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Carol Halley talks about her years navigating through the mental health system and the problems she’s had in Douglas County at her Dillard home recently.
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ENLARGE
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These are the medications that Carol Halley is currently taking. She says has been diagnosed with more mental illnesses over the last few decades than she can list and her medications have been changed 13 times in the last year.
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Carol Halley has been diagnosed with more mental illnesses over the last few decades than she can list.
She’s been told she is schizophrenic, bipolar, depressed. Doctors and therapists have told her she suffers from post traumatic stress disorder, attention deficit disorder and severe anxiety.
The various orange pill bottles lined up on her living room end table illustrate the manner in which she says doctors approach her various conditions.
“Everybody has a different diagnosis,” Halley said, while sitting in her Dillard home. “They just treat my symptoms at the time.”
The 42-year-old said she has had her prescriptions changed 13 times in the last year. She visited Mercy’s Behavioral Health Unit four to five times this year for mental health care until Mercy closed the unit in October.
Now that the BHU has closed, Halley relies solely on counseling, therapy, medicine management and other services provided by Douglas County Mental Health and Douglas County Senior and Disabilities Services. Halley is legally blind and was diagnosed with debilitating fibromyalgia some years ago. She attributes her blindness to a drug she was given in the early ’90s for schizophrenia. The drug, Mellaril, reportedly can cause progressive eye disorders that may eventually lead to blindness.
She’s been told she is schizophrenic, bipolar, depressed. Doctors and therapists have told her she suffers from post traumatic stress disorder, attention deficit disorder and severe anxiety.
The various orange pill bottles lined up on her living room end table illustrate the manner in which she says doctors approach her various conditions.
“Everybody has a different diagnosis,” Halley said, while sitting in her Dillard home. “They just treat my symptoms at the time.”
The 42-year-old said she has had her prescriptions changed 13 times in the last year. She visited Mercy’s Behavioral Health Unit four to five times this year for mental health care until Mercy closed the unit in October.
Now that the BHU has closed, Halley relies solely on counseling, therapy, medicine management and other services provided by Douglas County Mental Health and Douglas County Senior and Disabilities Services. Halley is legally blind and was diagnosed with debilitating fibromyalgia some years ago. She attributes her blindness to a drug she was given in the early ’90s for schizophrenia. The drug, Mellaril, reportedly can cause progressive eye disorders that may eventually lead to blindness.
The counseling and therapy she receives from the county has saved her life, Halley said, but in times of severe crisis she feels like she has nowhere to go. “I feel let down,” Halley said. “I want a program to go to.”
Last week Halley said she was facing one of those times. She called the county’s mental health office, but was told unless she was suicidal or homicidal she couldn’t be seen by a crisis worker.
Janet Holland, the county’s mental health director, said the department must be restrictive about who receives crisis treatment because of a lack of funding and a resulting limit in available services. The department has counselors to whom they can refer patients, but few psychiatrists to back up the services.
“Mental health has done a lot for me,” acknowledged Halley. “More than any other agency in this town, but their hands are tied.”
<b>TREATMENT TRANSITION</b>
When Mercy’s BHU closed its doors, it marked the first time in 30 years the hospital hasn’t had some sort of designated mental health unit within its walls. When the hospital moved to its current location in 1977, it had a nine-bed mental health unit, and then in 1998 it opened the BHU. Even before the move, mental health treatment was available within the hospital, there just wasn’t a specific unit for the care, Nickel said.
After the BHU closed, the county’s mental health department saw a spike in the number of patients needing care. They treated 60 more patients in October than in September.
Last week Halley said she was facing one of those times. She called the county’s mental health office, but was told unless she was suicidal or homicidal she couldn’t be seen by a crisis worker.
Janet Holland, the county’s mental health director, said the department must be restrictive about who receives crisis treatment because of a lack of funding and a resulting limit in available services. The department has counselors to whom they can refer patients, but few psychiatrists to back up the services.
“Mental health has done a lot for me,” acknowledged Halley. “More than any other agency in this town, but their hands are tied.”
<b>TREATMENT TRANSITION</b>
When Mercy’s BHU closed its doors, it marked the first time in 30 years the hospital hasn’t had some sort of designated mental health unit within its walls. When the hospital moved to its current location in 1977, it had a nine-bed mental health unit, and then in 1998 it opened the BHU. Even before the move, mental health treatment was available within the hospital, there just wasn’t a specific unit for the care, Nickel said.
After the BHU closed, the county’s mental health department saw a spike in the number of patients needing care. They treated 60 more patients in October than in September.
