Archive | 9:41 pm

the peec

22 May

(Psychiatric Emergency and Evaluation Center)

I have some very intelligent, kind, thoughtful friends who are absolutely opposed to universal health coverage.  Their arguments are sound and logical.  And I disagree with them wholeheartedly.

During my training to work as a waitress at a local pub in Charlottesville, the owner told us, “In my ideal world, everyone would have to work at least one year of his/her life as a server.  What you learn about others, about yourself, about what it means to be at the service of others–it’s invaluable.”

In my ideal world, everyone would spend at least one night meeting and interviewing patients in the PEEC, the place where patients who presented to the Emergency Department with possible psychiatric problems are evaluated for admission.  In what world would it be better for society for these patients to not have health care coverage?  In which the alone schizophrenic woman who is beaten and raped, and almost smothers her infant child during a period of postpartum psychosis (like one of my patients), is denied treatment for her condition?

The drift hypothesis is an argument that mental illness causes one to have a downward shift in social class that often, in turn, exacerbates the problem and causes further drift and isolation.  A famous, albeit controversial, study by E. M. Goldberg and S. L. Morrison examined the relationship between schizophrenia and social class.  It determined that there was a strong association between schizophrenia and a lower social class.  However, the social class in which the participants were raised was found to be similar to that of the general population.  Schizophrenia led to a fall in social class, rather than the reverse.

The vast majority of my patients are either without health insurance entirely or on medicaid.  Medicaid provides some assistance, for sure, but it’s still disheartening to put these young men and women on second-line antipsychotics that are going to leave them with irreversible side affects later in life because the first-line drugs are outside their coverage.

Just a piece of the argument…a far stretch from completely thought out on my end.