|
by Stephen R. Jaffe A close relative of mine, whom I call "Bill" here, suffers from a mental illness. Bill was recently treated in a hospital in Oakland County. When the time for Bill's discharge recently arrived, his social worker at the hospital arranged for him to be placed in a state-licensed facility variously called a "group home" or "adult foster care" home. The social worker who arranged this placement told me that he had never been in or seen the facility to which he sent Bill and that he had picked it from a list of licensed facilities kept at the hospital. Well, I have been in that facility. It is a dirty, smelly, dark, old, falling apart, depressing building sitting alongside the railroad tracks in a bad area. The building looks as of it has been expanded over the year by several additions, none of which fit quite right onto the former structure, leaving long hallways and corridors and stairs which, in case of a fire or emergency, would be horrific traps. The linens on the residents' room were visibly dirty and threadbare. The room had large coils of TV cable with bare wires sticking out of them, rendering then useless at best and hazardous at worst. When I went to adjust the window in Bill's assigned room, the entire lower pane of glass fell out of the window casement. When Bill went to use the bathroom, he was unable to do so because there was no toilet paper. This particular facility served an alleged dual purpose: as an "adult foster care" facility and a "substance abuse treatment facility." There was no one within 10 years of Bill's age there. However, there were some adults wandering around the halls and outside the building, some talking to themselves. Two of the female residents actually panhandled me for "spare change" while I was in the facility. It is a place of hopelessness and despair, a dumping ground for what is perceived to be the human refuse of our society, the indigent chronically mentally ill. His first night there, Bill called his father and asked to be picked up. Bill never returned to the facility again. About 10 days later, Bill had the opportunity to go to a facility called Rose Hill in Holly, Michigan. I accompanied him. Rose Hill is a subacute treatment center for people with Bill's particular illness to help give them a chance to learn to live independent and productive lives. Set on almost 400 acres in northern Oakland County, it is an idyllic, Rockwellesque collection of buildings, residences, barns, fields, and a three lakes. The day we went was one of those glorious fall Michigan days and only added to the beauty of what we saw. Like the "group home," Rose Hill is not a lockdown hospital, but a transitional place to assist selected mentally ill people to bridge the worst of their illness in a hospital or elsewhere towards an independent life. But that is where any similarity between the two places ends. At the group home, no staff member was present when we arrived. An off duty cook showed us Bill's room. In contrast, the Rose Hill Admissions Director met us as we got out of the car and greeted us warmly. When I first met him, the first subject of discussion by group home's owner was that he would be taking virtually all of Bill's Social Security money and needed to have the difference between that sum and what he charged made up immediately. At Rose Hill, while there is, of course, a cost to the treatment, money was never mentioned during the initial visit. Bill's medical needs were the appropriate centerpiece of the conversation. How can two such profoundly dissimilar places, both supposedly existing for the same purpose, to help the same people, both licensed by the State, exist within the same county? How is it decided who gets sent to the dark, decrepit and depressing unlit corridors of the group home and who gets sent to a place full of beauty, hope and promise such as Rose Hill? Mental illness is truly the last stepchild of health care to gain public attention. Because of the unfortunate and undeserved stigma attached to it, it is the illness we hide in the closet or sweep under the rug. One percent of the American population (almost three million people) suffers from schizophrenia alone, far more than HIV. And, since the disease usually strikes in early adulthood, almost all of those three million people are adults, making the percentage of adults with schizophrenia closer to two percent than one percent. And yet, at Governor Engler's urging, the State of Michigan has systematically closed most of its mental hospitals and treatment facilities and replaced them with Dickensian human warehouses such as the group home described above. It is time for this to stop. Oakland County, the State of Michigan and our nation need more Rose Hills and less of the hopelessness and squalor of substandard group homes where the spirits and bodies of the people within them slowly die. |