Mental health:
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<b>TODAY: Cracks in the system</b> — A look at how the needs of the mentally ill are not being met and what’s being done to fix the problem <b>THURSDAY: Cycling through the courts</b> — Criminal justice system catches many who fall through mental health system gaps <b>Child care</b> — Where do children go for mental health care in the community? <b>FRIDAY: Wounds of war</b> — Military veterans seek treatment for mental trauma at the Roseburg Veterans Affairs Medical Center <b>SUNDAY: Circle of support</b> — Douglas County mental health professionals adapt to health care gaps with therapy, support groups |
Last month the number of patients seen by the department settled back down to 127, close to where it was before the closure, Holland said. The jump may have been caused by the panic many patients faced when they realized the BHU’s 18 adult acute care beds would no longer be available, Holland said.
The hospital closed the unit after losing more than $2 million on it last year. The BHU had been in the red for the last 10 years and could no longer sustain such losses, said Kathleen Nickel, Mercy’s communications director.
Mercy has been negotiating with a private company, Telecare, to lease the BHU building and provide mental health services for adults in Douglas County. A second company, ChristieCare, also had plans to come to the Roseburg building to provide services for children and teens, but backed out of the deal because it could not get adequate funding from the state.
Telecare is still working out contracts and funding issues with the state and Jefferson Behavioral Health, the regional mental health organization that disburses state funds to six counties, including Douglas County. For now, though, the building remains empty.
<b>GETTING CARE</b>
When the BHU was open, people in crisis, like Halley was recently, could go to the hospital’s emergency room for mental health treatment. Patients entering the ER would see a triage nurse and be evaluated to determine how serious their conditions were.
If a patient was acutely ill, he or she would be put in an emergency department bed where the person would receive a physical health screen and doctors would call a BHU crisis worker. From there, a plan of action would be determined. The patient would either be admitted to the BHU or would be released according to the developed plan.
If the patient was not acutely ill, he or she would sit in the waiting room until being seen by a doctor and then would go through the same process, said Debbie Boswell, Mercy’s chief operating officer.
When the unit closed, the hospital added two beds to the emergency department, for a total of three beds designated for people with mental illnesses. Patients in crisis can still go to the emergency room and will go through a process similar to the one they would have gone through prior to the closure. Now patients will see a 24-hour emergency department crisis worker, rather than one from BHU, or Douglas County Mental Health patients will see a county crisis worker.
The main difference between the two processes is now doctors do not have a local acute care unit to which they can refer their patients. Instead, patients are either stabilized in the emergency department beds or are held there until they can be sent to a hospital out of the area that has an acute care unit, Boswell said.
<b>FILLING GAPS</b>
In addition to the three beds in the emergency department, ADAPT’s Crossroads treatment facility opened six beds, available to people needing sub-acute mental health care and treatment for an alcohol or drug addiction. Halley, who has fought addictions to methamphetamine and alcohol, tried getting a place on one of those dual-diagnosis beds but said she was told the treatment facility was not the proper place for her.
Patients are selected for the Crossroads program on a case-by-case basis. They must be able to function in a structured residential setting and follow the rules that keep themselves and others safe, said Dr. John Gardin, a psychologist and director of behavioral health and research for ADAPT.
Gardin couldn’t comment specifically on Halley’s case due to client confidentiality restrictions.
The six beds at the facility have a high turnover rate, and no patients have been turned away because beds were unavailable, Gardin said. As of last week, the facility had one patient using a dual-diagnosis bed and another one scheduled to arrive in January.
Besides the Crossroads beds, Halley has tried to get housing through the county disabilities department, but she is on a waiting list and it may take years for her name to reach the top, she said. She feels as though she’s running out of options.
“I would go to jail now just to get out of the environment I’m in now,” Halley said. “I would rather be in jail and have time to think, to get my head straight.”
The county’s Mental Health Advisory Board hopes to keep people like Halley from feeling like they have to resort to desperate measures just to receive help. For the past couple of months, the advisory board has focused on prioritizing the needs of mental health patients in Douglas County.
Most of the areas discussed revolve around the idea of forming a continuum of care. The notion is being embraced across the state as the best way to provide a range of services to people, from preventive measures to hospital and residential care. It is believed the more comprehensive approach to mental health treatment would help keep people out of jails and off the streets and would provide them with the level of treatment they need at a safe place.
The county addiction and mental health departments are working together to create a biennial plan for these goals, but are only in the planning and information-gathering stages.
While funding shortages are affecting all aspects of mental health services, one area that is continuously neglected is care for people who do not qualify for the Oregon Health Plan and who do not have private insurance coverage, Holland said. Funding for people in this predicament is hard to come by and is beginning to be addressed at the county level through nonprofit, voluntary counseling.
Even though plans are being made for the future of mental health care, Halley said she can’t wait any longer. She is planning on leaving Douglas County and moving to an area with a treatment center, somewhere she can receive help the next time she is in a crisis situation.
