Lost Patients Live: First-Person Stories from Seattle's Mental Health Crisis – A Comprehensive Summary

Released on June 26, 2024, "Lost Patients Live" is a pivotal episode of the "Lost Patients" docuseries by KUOW News and Information. Hosted by Will James, this live recording delves deep into the complexities of mental healthcare in America, particularly focusing on Seattle's ongoing mental health crisis. The episode features a blend of journalists, patient advocates, and mental health professionals who share insights, personal stories, and discuss potential pathways for reform.

Introduction to the Live Event

Will James opens the session by acknowledging the overwhelming response to the "Lost Patients" series, noting hundreds of messages from listeners dealing with serious mental illness or connected to those who are. He emphasizes the urgent need to address systemic failures in psychiatric care, setting the stage for a transformative conversation aimed at uncovering solutions and fostering meaningful change.

Panel Discussion with Journalists

Understanding the Past to Fix the Future

Libby Denkman, the moderator from KUOW, initiates the discussion with Sydney Brownstone and Esme Jimenez, both investigative reporters whose work has been instrumental in unmasking the intricacies of mental health care systems.

• Sydney Brownstone highlights the importance of viewing mental health care through a historical lens. “If you hold up a bad guy or a one law, that is the problem, the reason that all of this is breaking down. It’s a structural issue,” she explains (09:54).

• Esme Jimenez delves into the historical context of deinstitutionalization, explaining how financial motivations have consistently undermined the well-being of patients. “What would happen if instead we had the imagination and the capacity to approach it not from what's the least amount we can pay for this, but what would actually effectively serve the people who need help the most?” she poses (10:34).

Accountability Without Blame

The panel discusses the delicate balance between holding systems accountable and avoiding the trap of assigning blame to individuals. Sydney Brownstone emphasizes structural issues over scapegoating individuals, stating, “I didn’t want to distract us from that. I wanted Heidi’s last words... that we all failed Adam to be the words that rang the loudest” (07:56).

The Legacy of Deinstitutionalization

Esme Jimenez sheds light on the repercussions of deinstitutionalization, where the closing of large mental hospitals without adequate community support led to increased homelessness and incarceration of mentally ill individuals. This historical neglect underscores the necessity for sustained investment in mental health infrastructure.

Structuring the Narrative

Sydney Brownstone explains the episodic structure of "Lost Patients," aimed at layering complex ideas and reframing narratives over time. “We are starting at a certain point and then with each episode we are layering more ideas on top of what people have heard before and reframing the prior episodes,” she articulates (13:05).

Lived Experience Panel

Personal Journeys Through the System

The episode features heartfelt testimonies from Laura Van Tosh and Carolyn Panzoa, both patient advocates who have navigated the tumultuous landscape of mental health care.

• Carolyn Panzoa shares her harrowing experience with involuntary commitment, expressing a desire for more inclusive storytelling. “I would have liked to have heard Adam’s point of view because he seemed like a great guy,” she mentions (26:28).

• Laura Van Tosh recounts her struggle with institutionalization and the realization of needing to take control of her own treatment journey. “I realized that I needed to be the one to get myself out,” she reflects (24:09).

Constructive Feedback for "Lost Patients"

Both advocates provide insightful feedback, urging the inclusion of diverse perspectives and highlighting the absence of patient rights organizations in the series. Laura emphasizes the importance of organizations like Disability Rights of Washington, stating, “They were not mentioned. There was nothing,” underscoring a critical area for future coverage (27:02).

Positive Models and Paths to Recovery

The panelists discuss successful community-based initiatives that foster recovery without reliance on involuntary treatment.

• Carolyn Panzoa highlights the effectiveness of community centers like the Reach Center and Recovery Cafe, where individuals are treated with respect and supported through empathetic, non-stigmatizing interactions (34:46).

• Laura Van Tosh expresses optimism about the upcoming crisis care center levy in Seattle, which aims to transform crisis response from a reactive to a proactive approach, ultimately reducing the need for involuntary treatment (28:58).

