Abstract
Although mental healthcare has been gaining more social acceptance since the onset of the COVID-19 pandemic, several barriers still exist for new service users in the US. Prospective consumers and recently diagnosed individuals are often left to navigate this complex system with minimal support, which can lead to delays in achieving a higher quality of life. The author attempts to promote equitable care outcomes by encouraging consumers to engage in self-advocacy via education, community resources, and opportunities to lobby for client autonomy, universal accessibility, and disability inclusion. As a rehabilitation counselor trainee and a long-time recipient of psychiatric care, the author provides a unique perspective from both sides of the traditional mental health hierarchy and suggests future directions for collaborative approaches. Her professional insights inform a discussion of the standards to which clinicians should be held, while her lived experiences are woven throughout the text to underscore the shortcomings of the current system and offer examples of resilience.
TopIntroduction
I was twenty years old when I first entered the US mental health system. In the blink of an eye, I went from an over-achieving high school student to a college dropout with psychological symptoms that rattled my understanding of reality. It would not be until age twenty-five that I would receive my first mental health diagnosis and, as a result, the multidimensional support I needed to flourish. Today, I am in my final year of graduate school at twenty-eight years old. I plan to become a rehabilitation counselor and empower other individuals with psychiatric disabilities so they can fully participate in work, school, and the community at large. My symptoms have never fully disappeared. At least a few times per year, another episode catches me off guard and causes me to doubt my competence. The biggest differences between today and eight years ago are my ever-growing toolbox and an unwavering support system. Looking back on my journey, there are three major realizations that I feel I made far too late: how to differentiate between healthcare providers and each of their roles in obtaining services; how to use supplemental local and online resources to my advantage; and finally, how to exercise my rights and speak up for myself in the system so that I could confidently change course if I were dissatisfied with the direction of my treatment. Weaving the story of my recovery throughout this discussion is my attempt to exemplify self-advocacy through education, adaptation, and acceptance. I share all of these insights with the hope that those who are new to the mental health system might expedite their path to wellness.
Key Terms in this Chapter
Partial Hospitalization Program (PHP or Partial for Short): A short-term day program held at a hospital or securely via online video groups that offers back-to-back group sessions in a variety of coping skills, therapeutic interventions, and self-care ideas. Meant to help folks who have been hospitalized transition back into the community OR provide extra mental health support to people who are in danger of being fully hospitalized.
Autonomy: The right for an individual to make decisions for themselves and dictate the trajectory of their own life.
Psychiatrist: A licensed medical doctor who graduated with a specialty in prescribing and monitoring the use of psychotropic medication, also known as medications, used to address the symptoms of mental health conditions.
Americans with Disabilities Act (ADA): A law originally passed in 1990 that explicitly outlaws discrimination against individuals with physical, intellectual, and mental health disabilities.
Telehealth: A virtual meeting where participants can discuss physical or mental health concerns with their chosen provider using an internet connection to access a secure server.
Universal Design: An approach to building inclusive physical spaces and safe psychological cultures by structuring environments so that all people have equitable access to the resources they need to thrive. This concept is meant to improve quality of life across the board instead of providing case-by-case accommodations for people with disabilities.
Dialectical Behavioral Therapy (DBT): A mode of therapy that teaches four modules of skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.
Primary Care Physician (PCP): Sometimes known as a family doctor, this person is your trusted point person for all health-related needs and can make referrals to several specialists as well as advise next steps for a number of treatment concerns.
Psychologist: A licensed psychological professional with a Ph.D. or PsyD credential who can legally and ethically provide therapy services and may or may not have at least one area of research expertise.
Patient Advocate: See also “healthcare navigator.”
Asylum: Popularized in the 1800-1900s, an institution where people with mental health conditions were held on the grounds of hospitalization but were often denied humane care.
Social Model of Disability: A perspective that emphasizes the social attitudes and political barriers that prevent many people with physical and psychological disabilities from achieving the same work and personal life outcomes as their peers.
Healthcare Navigator: An individual who works for an insurance company and specializes in supporting subscribers’ healthcare needs by scheduling appointments, organizing schedules, and overseeing referrals.
Accommodations: Modifications made to a person’s work or school environment that allow them to perform the essential functions of their role.
Medical Model of Disability: A cultural perspective that defines physical and psychological disabilities as sickness and, therefore, something to be cured. This view suggests that the limiting factors of disability are due to problems within the person, which ignores the social and political obstacles that are so often the reason that people with disabilities have difficulty integrating into society.
Therapist: A licensed psychological professional who has graduated from an accredited Master’s degree program and fulfills state requirements to provide therapy services.