuated by the drugs they give you on prescription. ( I feel we are all guinea pigs and in some giant experiment). There’s no easy answers but slow tapering whilst receiving counseling or psychological help may benefit. A friend of mind had early onset dementia through heavy use of marijuana.
The system seems so lacking when we know our loved ones need more/longer inpatient or even outpatient care. First, I think it is helpful to know the involuntary commitment laws in your state if you don’t already. The hospital is attempting to follow that law but I honestly believe, sadly, that insurance and money can also be a factor. (If they can replace the “bed” with someone else who has insurance with a higher reimbursement rate, for example.) If a person is to be discharged, it is prudent that the hospital discharge to a safe place (but does not guarantee that they will). While it is a difficult thing to do, in some cases, it might be helpful to longer term recovery if you tell the hospital prior to discharge that your loved one cannot come home. That can encourage them to find a place for the individual to go. You can insist on and possibly help locate a recovery program or other residential program where medication and compliance and sobriety is a requirement. There are so much unknowns, especially when we know our LO needs additional help. I understand and am sorry you are having to experience this.