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The Handbook:

Table of Contents

Introduction

Brain Disorders

Coping in Crisis

Medications

Resources for Care

Effects on the Family

Public Health Services

Financial Resources

Working with the System


Appendices:

NAMI Phone Numbers

DuPage Health Services

Chicago Area Hospitals

Community Resources

Legal Resources

Books, Videos, Journals

Hospitalization Form

Judicial Admission Form

Declaration of Treatment

Drug Reimbursement

Public and Private Resources for Care

Hospitals

A hospital may be sought for emergencies either for voluntary or involuntary hospitalization. Be sure to keep the telephone numbers readily available.

Appendix C has a list of hospitals serving DuPage County which are equipped to respond to mental illness emergencies. If, rather than using services provided by the Behavioral and Mental Health Services of the DuPage County Health Department or the state hospital, the choice is private care, there are several things to consider:

• If the patient is seriously disturbed but refuses treatment, the family may have to consider how to accomplish involuntary commitment. See "Involuntary Hospitalization." This ordinarily means use of the state hospital or a general hospital that has a psychiatric unit and accepts involuntary patients. Be aware that some people are willing to be voluntary patients if they know they are about to be placed involuntarily.
• Private insurance may cover a short hospitalization. Check carefully to see how much of the cost is covered; most policies have very limited coverage for psychiatric problems. Check with your insurance company about continuing your child 's coverage after the age when coverage generally stops. It may be possible to continue coverage past that age on a parent's policy.
• Medicaid may cover hospitalization if there is no private insurance coverage. A case manager or Health Department counselor with whom the client is working may assist with application for Medicaid.
• Available resources may include either psychiatric hospitals or general hospitals with psychiatric beds. During an acute episode, if inpatient care is not actually necessary, the Access and Crisis Center may provide care.

The Mental Health Treatment Team

The treatment team is made up of professionals who are collaborating on the case and should include the client and family members:

• Psychiatrists are physicians who assess, diagnose, and prescribe medications. They work with the treatment team to decide on a treatment plan, i.e., approaches to treatment, medications, and aftercare.
• Psychiatric nurses usually have major responsibility for planning care in the hospital, the day treatment program, or the medication clinic.
• Social workers obtain social history information from both the patient and family to assist in formulation of the diagnosis, treatment, discharge plans, and commonly serve as liaison between the treating agency and the family as well as the community resources.
• Case managers coordinate care and treatment for the mentally ill in the community and sometimes help when there is a problem with a mentally ill person complying with treatment or medication.
• Clinical psychologists may be involved in administering diagnostic tests, conducting individual or group sessions for patients, and planning care both inside the hospital and after discharge.
• NAMI of DuPage County and the DuPage County Behavioral and Mental Health Services consider family members to be part of the treatment team.  As soon after admission to the hospital as possible, concerned family members should make an appointment with the treatment center to discuss the following:
• What is the diagnosis? Please explain.
• What is the treatment plan?
• What are the specific symptoms about which you are most concerned? What do they indicate? How are you monitoring them?
• What medications is the patient getting? Is the response what was hoped for? What side effects should be watched for?
• Has the doctor or nurse discussed with the patient the diagnosis, medications and their side effects, and the treatment plan?
• How often can we meet to discuss progress?
• What is the discharge plan to ensure that the patient can maintain stability in the community?
• How can I be of help and support to assure a team effort?

The patient must give his/her consent before a staff person can release information. Therefore, you may ask your relative to sign a release of information. If your relative does not want to sign a blanket (all-inclusive) release, you may ask for a release for specific information, such as diagnosis, prognosis, signs of relapse, kinds of medications or discharge plans, and the release form can be revised to specify that. If you have difficulty getting necessary information, call NAMI of DuPage County (752-0066) whose volunteers may be able to help.

Ongoing Treatment

Serious mental illness is usually a long-term condition. Families who have lived with mental illness for a long time often describe how overwhelmed they were at the time of the first episode. They sometimes imprudently committed themselves to exhausting, unproductive and expensive treatments in expectation of a cure that was never to be realized.

After a thorough physical checkup has ruled out other illnesses and a firm diagnosis of a brain disorder has been established, patients will need:

• medical therapy, psychosocial and psycho-educational rehabilitation,
• a safe, stable place to live,
• a chance to learn about their illness and to develop or relearn social skills,
• someone who cares about them.

Resources are available through the DuPage County Health Department. Their Access and Crisis Center (627-1700) can provide extensive information and referral services, both public and private, related to mental or emotional problems. If such services are not available, you may need to ask again, or even seek legal advice.  Also, NAMI of DuPage County (752-0066) may be able to help you.

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