The rules around seeking and staying in treatment

The article below is part of an educational series to help the community better understand Behavioral Health Services (BHS) available to them in Gillette, Wyoming.

There are many misconceptions around seeking and staying in mental health treatment. If you have a broken arm one would expect to find a service that can treat that particular issue. Once the arm is set, there are follow-up appointments to make sure that infection does not set in and that the arm is healing properly. If the person with the broken arm goes to the Emergency Department to get it set, but does not follow up to make sure things are healing correctly and then ends up with a bad infection or the arm heals in an abnormal way, who is responsible?

In mental health there are rules we try to follow. To name three:

1. If a person has a substance abuse issue, they need to seek treatment on their own. It has been shown on many occasions that a person forced by family and friends into treatment rarely succeeds (In fact, the average number of relapses is seven).
2. If a person in treatment for mental health issues does not show for appointments or does not give proper notice for missing appointments, they need to be discharged from care.
3. And finally, people need to pay something for their care.

There are many reasons for these rules and I want to go through a few of the key points below:

• The self-realization that one needs help with a substance abuse issue always is the best case scenario. It prompts motivation. The only other acceptable way this can happen is through the courts and even that has a lower success rate than self-realization.
• Accessing mental health treatment is a first step. It is like finally going to a doctor after finding a lump. Seeing treatment through is much more challenging and being responsible with your communication (24-hour notice for a missed appointment) is the second and third thing that a vested person must do to support their own efforts in getting well.
• Behavioral Health professionals cannot and should not believe that they are fixing people. People fix themselves with the aid of a professional.
• No-call and no-shows erode the resources of the mental health professional and prevent others who truly want the help from getting it. Here is a typical situation: someone calls in after finally deciding they need help. They are told that the next available appointment is three weeks away. Reluctantly, they take that appointment. The next day someone who had an appointment no-calls no-shows and the professional sits there alone. One might say that we could call those that are scheduled out further and find someone that wants to get in sooner. We do that. But, and this is real, people have lives and they plan things around their appointments. Not often do we find patients, that once scheduled, want to change. If you are not vested or responsible with your care, what are we to do? I ask that you think about that. 24-hour notice is not asking too much.
• It has been shown in many studies that people who pay for something find more value in it. We have numerous ways to pay a bill at BHS. We offer everyone that walks through the door a sliding fee scale. People who are the most strapped and those who have resources all can get the same quality care.

Jeff Rice is the director of Behavioral Health Services at Campbell County Memorial Hospital. BHS provides professional mental health and substance abuse services to the community through prevention, education, advocacy and treatment for all ages in the community. Appointments are available Monday–Friday from 8 am–5 pm. Call 307.688.5000. Learn more at www.cchwyo.org/BHS.