I am no expert on mental health crisis intervention. I have only seven personal experiences to base my opinions on. Nonetheless, it is not a stretch to say that there are some major flaws in the system that should be addressed. I know I am not alone in such an assessment and hope that we can share our ideas for how to make it better.
In trying to better understand all of the points of view, I have spent a lot of time discussing it with all sides of the debate. I gained some great insight from those who identify themselves as part of the anti-psychiatry movement. I could be wrong, but it seems that much of the hostility that they have comes from bad experiences when in crisis. I have a unique perspective on such experiences because I was once hired to stay with someone during his lockdown in a psych facility. I saw first hand how bad it can be while I had the clarity to know what was going on.
My client had been picked up on what in California they call 5150. 5150 is the police code for a 72 hour forced hold. The treatment he got could easily be described as abusive. It was for me a lesson in how an emergency situation can quickly move to presumptions, judgments, and forced medications.
It is why he and others respond with determined refusal to take any medication and become more agitated rather than becoming cooperative. What patients need is a chance to relax and help getting the condition to slow down instead of a situation that makes things worse.
It got me thinking that there must be a better way. I came up with the idea that I call 5149 – the place we would go to if we designed it and were given the choice to go there instead.
Much of the problem is our own self determination is taken away. One way for us to get it back is to design the system ourselves. For that, we need to all share both what we have seen that is wrong, but more importantly, what we think would be a better way. What things would you like to see in the new 5149 facility? What parts of 5150 need to change?
I have some ideas of my own, but would prefer to be part of the conversation and add them along with yours.
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Last reviewed: 6 Jun 2011