Its time to get help, now what ?

acollier-article21Something is very wrong (again) Mom, the voices are telling me to do terrible things, and I really don’t know where I am at. I just want to die, its so frightening. (He has already overdosed medications and rushed to hospital twice from group homes, so he is at parents home, waiting for months for his new case manager to place him in a decent group home…)

What’s wrong, son ? Why did you just throw up ? My head hurts so bad, its another migraine. The voices are terrorizing me, and raping me.

Hold on son, we will call for help. We call SAMHC, at 520-622-6000, a newbie operator this time… (a part timer who is also a case manager for La Frontera, no less)

She says to take our son in to the ER ourselves, but we may not even be able to get him safely to a hospital. He could jump out of the car, or just decide not to cooperate. He doesn’t know where he is at at all. He thinks there are bad aliens attacking him in a war setting.

We call back SAMHC and ask for a manager. The manager then gets the SAMHC emergency response team and optionally, the police to respond, and BINGO, one time he gets an evaluation and a stay at the La Frontera in-patient psychiatric health facility, aka the PHF, a very small facility with only a few beds. Actually they are full, so they  put him into Casa Allegre first for a couple days, its a 7 bed boarding transition home, which is much better than the lice-infested  homeless shelter that La Frontera case management has placed active psychosis patients to spend the night.

Luckily, we in Tucson have SAMHC to respond and hold the system somewhat accountable.

But, now there is a new placement destination for in-patient psychiatric emergency care, the CRC (Crisis Response Center) at UPH South aka “Kino” hospital.

But if its a holiday, and they cannot reach a La Frontera case manager, they can just discharge without a serious evaluation, and won’t even contact those who know the patient (family or friends, or even SAMHC). Its quite a fall through the cracks, so its important to get to the hospital yourself to insure your sick one gets an evaluation. Bring proof that you are an authorized representative of your loved one, just a statement they can sign.

A program is available at UPH South called Epicenter, call 520-874-7531 for appointment, they provide group therapy, family member classes, and evaluations/assessments.

Also, an alternative to the CRC for in patient emergency psychiatric care is Palo Verde hospital, adjacent to TMC (Tucson Medical Center). They have had a mixed record, but won’t turn active psychosis patients away like the others do.

Finally, when La Frontera case management returns to work after the holiday, we still might not get even that first call back, or even a first appointment with our new latest case manager, who has not returned any calls for months since they were appointed to get living arrangements set up, and a psychiatric care plan, but most especially having contact with the patient’s authorized representatives (usually family). Case management is getting very poor, and getting worse, not better, in Tucson.

As Arizona taxpayers, we must know about CPSA’s multi-million dollar annual state taxpayer-funded budget, and that La Frontera is one of the contractor organizations along with the CRC, that are getting paid this money to provide case management and care so that society can feel safe from these patients just wandering around in danger to self or to others.

Case managers at La Frontera have said in the past few years, that they are overloaded, and that there are “cutbacks” in service. Once at a La Frontera appointment with a former case manager, we watched a homeless elderly woman in a wheelchair being turned away, as she was told to make an appointment to get service. They could have referred her to SAMHC, but they were not concerned.

CPSA personnel who oversee all this are not proactive even when ongoing problems are documented, they are sometimes responsive in crisis situations, and sometimes are not available for several days, with no backup.

Local Tucson hospital emergency rooms and jails continue to respond and take on greater burdens as the default stop for those mentally ill people falling through the cracks.

For big problems, CPSA has a grievance process that essentially allows them to collect information to cover their legal “behind”, while doing nothing of remedy, even when police reports of abuse are documented, and this is sanctioned all the way to the organization president, where there is no grievance appeal, other than a lawsuit, which is not easy when someone is mentally disabled.

Again, no matter the situation, SAMHC will partner with you to try for help in a crisis:
from SAMHC web site:

Individuals experiencing a mental health or substance abuse crisis may walk in to the Crisis Center, located at 2502 N. Dodge Boulevard (entrance on Flower Street) in Central Tucson from 8am to 8pm, 7 days a week.
Mobile teams are available 24/7 to respond to crises in the community and can be accessed by calling (520) 622-6000. SAMHC works closely and collaboratively with the public behavioral health system.

We hope your luck is better than ours. Please remember sometimes real health problems can compound an active psychosis, and their is virtually no plan at any Tucson facility we have worked with, to get normal health care follow up for psychiatric patients, especially obtaining critical prescription refills, or care for a contagious illness, to get them to a regular doctor or hospital from the psychiatric facilities.

One way to push back people is to document these events, and report to (phone) 911 (police) and the Arizona state medical board, and Adult Protective Services, when your loved one is subject to abuse and poor care.

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