Pictures. One of the key ways that we communicate with one another. They amaze. Shock. Share realities different from our own. Like the picture of the small child sitting alone in an ambulance after a bombing in Aleppo. I avoided seeing that picture for days because I did not want one more image of a child I could not help etched on my brain.
There is one picture, though, that you will not see. And that is the picture of my friend’s daughter as she sits alone, waiting for the transportation that will take her to a mental health facility. She, too, is small, like that child in the ambulance in Aleppo. She, too, is sitting alone and still. She is just 10 years old. But she and her mother have been swept up into a system that all too often, in its attempt to serve, causes more damage and fails on every level to meet even the most basic of needs.
For almost a month, my friend had been unable to refill her daughter’s medication. There was some screw-up in the interminable “system,” and the pharmacy could not get the medication approved. With a growing sense of hopelessness amid daily calls to try to get the problem resolved, she watched her child’s condition deteriorate.
When it came to the moment that her child began to try to harm herself, she could not wait anymore. She took her for assessment, and the hospital agreed she needed to be hospitalized. There was no bed available. They sent my friend home to her other children that night, leaving her daughter to the care of the assessment facility, which scrambled to find a bed.
They did locate a bed about 11 p.m. They just did not call her. They did not call her until the next morning, 10 minutes before her daughter was to leave. Without discussion with her mother, the child was headed to a facility over two hours away.
My friend lives in Raleigh – with world-class facilities minutes away. People come here for care not only from all over our state, but from all over the country. Except if you have a mental illness. These people we send away.
And so my friend loaded her children into the car and rushed to see her 10-year-old child before she was sent to a facility her mother knew nothing about in a place neither had ever been and that her mother would have a hard time ever getting to. She walked in to see her daughter sitting alone. She did not have time to explain to her what was happening, to assure her that her mother would be involved in her care, to tell her that she loved her, to even take her a change of clothes or her favorite stuffed animal as a piece of home in this strange place.
How does this happen? How is it that my friend had to call the hospital for four days before she could speak to her daughter? How is it that she was told she could not speak to her daughter because the child was in front of a judge? In front of a judge? Her daughter was not involuntarily committed. She is 10 years old. She has a mother who is legally responsible for her. How is it that her parent was not notified that she was to go before a judge and was not given the opportunity to be present? How does it happen that after five days of care, five days of multiple phone calls, she wasn’t able to speak to anyone who could tell her about her daughter’s care, a plan for treatment or a plan for discharge?
A medical system that fails to recognize the role and rights of parents of a minor fails. A medical system that fails to recognize the emotional need of children to know that their parents are present and are involved in everything that is happening to them fails. A medical system that fails to support communication and ongoing involvement between a parent and a child in a time of crisis fails. A medical system incapable of providing a bed even in the state’s capital, surrounded by leading medical facilities, that will ensure that a parent can have a physical presence in a child’s life during a hospitalization fails.
We are failing. On so many levels. We are failing to provide the services that address the needs that those affected by mental illnesses have on a very basic level. And our failures only serve to deepen the crisis and the pain.
This is the picture. Not ribbon-cutting ceremonies at the opening of hospitals built to replace facilities we have closed that provide no new beds. This is the picture. A 10-year-old child, waiting alone in a room. Her mother shut out of her care.
Donna Kay Smith of Raleigh is co-chair of Stand By Me NC, a mental health advocacy group.