Broken system sets stage for tragedies such as Clancy case
Re “She sought help; the system moved her along: Lawsuits from Clancy family paint an all-too-familiar portrait of failures” by Yvonne Abraham (Metro, Feb. 8): I worked in emergency rooms in Boston and across more than 10 states for a decade, evaluating thousands of people in psychiatric crisis. I eventually had to stop because the daily moral distress became overwhelming.
The mental health system is broken, and it is contributing to the burnout of hard-working, caring clinicians. My peers in the field of behavioral health are deeply conscientious. We work overtime, make endless collateral calls, wait on hold with insurance companies, and take on tasks far outside our formal roles. Yet how hard we work, and even what we recommend, often has little effect on what actually happens.
Detailed psychiatric evaluations are frequently reduced to a single question: Is the patient suicidal, with intent and a plan? If the answer is no, hospitals and insurance companies often decline the indicated treatment, regardless of how impaired or unstable the patient may be. Even when patients meet criteria for acute care, they often wait in emergency rooms for days without assistance. If psychiatric symptoms fluctuate, as they often do, patients may be discharged still untreated and profoundly ill.
All of this is not due to time limitations or a failure of listening or compassion. It is a structural failure of a system designed to ration care.
My heart aches for Lindsay Clancy and her family. What should terrify us is how easily this can happen to any of us and how little control highly trained, experienced clinicians often have within a system that routinely overrides even expert medical recommendations.
Dr. Karina Tamir
Newburyport
The writer is a psychiatrist.
Care for people experiencing psychosis is profoundly lacking
Yvonne Abraham’s column “She sought help; the system moved her along” and Globe reporting on the malpractice suit filed last month by Lindsay Clancy’s husband, Patrick, underscore a devastating truth: the profound lack of adequate medical care in Massachusetts that is available to individuals experiencing psychosis, regardless of its cause.
As executive director of the National Shattering Silence Coalition, an organization dedicated to improving outcomes for people living with severe mental illness and their families, I work closely with families who have repeatedly begged for help, only to experience similarly tragic and preventable outcomes.
Psychosis is a loss of touch with reality and must be treated as the medical emergency it is. I hope this case sets a meaningful precedent and finally holds our systems accountable for failing to provide appropriate, timely medical care. Families such as the Clancys and so many others should never have endured such unimaginable tragedies when proper treatment could have made a difference.
Ann Corcoran
Swampscott
The writer holds a master of science in nursing.
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