Mental Health Parity and quality of care

In response to Laura Crabtree’s excellent letter to the Portland Tribune (Oct. 9, 2008 – and see below), I see the quality of care received by psychiatric patients to be a parity issue. However, I think it is important to note that rude behavior on the part of staff is not restricted to the psych units, nor to hospitals only.

I tried several different primary care clinics until I found satisfaction at Providence Portland Medical Center. I rejected as many as six because front desk staff were so rude. Providence staff are, without exception, professional and courteous.

Another area in which staff can be unprofessional is in geriatric care. When my late father had Alzheimer’s Disease, he was in a care facility in Vancouver, Washington, where one staff member was extremely rude and patronizing to him. My family reported this person, who was from a staffing agency, to the management, and she was let go immediately.

Ms. Crabtree says of her hospital stay at Good Samaritan medical unit and psychiatric unit:

“The difference in treatment from staff on the separate units was like night and day. On the medical unit, the staff members were incredibly kind, always professional and eager to be helpful. On the psych unit, many of the staff were rude, unprofessional and clearly inconvenienced by my needs.”

Just this month (October 2008) Congress passed and the president signed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. I had thought this meant that care for physical and mental health issues would now be equal. However, Jason Renaud of the Mental Health Association of Portland tells me that mental health parity does not apply to quality of care, only quantity, which means the dollars available for care can now be equal.

I’m appalled by Ms. Crabtree’s experiences, and we can only hope that someday all staff who work with people who have any sort of illness will have patient-centered compassion.

Marian Drake – Adviser to the Mental Health Association of Portland

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Hospitals’ use of restraints needs impartial monitor

As far as I can see, the only reason hospitals will not reveal their data on restraint use is because they have something to hide (Hospital restraint numbers murky, Sept. 18).

As Beckie Child, president of Mental Health America of Oregon, says, people with mental health issues are still deemed less than others and, believe me, are treated as such.

I have been on both medical and psychiatric floors (such as at Good Samaritan), sometimes as part of the same hospitalization. The difference in treatment from staff on the separate units was like night and day.

On the medical unit, the staff members were incredibly kind, always professional and eager to be helpful. On the psych unit, many of the staff were rude, unprofessional and clearly inconvenienced by my needs.

But even if the hospitals end up having to spill this information, why would anyone believe them?

I mean, the informers are the same people who are under scrutiny. There needs to be an impartial, anonymous agency to monitor the activities of these hospital units.

Child notes that there is so much potential for abuse in the use of restraints; I am afraid that the abuse is both actual and common in psych units and cannot always be measured in something as clear as numbers.

Laura Crabtree
Northeast Portland