“I need help just to get my head straight, just to make decisions that aren’t manic,” Halley said. “I’ve got problems, but I think they can be fixed.”
• You can reach reporter Marissa Harshman at 957-4202 or by e-mail at mharshman@newsreview.info.
The hospital closed the unit after losing more than $2 million on it last year. The BHU had been in the red for the last 10 years and could no longer sustain such losses, said Kathleen Nickel, Mercy’s communications director.
Mercy has been negotiating with a private company, Telecare, to lease the BHU building and provide mental health services for adults in Douglas County. A second company, ChristieCare, also had plans to come to the Roseburg building to provide services for children and teens, but backed out of the deal because it could not get adequate funding from the state.
Telecare is still working out contracts and funding issues with the state and Jefferson Behavioral Health, the regional mental health organization that disburses state funds to six counties, including Douglas County. For now, though, the building remains empty.
<b>GETTING CARE</b>
When the BHU was open, people in crisis, like Halley was recently, could go to the hospital’s emergency room for mental health treatment. Patients entering the ER would see a triage nurse and be evaluated to determine how serious their conditions were.
If a patient was acutely ill, he or she would be put in an emergency department bed where the person would receive a physical health screen and doctors would call a BHU crisis worker. From there, a plan of action would be determined. The patient would either be admitted to the BHU or would be released according to the developed plan.
If the patient was not acutely ill, he or she would sit in the waiting room until being seen by a doctor and then would go through the same process, said Debbie Boswell, Mercy’s chief operating officer.
When the unit closed, the hospital added two beds to the emergency department, for a total of three beds designated for people with mental illnesses. Patients in crisis can still go to the emergency room and will go through a process similar to the one they would have gone through prior to the closure. Now patients will see a 24-hour emergency department crisis worker, rather than one from BHU, or Douglas County Mental Health patients will see a county crisis worker.
The main difference between the two processes is now doctors do not have a local acute care unit to which they can refer their patients. Instead, patients are either stabilized in the emergency department beds or are held there until they can be sent to a hospital out of the area that has an acute care unit, Boswell said.
<b>FILLING GAPS</b>
In addition to the three beds in the emergency department, ADAPT’s Crossroads treatment facility opened six beds, available to people needing sub-acute mental health care and treatment for an alcohol or drug addiction. Halley, who has fought addictions to methamphetamine and alcohol, tried getting a place on one of those dual-diagnosis beds but said she was told the treatment facility was not the proper place for her.
Patients are selected for the Crossroads program on a case-by-case basis. They must be able to function in a structured residential setting and follow the rules that keep themselves and others safe, said Dr. John Gardin, a psychologist and director of behavioral health and research for ADAPT.
Gardin couldn’t comment specifically on Halley’s case due to client confidentiality restrictions.
The six beds at the facility have a high turnover rate, and no patients have been turned away because beds were unavailable, Gardin said. As of last week, the facility had one patient using a dual-diagnosis bed and another one scheduled to arrive in January.
Besides the Crossroads beds, Halley has tried to get housing through the county disabilities department, but she is on a waiting list and it may take years for her name to reach the top, she said. She feels as though she’s running out of options.
“I would go to jail now just to get out of the environment I’m in now,” Halley said. “I would rather be in jail and have time to think, to get my head straight.”
The county’s Mental Health Advisory Board hopes to keep people like Halley from feeling like they have to resort to desperate measures just to receive help. For the past couple of months, the advisory board has focused on prioritizing the needs of mental health patients in Douglas County.
Most of the areas discussed revolve around the idea of forming a continuum of care. The notion is being embraced across the state as the best way to provide a range of services to people, from preventive measures to hospital and residential care. It is believed the more comprehensive approach to mental health treatment would help keep people out of jails and off the streets and would provide them with the level of treatment they need at a safe place.
The county addiction and mental health departments are working together to create a biennial plan for these goals, but are only in the planning and information-gathering stages.
While funding shortages are affecting all aspects of mental health services, one area that is continuously neglected is care for people who do not qualify for the Oregon Health Plan and who do not have private insurance coverage, Holland said. Funding for people in this predicament is hard to come by and is beginning to be addressed at the county level through nonprofit, voluntary counseling.
Even though plans are being made for the future of mental health care, Halley said she can’t wait any longer. She is planning on leaving Douglas County and moving to an area with a treatment center, somewhere she can receive help the next time she is in a crisis situation.
“I need help just to get my head straight, just to make decisions that aren’t manic,” Halley said. “I’ve got problems, but I think they can be fixed.”
• You can reach reporter Marissa Harshman at 957-4202 or by e-mail at mharshman@newsreview.info.
