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The NSPA Blog

What is a SMHRF, anyway?

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Posted on September 13th, 2018 by Teri Dreher, under Healthcare Reform, Long Term Care, Patient Advocacy, Something New

A Specialized Mental Health Rehabilitation Facility, that’s what

This month we’re giving a lot of attention to behavioral health and suicide prevention awareness. Coincidentally, I had a new client whose family came to us for help with placement. The brother, who had been diagnosed with a serious mental illness in his 20’s, had been disabled and unable to work for the past 12 years due to side effects of psychotropic medications. The medications were prescribed to him from his doctor. Although disabled, the brother was stable. That is, until their father passed away and he and his mother moved to Chicago. With the move came a new psychiatrist. The psychiatrist made a judgement call to change the medications this man was on. Unfortunately, it was the wrong call.

Changing medications for a serious mental illness is a big deal

Hallucinations and delusions of persecution started up that hadn’t been felt in years. His behavior changed radically and he became convinced that he and his family were in danger. The delusions intensified. His sister was worried and made the call herself to bring in the police. Before they could arrive, a fight ensued. The man scared his sister and mother, and they barricaded themselves in the bathroom. Sadly, as so often happens with cases of mental illness, the man turned his anger inward. People struggling with serious mental illness are far more likely to do harm to themselves than anyone else. And that is what happened. He took a knife to his wrist and cut down to the bone.
Police arrived with paramedics and fortunately got him to a hospital quickly. He then underwent five hours of surgery to repair an artery and tendons. Upon transfer to the local locked psychiatric unit, it was determined that most long-term facilities would refuse to take him based on his suicidal history. Calling in a professional advocate was necessary to place this gentleman in an appropriate and safe facility as the family determined that living with his aging mother was no longer an option.

A light at the end of the tunnel

What I discovered in researching for this case was a whole new world. Specialized Mental Health Rehabilitation Facilities. I vetted a few in Chicagoland, and was very impressed. Think of them as nursing homes for people struggling with serious mental illness. Clients who are unable to function on their own in society, either for short-term or permanent time frames. Years ago when states emptied out their state run psychiatric facilities, a large number of patients ended up homeless, self-medicating themselves with illicit drugs and turning to crime to survive. What a disaster for these people as well as for society! These new facilities are strictly for people who have mental illness as their primary diagnosis. Nursing care beyond medication management is rarely needed. Staff are vigilant about patients taking their medications and have a structured behavioral and social rehabilitation program.
What I liked best was the wonderful attitude and respect between patients and staff that I witnessed. Most Executive Directors and Directors of Nursing and Admissions Directors I met had been there for decades and loved what they do. It was refreshing to find so many professionals who sincerely love to work with this population, almost all of whom are on Medicaid and often alienated from their families. Something that our state is doing right: working to care for mentally ill who are at very high risk of falling through every crack imaginable in modern healthcare. SMHRF’s are a great solution!

What makes it all worth it

And best of all, our client returned to his normal sweet, gentle self, safely placed in a wonderful facility north of Chicago where he is presently adjusting well. His family has peace of mind. Untangling challenging situations for patients and families is what we love doing. For more information or needs, think of us for guidance in physical, mental and emotionally challenging family crises. We have the answers you need!

With over 36 years of clinical experience in Critical Care nursing, home based health care and expertise as a cardiovascular nurse clinician, Teri is well acquainted with the complexities of the modern healthcare system. She has served as a nursing leader, mentor, educator, and consistent patient advocate throughout her career in some of the best hospitals across the country. Her passion to keep the patient at the center of the model of nursing care led her to incorporate NShore Patient Advocates, LLC in 2011, serving clients throughout the northern suburbs of Chicago.

For a no-cost 30 minute initial consultation, please call 847-612-6684 or click here to fill out our online callback request form.