When care can’t wait: Young adults with mental illness have few options in many states

Young Adults with Mental Illness

Mental health care for Gus Deeds ended in an emergency room in Virginia on the last day of his life, when he was discharged and sent home.

On Nov. 19, 2013, just a few hours after leaving the hospital, Gus Deeds attacked and injured his father, Virginia State Senator Creigh Deeds, then killed himself. Gus didn’t get the care he needed, and it is a story repeated too often across the nation.

In a CBS 60 Minutes broadcast, news correspondent Scott Pelley explained that the young man had been grappling with mental illness for several years, and the final emergency room visit just hours before his death is testimony to how the U.S. deals with mental health.

While many mentally ill teenagers and young adults are not violent, the parents of those who are or may be often find that when a crisis erupts, there is literally nowhere to go.

A warning that can’t wait
When Pelley interviewed Senator Deeds on 60 Minutes just four weeks after the attack, Deeds told 60 Minutes that it was important for him to share certain facts right away.

“Gus was a great kid. He was a perfect son. It’s clear the system failed,” he told Pelley.

Asked what could have saved his son, Deeds answered that had Gus been hospitalized and medicated that night, he himself could have worked to get his son into some type of long term care program.

How mental illness transforms
Four years earlier, Gus Deeds had been a college kid, on the Dean’s List at the College of William and Mary and a gifted musician.

According to Senator Deeds, when Gus turned 20, he decided to take time off to help with his father’s gubernatorial campaign, a time Deeds remembers fondly. When the campaign was over, for no obvious reason, his son became paranoid and anti-social, dropping out of college and losing one job after another.

As a precaution, Deeds removed the hunting rifles from their farmhouse. But once on medication, Gus seemed better and went back to college – until the fall of 2013.

“Gus had posted weird things on his Facebook page about, you know, how the professors were ganging up against him … It was pretty clear to me that he wasn’t taking medicine. I told Gus that he and I needed to talk to somebody together,” Deeds related.

At that point, Deeds learned that getting treatment for mental health conditions is significantly more challenging than seeking help for physical ones.

The mental health landscape
Beginning in the 1960s most large mental institutions started to close, but adequate community facilities, intended to help mentally ill individuals reintegrate with society, couldn’t support the population, according to PBS. The number of beds available to psychiatric patients in America dropped from more than half a million to fewer than 130,000. Many mental health patients were left homeless. Still today, that leaves many in crisis with one option: the emergency room.

Beyond that, options are limited. A recent survey from the University of Michigan found that more than half of the adults in the U.S. believe young adults with mental illness have extremely limited or no way to receive appropriate mental health care services, and even in communities where they have plenty of access to primary care and hospital care, mental health care is far less available to them.

Examples close to home
To get a clearer picture of the accessibility of mental health services, the 60 Minutes team traveled to Yale New Haven Hospital in Connecticut, considered one of the best in the nation for psychiatric care, and asked nurse practitioner Brian Geyser about the situation in the emergency department. He explained that there are 52 psychiatric beds at the hospital, and with all 52 full, seven kids were in the emergency room waiting for an open bed.

“You know, every day, we have 10 to 20 kids with psychiatric problems come into our emergency department, kids who wanna kill themselves, who’ve tried to kill themselves, who’ve tried to kill somebody else,” he added. What happens, said Geyser, is that some insurance companies, after three or four days, are saying, “All right, you know, it’s time. Let’s get this kid out.”

What needs to happen
Many patients need long term care but the few such facilities that offer it are often expensive and may not accept insurance, so kids, as Pelley put it, “spin in the emergency room’s revolving door.”

Geyser agreed: “We need to be able to set up a system where we follow these kids into the community, we follow the families, we make sure that they have a safety net … It could be six months from now, and the child will do something again, but if they are not hooked into a system that is watching them, taking care of them, then we could have problems on our hands.”

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