I'm writing to share some of my personal experiences with the mental health system in this country. I became sick about eight years ago and had my first experience in a hospital ever at that time. I was very surprised that on the psychiatric unit there was no therapist, but it turns out that this is standard practice for psychiatric units everywhere. The problem was that there was no one to really talk with. I did work with the social worker and I spoke with the nurses, but there was no one to help me understand what I was going through and how to help my community and family understand me. It came as a surprise that psychiatrists on these psychiatric units and in regular practice no longer do therapy but only prescribe medications. As a result I also did not do therapy with my psychiatrist while at the unit.
One of the far reaching results of this was that I unwittingly accepted the idea that I had to move away from my community and stay separate as a result of my illness. This was the guidance of my closest friend at that time, with whom I was living and who was giving me the most guidance. I really longed to go back to my community and home there. However, I was very disturbed and shocked by the advent of my own illness and so was my community. I needed guidance and encouragement to go back and speak with friends and administrators there to explain what had happened. I did not understand myself what had happened and I very much needed a therapist on the psychiatric unit to help me get perspective and help make arrangements to go back home and stand up for myself and stay rooted there. This did not happen. Instead, my illness began a long process of disengagement from everything that I had known and ended with my being alone in new surroundings and with an illness I did not understand.
When I got out of the psychiatric unit I could not afford a therapist. Later when I finally did get a therapist, it was hard for her to understand why I wanted to go back to my community. It seemed to her that they had not supported me during my illness, so why would I want to go back. I found that reaction in many therapists over the years. However, I do understand that it is hard for behavioral health providers to understand whether the patient is better with their family and community or in a new environment. It is generally agreed that patients need family and community support.
What I am proposing here is that it is important to have a therapist on modern psychiatric units where the therapeutic process often begins for a patient. I am also proposing that the role of that therapist could be pivotal in helping the patient stay integrated in her or his community and family, by helping to understand the process of the illness and recovery and stop the disengagement process that often takes place around the onset of the illness. Mental illnesses have a tendency to create separation rather than integration, by their nature. This was my over arching experience when I first became a mental health patient. Since, I became stable on medication and started to become aware of my situation, I realized that a lot of pain could have been avoided with proper understanding and support.