Op-Ed: First Hospital closure evokes pain of father’s lifelong mental health struggles

Op-Ed: First Hospital closure evokes pain of father's lifelong mental health struggles
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I am the son of a parent with schizophrenia.

That has been the reality of my life for nearly 50 years. I learned the word before I was in grade school. I learned the reality of living with someone whose behaviors included physical violence, screaming, and outlandish, incomprehensible statements.

I also learned that “the system,” even when it seemed to be working, offered limited and imperfect solutions to families struggling to deal with a loved one whose behavior was disruptive and unpredictable at the best of times, terrifying at the worst of times.

The options for my father after his worst episodes always seemed to boil down to these three:

• Have him arrested if he committed a crime.

The beatings my mother endured at his hands certainly were. She always declined to press charges, and the frustrated police who came to our home more than once were not required to charge domestic suspects at that time. I know my mother feared his wrath if she had pressed charges, but also vainly hoped the arrival of officers might scare him back into line. Sometimes it did, briefly.

• Have him committed if his condition and behavior justified it.

My grandmother and my mother mostly resisted the idea of ​​doing so. First there was the stigma: Both saw having my father committed to a “mental hospital” as a failure and a betrayal. Sadly — though with some cause in that era (1960s and ’70s) — such facilities were feared.

Then there were his threats. He warned them that if they tried to commit him he would never be held for long, which was correct, and he would exact revenge on them when he got out. They tried twice that I know of. He lived up to his warnings.

• Seek outpatient treatment, therapy and medication, which he almost never consented to. The doctors were part of a global conspiracy to drug and kill him, he always told us. He never told them that, and his ability to seem charming and lucid always seemed to keep him from long-term committals. He wasn’t deemed a threat to himself and society.

This was decades ago, hundreds of miles away from here in a larger metropolitan area where, even then, we had more treatment options than Northeastern Pennsylvania does today — and more than Luzerne County will have come Oct. 30, when First Hospital is scheduled to close, according to operator Commonwealth Health. As my colleague Bill O’Boyle pointed out, that move means the hospital’s inpatient services and affiliated outpatient offerings are expected to end.

I didn’t grow up here. I didn’t deal with “the system” here. My father and his encounters with mental health care are part of a distant personal past in another state. And yet news of the hospital’s impending closure felt very personal.

First and foremost, I have friends whose families have connected on the hospital’s services. For them, the impact will be very real. Their stress and concern over this news is significant.

For myself, it brought back echoes of my childhood, and watching the strain my father’s condition placed on an entire family. Familiarity with a given facility and its medical staff can be an important source of continuity and stability for patients and their loved ones. Losing that facility will mean losing a lifeline for many in Lucerne County.

As another colleague, Mark Guydish, reported in a companion piece on Sunday, there are many other providers in the county, but there is no facility like First Hospital, with critical services available 24/7 for those feeling suicidal or destructive.

“Our local people will have to travel a further distance unless somebody buys out the hospital,” Misericordia Assistant Professor David Hage told Guydish. And even if they do get suitable referrals, it likely will not be with providers they’ve come to know. “Continuity of care is always helpful,” he said. “It’s a challenge to start with new individuals.”

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The ripple effects of such a major change can be devastating to those in treatment, especially when the change may require significant travel to reach a new provider.

As Guydish’s story also points out, one study projects a shortage of 130 to 300 beds in the next few years for Lucerne and Lackawanna counties.

Geisinger, in particular, is working to expand mental health offerings, but Guydish explained that those solutions will take time; some will come in the form of additional mental health beds and facilities in neighboring counties. For those reasons, experts warn that the short-term loss of First Hospital will mean an increase in psychiatric and behavioral patients coming to hospital emergency departments.

Will the hospitals and patients adapt? Of course. Is it an ideal situation? Not at all. For those in crisis, the trip from greater Wilkes-Barre to Moosic, Bloomsburg, Danville or some other distant facility could pose real challenges, and make some less likely to get the help they are already reluctant to seek.

I say all this as someone whose family tried unsuccessfully to convince a loved one to seek treatment. Those who have managed to get a relative into care, only to see that care suddenly jeopardized, are right to be frustrated.

Jennifer Mickle-Symons, who spoke to me and other reporters at a press conference across the street from First Hospital last week, described how her 17-year-old son has been progressing in his therapies at the facility.

For Mickle-Symons, who lives in Larksville, the next nearest treatment option she is aware of is in Tunkhannock, over 20 miles away.

“It could lead to further depressions — a spiral — things like that. As of right now, he has asked ‘where do I go from here? Why do I even bother?’”

I understand that feeling.

My father’s condition was extreme, and not necessarily typical of the many people who seek mental health care in this country. Indeed, the presence of hospitals almost seemed not to matter in his case.

Our struggles with trying to lead him to treatment, and keep him there, ultimately failed. Last we knew he was living in his car and wandering from town to town after refusing help from my aunt and my brother, both of whom made it clear that help was contingent on seeing doctors and taking his meds. He’s in his early 80s, if he’s still alive.

That is my family’s tragedy. I share it here because I believe talking about mental health challenges helps reduce the stigma. I hope it may help underscore how many families are affected and how difficult it can be to find long-term solutions for those with chronic mental illnesses.

The tragedy for this community is that people who trusted the system and are in treatment may have it pulled out from under them with comparatively little warning.

***

Roger DuPuis is news editor of the Times Leader. The views expressed here are his own.

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