Ones that creep, crawl and cry,
Ones that howl, hurt and terrify,
Ones that live in the deep dark hole
That feed on your flesh, as well as your soul.
People tell me they aren’t real,
But I greatly disagree,
For monsters who hurt and cause so much pain
Aren’t always ones with horns and fangs.
Yet they are the ones that creep and lie,
That destroys, hurt and terrify
They live in the holes of our depression
And they consume our souls; a monsters impression.
— Tiane Marie Oliver
This poem was written by a 13-year-old girl who has suffered greatly with depression since Hurricane Katrina and read aloud by her mother at the conclusion of the most recent City Council mental health committee meeting. On the panel that day were those who govern our mental health care discussing the impending closure of emergency and acute mental health services at the LSU Interim Hospital as a means of balancing their recent budget. However, as the poem was read, most who are responsible for making these cuts had already left the room to return to their enclosed offices in the bowels of City Hall — shut away from the reality of this nightmare soon to wreak havoc on our city streets.
Almost six years post-Katrina, we now reflect back on lessons learned and the hope that we never, ever have to go back to those dark days. Days of emptiness, days in which little hope could be provided to those seeking mental health help. I remember on my journeys with the NOPD crisis unit picking up those helpless, hopeless and suicidal people and wondering, now what to do? Where can I find help for them?. A few scattered sights were the only options, hospital emergency bays overwhelmed. An abstract by Dr. Potash written in 2008 gives an historical overview of what happens when chronically un-medicated mentally ill folks are unable to get help. The end result is often death in high-profile cases that hit the media. The one we all know the best is the death of Officer Nicola Cotton and her 8-week-old unborn child, killed in the line of duty by a gentleman known in the mental health community, discharged from a mental health hospital to the streets of New Orleans unable to access greatly needed medication to control his delusional, violent behavior. But as time marched on and our cries for help were heard, services for the mentally ill began to come on tap. LSU responded by setting up two emergency trailers, 10 beds apiece, known as the MHERE (mental health emergency room extension) to provide a safe place for folks to be evaluated. They opened a 20-bed inpatient detox unit that would provide medical assistance to those who desired to go into a rehab facility but first needed medical detox. They leased 32 beds on the old Depaul campus for short-term psychiatric hospital stays, not nearly enough, but at least the beginnings of some level of inpatient health care for this population.
How could it be possible that now, 2012, a decision was made to eliminate these services by over 50% as a means to balance a budget? Closing this week will be 10 emergency beds, the entire 20 bed detox unit and 9 inpatient beds at Depaul — all beds that were full to capacity.
Entering the city council chambers meeting that morning, I found myself a bit delusional truly thinking that I would hear those who worked for the Office of Behavioral Health, Department of Health and Hospitals or LSU officials saying they realized a horrific mistake had been made and that they had reconsidered their decision, that mental health would not be attacked as a way to balance their budget, that they take responsibility for overspending their money, that they have found a way to keep these services in place, that they recognize that providing a robust mental health system is instrumental in providing public safety to self and citizens… But no. That is not what was heard at all. The decision is made they said, pink slips have gone out, the doors are shut, the deal is done.
After the panel discussion, as those in higher places slinked out of the room, citizens who suffer began to share the concerns and fears that we all know from the recent past is a reality of what is to come. With this decision, we take two huge steps back to a time in which emergency rooms are overcrowded with mental health patients, a time in which families are exhausted in the care of their loved one, a time in which jails become the soul provider of inpatient mental health care, a time in which monsters return to creep, crawl and terrify — a time to which we never wanted to return.
Cecile Tebo, a licensed clinical social worker, spent the last 10 years with the New Orleans Police Department crisis unit, and resigned in October to pursue a dream of finding new ways to improve services for the chronically mentally ill in New Orleans. Her thoughts on mental-health issues and resources in New Orleans appear Tuesdays in UptownMessenger.com.