71. Inpatient Psychiatric Care Exposed: Are We Healing Or Hurting Patients? w/ Dr. Morgan Shields
Mental health care remains one of the most challenging aspects of the healthcare system, often shrouded in stigma and facing numerous systemic hurdles. In this two-part episode of our podcast, we delve into the intricacies of mental illness treatment with Dr. Morgan Shields, an assistant professor at Washington University in St. Louis. Dr. Shields brings both professional expertise and personal experience to the conversation, as we unpack the complexities surrounding inpatient psychiatric care and the subsequent effects on patient well-being.
Exploring Inpatient Psychiatric Care
Inpatient psychiatric care is often seen as a last resort, intended for individuals experiencing severe mental health crises. However, as Dr. Shields reveals, the quality of care in psychiatry is fraught with challenges that can sometimes exacerbate the very issues it aims to resolve. Through her personal experiences and research, Dr. Shields highlights how these settings can feel anticlimactic, distant from the therapeutic environment outpatient care often provides.
Dr. Shields shares harrowing personal accounts, including her father's struggles with bipolar disorder and her own involuntary encounters with psychosis and psychiatric hospitalization. These experiences not only opened her eyes to the grim realities that patients face but also fueled her commitment to advocating for a more patient-centered care model.
The Impact of Psychiatric Hospitalization
Research cited by Dr. Shields indicates the troubling reality that people discharged from psychiatric hospitalization face exponential increases in suicide rates. The concept of iatrogenic effects—conditions caused by medical treatment—further emphasizes the critical need for reform within these institutions. Dr. Shields’ 2023 paper, "Patient Centered Inpatient Psychiatry is Associated with Outcomes, Ownership, and National Quality Measures," explores these issues and suggests that the current system is far from ideal in safeguarding patients' emotional well-being.
Personal Journey and Psychosis Experiences
Dr. Shields' personal journey through the mental health care system exemplifies the urgent need for change. From a young age, she witnessed her father's manic and depressive episodes, leading to periods of homelessness and family disruption. Her father’s experiences molded Dr. Shields’ understanding of mental health stigma and the importance of trauma-informed care.
As she recounts her own psychosis experiences, Dr. Shields underscores the emotional turmoil faced by patients in crisis. Moments such as being restrained and medicated under duress highlight the lack of empathy often present in psychiatric facilities. These traumatic encounters have left lasting impacts, making the need for compassionate, effective mental health support ever more pressing.
Challenges and Necessary Reforms in Psychiatric Care
The healthcare system's inability to ensure quality care in inpatient settings is underscored by issues like understaffing, lack of patient agency, and insufficient follow-up resources post-treatment. Dr. Shields advocates for mental health awareness and mental health education, stressing the importance of understanding and overcoming biases that persist within the system. By addressing these healthcare disparities, we can work towards a mental health care model that prioritizes patient advocacy and emotional well-being.
Looking Ahead to Mental Health Reform
With countries like Italy serving as a successful model of community-based mental health systems, Dr. Shields raises the possibility of reformative approaches in the U.S. She discusses the role of patient-centered care frameworks that emphasize dignity, trust, and empowerment, highlighting the need for a societal shift towards respecting the rights of individuals with mental illnesses.
Dr. Morgan Shields’ story is a testament to the challenges and perseverance involved in mental health advocacy. Her insights shed light on the paths we must explore to achieve meaningful reform within psychiatric care. Join us next week as we delve deeper into potential solutions, including the differences between for-profit and nonprofit psychiatric facilities, and Dr. Shields’ research findings that point towards a brighter future for mental health support.
Dr. Morgan Shields is a Tenure-Track Assistant Professor at Washington University in St. Louis' Brown School and also serves on the Saint Louis Board of Health and Hospitals. She is a health services and policy researcher, focused on the quality and accountability of crisis mental healthcare services. While most of her work has focused on inpatient psychiatric care, she has been expanding her work to include community-based crisis services. Her research has been published in leading academic journals and has impacted local and national policy.