Another patient is rushed into an inpatient psychiatric ward. A million questions run through the head of the nearby staff as they try to figure out how to help this person who is so obviously suffering. One would naturally assume, of course, that these questions would be related to the person’s mental state: is he or she talking quickly? Does he or she seem down or blue? Is he or she crying? Has he or she had a recent trauma? Is this person dissociation? Has he or she been on a recent spending spree, or acting in ways that are not typical for him or her? All of these questions, of course, must be considered when assessing the state of and impact of a person’s mental health on them and the people around them. But, did you know that providers also consider questions regarding a patient’s physical and social health as well, right down to his or her ability to fulfill his/her basic needs? The truth is that not everyone knows that mental health professionals take overall assessments of functioning into account (global assessments of functioning) when determining the extent of how a person’s mental health affects his or her life.
The harsh reality is that mental illness doesn’t just affect the mind and emotions; it affects the whole body. When a patient comes into a hospital, even a psychiatric unit, one of the first considerations is whether or not the person is dehydrated. Are they eating? Are they sleeping? Are they doing drugs or drinking alcohol to self medicate? Do they have any other medical condition that is exasperated by their mental illness? Are they in pain? Much of the time, when a person says that he or she is depressed, or their PTSD is triggered, we assume that the person’s pain is in their head, or is an emotion, but mental illness affects the whole body and can exacerbate things like chronic pain and auto-immune diseases and really any chronic health condition, especially those that are influenced by inflammation. This simply is because the brain is part of the body, and that stress can influence inflammation. The brain is not separate from the body, however, much of the time people treat it as such. In order to attempt to understand mental illness, though, I believe that we need to further explore the mind-body connection that drives mental illness.
When we think about the workers in psychiatric units who have the responsibility to determine a patient is safe to go home (able to function independently), and the judges and social workers who do so as well, we must realize that they are not just looking at suicidal, self-injurious, or violent behavior. They are also concerned about whether a person can take care of themselves and can get their basic needs met, including social functioning. And, they likely consider whether the patient is being honest, delusional, and/or drug seeking, among other things. Basically, being able to stay safe in this society is much more complicated than just not having thoughts of self harm, etc. At least that is what I am noticing is the opinion from the professionals around here. But, don’t take my word for it 100%, because this is just what I have picked up on in only two weeks at the psychiatric unit that I’ve been at. It has been eye opening to me. What I can say about these people’s positions is that this is a huge responsibility to bear, especially considering the fact that mental illness really affect the person’s entire body and spirit, as does the impact of having to be institutionalized for any period of time.
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