Where have all the mental health beds gone?

Wednesday, March 1, 2023

By Courtney Wise

Where have all the mental health beds gone?

“​​Thirty-odd years ago, Time magazine hailed a new mental health facility in downtown Seattle as a place of hope,” begins a story in The Seattle Times. “El Rey, with its airy interior design and individualized approach to mental health care…had a modern, humane appeal.” It was one of several new or restored mental health homes, The Times reports. “Now, nearly all of them are gone.”

The report told a familiar story: As Washington’s state-run psychiatric hospitals closed in the 70s and 80s, the money needed to run community-based facilities didn’t follow. And since the 1990s, the number of mental health beds declined further. The El Rey shut down in 2020. “Behavioral health has never been a priority,” said Kelli Nomura, CEO of International Community Health Services. The county could have helped facilities squeezed by rising costs in the late 90s, but let them close.

In April, King County voters will decide whether to raise taxes and put more money into mental health care – $1.25 billion over nine years. But only 12% – $146 million – would be allocated for long-term residential facilities, with $886 million going to crisis care, sparking new worries from mental health workers on the ground. Daniel Malone, executive director of the Downtown Emergency Service Center, supports the levy. But he worries: “We’re going to divert or build up too much emphasis on crisis response, and we aren’t going to take care of the rest of the needs that, if done well and adequately, will prevent crisis in the first place.”

Therapy as Reparations: Working for Free Mental Health Access for Black Americans

How do you compensate a people for a lifetime – many lifetimes, in fact – of economic harm, violence and brutality that began with slavery and the splintering of families and continued with prohibitions against the right to vote, to own a home, to pursue higher education or to work in a job of your choosing? With a history that has exacted such a devastating toll on the psyche of Black Americans, what is needed to undo this incalculable damage?

Dr. Brian Dixon, an African American psychiatrist based in Texas, has a proposal. He wants to provide reparations for the damage. But he’s not talking primarily about economic reparations. Along with several other Black therapists, Dixon is a leading advocate of therapy reparations. In his view, that means providing free therapy to Black, brown and indigenous Americans to help them cope with generations of racial, psychological and economic trauma. 

Read the full story here…

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Is it safe to disclose your mental illness to your boss?

The pandemic prompted many companies to vow to make employee mental health a priority. Some retrained managers to become more sensitive to employees’ struggles, the Los Angeles Times reported; others expanded insurance coverage and employee assistance programs. But many workers still don’t want to disclose their diagnoses. 

“The vast majority of the corporations, the businesses that are saying, ‘Oh, we care, mental health is important,’ I just don’t believe it,” said Claudia Sahm, an advocate for healthy workplace environments who was diagnosed with bipolar disorder 12 years ago. “Until you actually put [in] the money and the resources and the training, it’s just words.”

Adults with mental illness are theoretically protected from workplace discrimination by the Americans with Disabilities Act – but only if they disclose their condition to their bosses. The act obligates employers to provide employees with reasonable accommodations – like quiet work environments, different breaks and work schedules, or changes in supervisor interactions – as long as they don’t create an “undue burden” on the employer. It’s about extending the same compassion for mental illness as is given to other serious illnesses, Sahm said. “You wouldn’t fire someone who had cancer because they were grumpy,” she said. “But with mental health, it’s a lot harder for someone to recognize and give that same kind of understanding.”

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Teens keep turning to TikTok to self-diagnose mental illness

The easing of stigma against mental illness is a good thing but when it’s combined with a shortage of mental health professionals, it can have some undesirable consequences. Like this one: Adolescents are scrolling TikTok for mental health advice and diagnosing themselves with serious mental health problems. “If I’m trying to figure out how to do something, I feel like it’s easier to go on TikTok,” Alexis Diomino, a third-year college student, told CBS News.

Open conversation about mental health on social media can help people find support and reduce stigma, said Michael Rich, director of the Digital Wellness Lab at Boston Children’s Hospital. But treating social media influencers like therapists is risky. 

“We need to understand why people are coming to these influencers for help. But we also have to have some kind of quality control,” Rich said. Influencers are trying to be there for their peers, he added, but are not trained “to detect how much distress someone is in or how close someone is to actually harming themselves.” And that can be dangerous.

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In other news…

Climate anxiety is very real – which could make for scary science fiction. But Yes! Magazine says “cli-fi” authors are also injecting a sense of hope with “a new and socially responsible look at what Earth could be like after an apocalyptic event.” 

The weight-loss drug Ozempic is putting people into war with their bodies, writes Matthew Schneier in The Cut. Approved in 2017 to help diabetics control their blood sugar, the drug is being used by people to trigger their bodies to lose weight. “Everyone laments the ghouls of body dysmorphia and eating disorders and the pressure social media exerts on teens,” Schneier writes. “Ours was supposed to be the feel-good era of Lizzo and Ashley Graham and Adele. Then Adele lost all that weight.”

“Your shift time is over…PLEASE GO HOME!” reads a new message to employees of  SoftGrid Computers in Indore, India. The message is intended to encourage staff to prioritize breaks and strive for work-life balance, said Shweta Shukla, co-founder and CEO of SoftGrid. “Since the pandemic, we have all been facing issues with working overtime and missing out on the social parts of our daily lives, like quality time with our families and loved ones,” she told NBC News.

Got a hobby? It may keep you healthier. Hobbies can reduce stress and depressive symptoms, and improve your daily outlook, says psychologist Tomeka McGee-Holloway. “Engaging in leisure activities reduces our cortisol,” she told Real Simple. “Cortisol, also known as the stress hormone, negatively impacts our energy, mood, and sleep.” Engaging in hobbies, she adds, “is a powerfully nourishing act of self-care and self-love.”

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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