Provider Panel

Systemic Disconnections in Mental Health Care

Dr. Paul Borgozzani and Tim Jolliffe, mental health professionals, discuss the fragmented nature of the current system. Dr. Borgozzani concurs with the metaphor used in the series, describing mental health care as a house designed by disjointed architects: “We simply don’t have a system,” he states (38:04).

Substance Use and Mental Illness Interplay

The conversation shifts to the complex relationship between substance use and mental illness.

• Dr. Borgozzani emphasizes that it's not a matter of choosing between drugs or mental illness but understanding their interaction. “It's both,” he explains, highlighting the need for nuanced approaches in treatment (43:19).

• Tim Jolliffe adds that substance use exacerbates mental health crises, especially in the context of homelessness, creating additional barriers to effective care (41:08).

Bridging the Gap Between Reality and Public Perception

Providers point out significant misconceptions in public discourse about mental health.

• Dr. Borgozzani critiques the oversimplification of attributing crises solely to medication non-compliance, advocating for a deeper understanding of individual crises (44:38).

• Tim Jolliffe calls for honest conversations about the financial investment required for quality mental health care, emphasizing that “quality care costs money” (43:49).

Moving Towards a Restraint-Free System

Dr. Borgozzani discusses ongoing efforts to eliminate the use of restraints in hospitals, signaling a fundamental shift towards more humane treatment practices. “The goal is to really fundamentally change things,” he affirms (46:55).

Q&A Session

Law Enforcement’s Role in Mental Health Care

An audience member questions how police officers can contribute to positive change within the mental health system.

• Sydney Brownstone responds by advocating for the decriminalization of mental health issues, suggesting that fewer crises would fall on the criminal justice system if mental healthcare was more effectively managed within healthcare frameworks (07:12).

Supporting Vulnerable Communities

Another question addresses how professionals, such as psychiatric nurse practitioners, can go beyond their duties to support vulnerable populations.

• Tim Jolliffe emphasizes the importance of collaboration between law enforcement and mental health teams to ensure better crisis response and ongoing support (50:33).

Involuntary Treatment Alternatives

The panel discusses envisioning a world without the necessity for involuntary commitment.

• Carolyn Panzoa envisions community-based support systems where individuals experiencing psychosis are met with respect and understanding, rather than fear and restraint (33:34).

• Laura Van Tosh underscores the need for supportive housing and early intervention to prevent crises from escalating to the point of needing involuntary treatment (28:58).

Closing Remarks and Future Directions

Libby Denkman wraps up the session by acknowledging the depth and breadth of the conversation, highlighting that this live event is just a chapter in the ongoing dialogue initiated by "Lost Patients." The collective insights from journalists, patient advocates, and providers point towards a future where mental health care is more integrated, compassionate, and adequately funded.

Will James concludes by reiterating the importance of continued efforts to reform the mental health system, thanking all participants and organizers for their invaluable contributions.

Notable Quotes:

• Will James: “This feels like a tiny sliver of what has been and will be a much longer and broader conversation.” [00:18]

• Esme Jimenez: “So many of the issues... have their roots in very old ideas about who is productive and who is unproductive.” [05:25]

• Sydney Brownstone: “I wanted Heidi’s last words... that we all failed Adam.” [07:56]

• Esme Jimenez: “What would happen if instead we had the imagination and the capacity to approach it... not from what's the least amount we can pay for this, but what would actually effectively serve the people who need help the most?” [10:34]

• Carolyn Panzoa: “I would have liked to have heard Adam’s point of view because he seemed like a great guy.” [26:28]

• Dr. Paul Borgozzani: “We simply don’t have a system.” [38:04]

• Sydney Brownstone: “How do we make this not a criminal justice problem anymore? How do we make this a healthcare problem?” [16:00]

Conclusion

"Lost Patients Live" serves as a critical examination of the systemic failures plaguing mental health care in America, particularly within Seattle. Through candid discussions, personal testimonies, and expert insights, the episode not only highlights the deep-seated issues but also underscores the collective commitment to envisioning and working towards a more effective and humane mental health care system. The collaborative efforts of journalists, patient advocates, and healthcare providers showcased in this episode lay the groundwork for meaningful reforms and sustained advocacy.