How (Not) to Find Psychiatric Help in New York City

By Sadie Long 08/04/17

Jimmy had insurance, and a wife to advocate for him. And he still got the Psych Ward run-around.

depressed man sitting hugging knees
A formerly addicted wife faces rejection and disappointment when she tries to find psychiatric help for her husband.

My husband tried to hang himself last week. Suicidal over the unmanageability of his life as a chronic alcoholic, he looped a noose around an exercise bar in our kitchen doorway. But he couldn't get the right angle, and he gave up and went back to drinking.

I found out about this when I arrived home the next day after a dogsitting gig. My husband sat there on the couch sobbing as he told me what he had done.

I am no stranger to suicide attempts, addiction, or depression myself. Once, I swallowed a bottle of Depakote, a mood stabilizer, and came to in the ICU just in time to hear a doctor telling my family that I might be permanently brain damaged.

It took 15 years and 12 hospitalizations to finally get sober, find the right meds, and become stable.

At the end of my rope dealing with my addicted, suicidal husband, I had been begging him to check into a hospital or rehab for months. Despite the fact that it took 12 hospitalizations for me to get well, I really had no other game plan for him.

Jimmy surprised me when he finally agreed to go to a hospital. The door of willingness, shut tight for so long, finally opened a crack. Amazingly, he was finally ready to ask for help.

We called Jimmy's sponsor, Gus, and Gus offered to drive us to a nearby university hospital, which supposedly has a good rehab program.

For a city the size of New York, there are surprisingly few detoxes and rehabs. Only about a dozen hospitals serve the needs of thousands of addicts who need help.

The whole drive down the Staten Island Expressway, I expected Jimmy to change his mind. But we safely arrived at the ER and began the process of being evaluated.

A nurse took blood, vitals, procured a urine sample. Jimmy sat there on a gurney, with me by his side, waiting for a psychiatrist to come talk to him.

After six hours, the doctor finally arrived to assess Jimmy's condition. He explained about the noose, the drinking. She did a mental status exam: Remember these three words: rabbit, truck, cloud. Count backwards from 100 in multiples of 7. Who is the president? What were those three words I asked you to remember?

At last, the doctor explained Jimmy's options. He could either go to the psych ward, or he could choose to go to detox followed by rehab.

Jimmy chose the detox and rehab. The doctor left to process paperwork and Jimmy smiled for the first time in weeks.

“I feel hopeful,” he told me, and I was so grateful. Perhaps there would be a good ending to this crisis after all.

And then came the bad news: No bed available in detox.

“OK,” I said to the nurse. “He'll go to the psych ward.”

“No,” she explained. “The doctor has discharged him. He can come back tomorrow morning to try to get a bed.”

How could they release him when he was suicidal? Didn't they hear him? He had tried to hang himself!

I was very angry, and scared. But it soon became clear that there was no getting around the doctor's decision to discharge him.

And so, after eight hours in the the hospital's ER, Gus drove us back to Brooklyn.

“I should really kill myself now so you can sue the hospital,” Jimmy said, and I knew he was only partially joking.

Gus explained that he couldn't take us back to Staten Island the following morning due to his job. And there was no way for us to get all the way out there without a car.

Gus suggested we try the detox at another nearby Hospital, and surprisingly, Jimmy agreed. But after sitting in that ER for two hours without even being acknowledged by staff, Jimmy decided he had had enough.

We went home. And I spent that night wide awake, listening to his snoring, afraid that if I wasn't vigilant, he would get up and try to kill himself again.

The next morning we reviewed our options. We called a few rehabs, listed on a printout given to us by the first hospital.

No beds were available.

And then a friend suggested a hospital in Manhattan. It supposedly has a good psych/addiction unit.

Amazingly, Jimmy was still willing to get help even after we wasted a day on Staten Island.

And so we took the subway into Manhattan and checked into the ER.

At first it seemed promising. The main ER was clean, bright, and staff was kind. We got through the intake process quickly and were then informed Jimmy would be going to the Psych ER.

Immediately upon entering the locked unit, we were overwhelmed by the smell of urine and body odor.

The room was painted a shade of puke green. And it was filled with several people brought in by police, handcuffed to gurneys.

A homeless man named Ronald came out of the bathroom butt naked and ran around the room, chased by staff who tried to put a gown on him.

Another man named Arthur kept yelling, “I need a ticket to Albany to go to my economics class!” And,

“Somebody give me an iced cappucino!”

He threw cups and garbage at staff when they asked him to empty his pockets and put on hospital pajamas. They bribed him with a tray of food: If he emptied his pockets and took off his boots, he would get the lunch tray.

Finally Arthur dumped about 20 granola bars and a jar of Folgers coffee from his pockets. But he continued to menace the staff and other patients.

And one of the handcuffed patients kept yelling and making inappropriate sexual comments to women in the room until the staff was able to stick him in the ass with a dose of Ativan.

To be fair, the staff were very respectful of the patients, despite the fact that many of the patients were really abusive. One staff member washed Ronald's sweat suit and brought him a new pair of shoes. He even helped Ronald put his socks and shoes on, despite the fact that Ronald's feet were pretty gnarly. And another psych aide didn't take the bait when Arthur called him the “N” word, even providing some ice to put in Arthur's coffee to placate his demands for an iced cappuccino.

At first it seemed the the doctors were going to send Jimmy upstairs to a rehab ward. We were told that the rehab ward would be calmer and less scary. So we sat there for hours amidst the chaos, waiting for this to happen.

Then we were informed that, instead of going upstairs, the doctors were going to keep him in the Psych ER for 24-72 hours for further observation.

“Please don't leave him in there,” I begged the nurse. But the plan was firm. He would have to stay with Ronald, Arthur, and the handcuffed patients in the urine-soaked, puke green Psych ER.

When I left Jimmy, I looked at him behind the locked door, and he looked so sad and alone.

He called me that night from the patients' pay phone.

“This is your fault I'm in this shithole,” he ranted. “You made me do this.”

 I felt heartbroken, but then my sister reminded me that I used to say the same thing to my family when I was locked up in psych wards. Just as it was clear it was not my family's fault that happened to me, so it was clearly not my fault Jimmy was in this situation.

Jimmy is a tough guy, and I knew he could take care of himself if the other patients got violent.

But I couldn't help but worry that he might get himself into trouble while locked up in there.

Two days later he was released. The hospitalization did nothing for him. He was given no medication and zero counseling. The doctors recommended he go to the Chemically Dependent Outpatient Program, but other than that referral it was a waste of time, not to mention being very traumatic.

Jimmy couldn't wait to take a shower when he got home to wash the Psych ER off himself. He quickly washed his clothes in case they had been in contact with bedbugs or body lice.

Amazingly, he was still willing to ask for help, and he followed through with applying to the outpatient program. Time will tell if this new treatment component helps him stay sober.

“It turned out to be a blessing for me that I was in there,” Jimmy told me. “It made me realize there's still hope for me. So many of those other people in there are beyond help.”

But it strikes me that when someone suicidal and struggling with addiction is finally willing to ask for help, it shouldn't be this hard to find it. It's truly shameful that in a city like New York, it is so hard to find help for mental health and addiction issues.

Jimmy had insurance, and a wife to advocate for him. And he still got the Psych Ward run-around.

What about those homeless people in the Psych ER and on the street? With no insurance, no one to advocate for them. If Jimmy has to jump through so many hoops to get help, what chance in hell do those people have?

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