Parkland's psychiatric services division has been getting a hell of a lot of bad press lately, and it continues today, with reports that an elderly woman in Parkland's psych wing ended up with broken bones after she claims she was forced out of her wheelchair. Earlier this week, the Center for Medicare and Medicaid Services threatened to cut funding to the hospital after it was found that a homeless patient who had attempted suicide was prematurely discharged. And after an incident this past March, several employees were fired after a patient was found to have been gagged with a roll of toilet paper.
The final outcome to these stories has yet to be revealed, and until then, the internet is exploding with rumors and pointing of fingers: Some are jumping to the defense of Parkland's health care staff, others are crying foul. While it's too early to draw any definitive conclusions, some of the concerns may be blamed on the challenges that are unique to public mental health care. And in any case it's clear that controversy surrounding the hospital, frustration, and increasing distrust, are reaching a boiling point.
Matt Roberts is the Executive Director of Mental Health America for Greater Dallas. Equipped with insider knowledge of the intricate, complicated web that is Dallas County public mental health care, he outlined some of the challenges that plague the system, and Parkland in particular.
"As a community, we need so desperately for Parkland to give the best care possible, because they're such an important part of the health system and mental health system," he says. "The public mental health system exists in a very financially strained environment but even still, the psychiatric patients involve the same skill level, respect, and attention that a heart patient would get."
In North Texas alone, the process of funding public mental health care services confusing at best, and riddled with chronic underfunding. Dallas falls under the NorthSTAR system blanket, which offers north Texas a different way of receiving state funds from the rest of the state. More often than not, though, Dallas ends up receiving substantially less money for public mental health services than the rest of the state.
Roberts says the lack of funding often limits employers from finding the right people for the job, or forces doctors to cut corners in providing services for psychiatric patients. The poor work compensation often leaves workers frustrated, some even leaving the system.
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And because Parkland is the largest county hospital, they receive the bulk of publicly-funded patients. "Parkland has the yeoman's job to take care of the county," says Roberts. "My feeling is frustration, because it seems like we keep hearing about troubles that have a similar ring to them. And I know Parkland has done a lot of work trying to make changes in a variety of departments, but here we are."
And the field of public mental health has to keep abreast of the latest movements in psychiatry and methods to help their patients -- which again costs the county more money. One of these is a push for 'trauma-informed' care. "That's a way of taking care of people where you try to be sensitive to the traumas they may have experienced, and are careful to set up a system that doesn't retraumatize the patients," says Roberts. "That's taken a lot of work to get that system in place. It takes management, time, and effort to see that this is the thing to do, and bring in resources to get your staff trained. So when you talk about unique difficulties, an example is the need to utilize new good practices like the need to follow trauma-informed care."
In any case, Parkland is not the first hospital to deal with the difficulties of the public mental health system in Dallas. But as one of the largest providers, the scrutiny they receive will undoubtedly continue to rise.
"I know Parkland has a million and one irons in the fire, but this is an iron that keeps getting burned over and over again," says Roberts. "And I know Parkland has new leadership and that psychiatric services may not be the biggest service at the hospital. But it's one that is, on the face of it, crying out for robust attention."