Breakdown: A Clinician's Experience in a Broken System of Emergency Psychiatry

When hospitals release seriously mentally ill patients too soon without outpatient follow-up, the patients can end up homeless, jailed, harming others, or even dead. When patients are deemed suitable for inpatient care, they can languish for weeks in hospital emergency departments before placements become available. Meanwhile, patients who fake the need for care are smoothly and swiftly moved to inpatient settings.

Breakdown opens a dialogue with anyone interested in improving the system of care for the seriously mentally ill population. This book helps to answer questions such as:

• Is inpatient care too inaccessible to those who need it most?

• Do mental health professionals discriminate against mentally ill patients?

• Are more stringent measures needed to ensure that patients take their medication?

• Is borderline personality disorder too serious to be classified as just a personality disorder?

Using vignettes based on real interactions with patients, their families, police officers, and other mental health providers, Lynn Nanos shares her passion for helping this population. With more than twenty years of professional experience in the mental health field, her deep interest in helping people who don't know how to request help is evident to readers.

• A woman travels from Maine to Massachusetts because she was ordered by her voice, a spirit called "Crystal," to make the trip.

• A foul-smelling and oddly dressed man strolls barefooted into the office, unable to stop talking.

• A man delivers insects to his neighbors' homes to minimize the effects of poisonous toxins that he says exist in their homes.

Breakdown uses objective and dramatic accounts from the psychiatric trenches to appeal for simple and common-sense solutions to reform our dysfunctional system. This book will benefit anyone interested in seeing a glimpse of the broken mental health system way beyond the classroom. It can guide legislative officials, family members, mental health professionals, and law enforcement officers toward a better understanding of the system.