Re: “Judge hopes to stop patients’ revolving door” (TNT, 3-15).
The article offers insights into the complexities of mental-health care and the difficulties of getting all needy patients effective treatment.
Our health-care system is failing both women discussed in the article. Neither is getting adequate help either in or out of the state hospital. Being difficult to treat can’t be justification for not hospitalizing someone in order to get them the necessary treatment.
These women suffer from a class of mental illnesses known as personality disorders. Personality disorders can be just as devastating as other mental illnesses like bipolar disorder.
There are significant treatment differences between personality disorders and other mental illnesses. The treatment is behavior-modification therapy instead of pharmacology. Personality disorders can be effectively treated using proven evidence-based treatment programs like Cognitive Behavior Therapy and Dialectical Behavior Therapy, developed at the University of Washington.
This treatment difference is where problems arise. Successfully implementing these therapies requires two scarce commodities:
• A well-trained behavioral psychologist and skills-building support team to implement the therapy.
• One to two years of intensive skills-building therapy can be required for the patient to master the skills necessary to control their behavioral illness.
Sadly, these needs may not fit well into a system that is already fiscally stressed and often focused on cost minimization rather than efficacious treatment. This is another example of how our involuntary treatment system isn’t working.
We need more effective personality disorder treatment programs and increased funding for all mental health programs.