State Hospitals

 For Jane Joe, the issues that led to her admission were the difficulties that the Assertive Community Treatment experienced connecting with her and getting her to stay on medication and the deterioration of her situation of her situation especially due to drunkenness. The refusal to take medication was a major problem which made her to remain seriously disorganized and forcing the health care providers to embark on involuntary medications (Radke & Goetz, n.d., 28). The major assessment that is needed for this situation is the medical cause or inherent personal problems that may have made Jane to refuse medication. The community seems to have offered their support for her but failed to bring her under control. Even with such social support there seems to be personal issues that might have led to her drunkenness and whose assessment would lead more light on the same. Jane needed treatments that would control the acute agitation episodes she portrayed even if it had to be done involuntarily (Radke & Goetz, n.d., 28). The treatment seemed to have worked for Jane as she was able take part in groups and even being integrated to the community. The management of the community worked very well for her so that she was able to manage her life after being discharged.

The case of Joe Doe shows neglect by the community around him that avoided him because of the behavior wrought by abuse of methamphetamine. Unlike Jane who the community tolerated her sleeping on door step, Joe had to break into a garage to find a sleeping place. The only way he was admitted to OSH was after he was found unfit to stand trial (Radke & Goetz, n.d., 29).  There various issues that might be assessed in this cause including community neglect, growing up in an abusive home where he had been adopted which made him to drop out of school and early drug indulgence. Unlike Jane who had the care of the community-based organization, Joe had none of it and his admission came after various incarcerations. The medications seem not to have worked for him, since he is barely able to participate in group treatment programs.   The treatment has not prepared him to be reintegrated into the community and even managing his own future. The community providers are quite skeptical and unlikely to embrace him and even his release is not likely to be released (Radke & Goetz, n.d., 29).  The management in the case of Joe seems has not had success in healing the psychological and social issues affecting the patient. Of more concern is lack of community empathy and willingness to walk through with Joe like Jane until substantial control is achieved.

The two admissions involved can only be compared in the role of medication in stabilizing and controlling both situations. Jane and Joe had to be undertaken through an involuntary medication only after their condition had deteriorated so that to control extreme agitation and violence.  For both individuals, psychiatric problems can be attributed to extreme substance abuse which makes them unfit in their own community and hence the admission for treatment. There seems to be deeper social issues that led to substance abuse , and the treatment methods seems not to address the core issues of this case. Unless the two individuals are placed under mandatory medication or hospital care, they cannot bring themselves to gaining control of their life and future.  Lack of resources is major problem as seen in the case of OSH.

The state psychiatric hospitals started out as a refuge for different people including the poor, mentally ill and having developmental disabilities. After they were placed under states’ management, they shaped their roles to serving individuals with persistent and serious mental illness. After deinstitutionalization in 20^th century and with increased population growth, the hospitals failed to grow proportionately to increasing needs and previously deplorable conditions returned (Radke & Goetz, n.d., 28). Presently, these hospitals serve different groups of mental patients including the children, adults and the elderly. The role of these mental health systems also include admitting individuals for forensic commitments , and many acts as tertiary care facilities which both long-term and intermediate range patients (Radke & Goetz, n.d.,36).

The hospitals have faced various challenges ranging from clinical, administrative and financial. The clinical challenges relate to the culture such as the need to phase out the use seclusion and restrained as a health care procedure for psychiatric patients. The clinical challenges also stems from lack of positive care environment at home and even in jail due to increasing cases of violence and even homelessness, conditions that worsen this situation. There are also patients with chronic conditions in state hospitals that are poorly treated or are not treated at all. The administrative challenges are linked to the financial and resource woes facing the hospitals. The high cost of accessing medical care for the patients visiting the community hospitals is a major problem. Meeting the criteria set by the states means that few patients can benefit from the high expertise placed in the community hospitals. The community resources ended up being stretched to their maximum (Radke & Goetz, n.d.,42). A case in example is the present shortage of hospital beds in the psychiatric state hospitals which leads to immature discharge of the patients and end up being readmitted or incarcerated (Torrey,2016,1).  

References

 Radke, A., Goetz, R., (n.d). State Psychiatric Hospitals in the Twenty-First Century.  28-42