My Hands Are Tied

Working in an Urgent Care Mental Health facility for the past eight years has afforded me tremendous challenges, experiences, and inspiration. This blog is intended to share my field experience in hopes to improve myself, my skills, and my sensitivity to the people I treat on a daily basis.

Today a father brought in his adult son for treatment. The son wanted help with anger and his mood but was resistant to taking medication for it. In working at a facility who's focus is on medication management for whatever ails you, my hands were tied. I, by law, can not force medication on anybody. Well, that is unless a person becomes a danger to themselves, to others, or is disabled to the point they can no long manage themselves. Pertaining to the son, he was not dangerous or gravely disabled so the only other option for him would be undergoing months of therapy. Why months? Because at first walls are up, first between therapist and client, and next within ourselves. What percent of the population are willing, and or able to undergo this level of therapy? According to the county of Los Angeles with acute clients - the vast majority do not have the inner resources to deal with their issues so medication management has become the mainstay in mental health treatment.

Working in the E.R. it is essential to assess people the moment you meet them. Are they dangerous? Are they in a medical crisis needing a medical doctor's care? Are they under the influence of a substance? Do they have the resources to handle their situation? Do they qualify to receive services from our facility? If not what facility would better serve them? Five seconds later I smile at them and introduce myself.

I opted to briefly interview his father since the son had a paranoid stare - worrying if I was about to lock him up in our facility. The father validated my impression, he was in no state to undergo deep psychotherapy further tying my hands. I couldn't help him, our Psychiatrist couldn't help him, but the local Mental Health facility may be able to if, and only if the son agreed to take medication.

What does an individual need to do if they want help, but the only hope available is against their wishes? This son has slipped between the cracks in our mental health system. Unable to undergo psychotherapy due to impatience, angry outbursts, and immaturity; not wanting the medication we have seen stable thousands of people that enter our facility on a yearly basis; this particular person unfortunately is back to square one - in distress and wanting a positive change in his life.