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How do you handle the pain of having a friend or family member who is experiencing a mental health crisis? How do you explain the need to intervene? Why should a family member be trusted with making tough decisions to improve a loved one’s well-being while remaining sensitive to the person’s wishes?
I am happy to offer a more than 15-year career in the mental health field, where I worked in both the emergency department and inpatient settings. To be blunt: I learned that the most devastating and frustrating decisions in the medical field are really personal. A few years back, I read a very well-written article by Dr. Michael D. Schmitz, MD, in Behavioral Med Clinics, titled “Inpatient Psychiatric Emergency Care.” Although our interview is lengthy, the piece touches on a wide range of issues in the emergency room, including the critical importance of patient confidentiality. In it, Dr. Schmitz notes that in hospitals, if someone is on the brink of death and requires treatment, he or she is often left in the hands of that loved one who is not a medical professional, and could very well “act as a de facto suicide” if left to run his or her own life while the family members are too busy to deal with the situation.
The piece points out that there is a serious problem with the way mental health care is delivered to patients – specifically with regard to how it is handled.
For me, the experience of intervening has been both educational and challenging. I’ve watched firsthand how family members, sometimes in conflict with each other, can make hard decisions with no prior training, expertise, etc. I am acutely aware of the many patients who are in my position now: a patient who is suicidal, an alcoholic who needs hospitalization, a schizophrenic with suicidal thoughts, an autistic or developmental child being removed from a family member, a patient with a parent who killed himself, an elderly family member who cannot afford a psychiatric evaluation, etc.
In one of my first emergency room conversations with a family member, I was struck by what a difficult task this was,
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