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Opinion: I needed emergency mental health care. As a doctor, I was distressed by what happened next.

Commentary | By Abbas Sedaghat | San Diego Union Tribune
October 21, 2022 | Fair Use Reprint

(Abbas) Sedaghat, M.D., is a retired professor of medicine with a 60-year career. His book “The Practice of Medicine in Three Continents: An Autobiography” was published this year. He lives in Rancho Bernardo.

In February, I found myself alone, having retired from an active and fulfilling career in the medical field and having my daughters leave our residence in Mira Mesa, where I was living at the time, to pursue their own professional aspirations. It was then that severe depression engulfed my being. I developed headaches and a loss of appetite, slept poorly, became forgetful, and noted a loss of interest in life’s pleasures.

I took several oxycodone tablets prescribed for my back pain in an attempt to depart from this world.

The seriousness of this action took me to the emergency room the next day, where I remained under observation for several hours before being transferred to a nearby hospital with inpatient psychiatric unit facilities.

The next morning, I observed a group of patients in the corridor being attended to by a group of harried nurses. I was allocated a psychiatrist whom I never met. The nursing staff informed me that the attending psychiatrists never visited the patients in the unit! One of my daughters removed me from that unsavory establishment and took me to a facility with which we were familiar, to attend its outpatient program.

The depressive disorder progressed relentlessly, making life intolerable. In April, I took many more oxycodone tabs. This medication depresses the respiratory center in the brain and damages the body organs by diminishing their oxygen supply. One of my daughters found me comatose and called emergency services.

Anyone experiencing a mental health crisis can call 9-8-8 or the San Diego Access and Crisis Line at (888) 724-7240 for immediate assistance.

Later that day, I found myself in a nearby hospital, having been intubated and placed on a respirator. The endotracheal tube was removed later on that day, leaving me with a sore throat and a hoarse voice. At the hospital, I was allocated a physician who came by daily, placed his stethoscope on my chest, nodded and left without saying a word. He showed little compassion and even less concern about my situation. Occasionally the “psychiatric team” would appear, and acknowledge our repeated requests for my transfer to a psychiatrist in-patient facility for appropriate therapy. But the health officials were unable to quickly do anything positive, telling me that an in-patient bed at another facility would become available soon and that I would have to wait.

Daily tests continued to be performed. My arms were black and blue from multiple blood draws and the daily painful testing continued in spite of my protestations. It became apparent that the nursing staff ran the show. Any problem that arose on the floor was passed on to the registered nurse by the licensed vocational nurses. The registered nurse would then decide on a response. Occasionally, the on-call psychiatrist would be contacted for advice, which would be implemented by the registered nurse. The actual appearance of a psychiatrist on the floor to visit a patient was non-existent!

Based on my experience of over 60 years in the field, the practice of medicine has altered considerably in recent years in that there is now very little physician-patient interaction and negligible empathy or concern shown by the staff towards patients.

I demanded to be discharged and returned to the facility where I had been an out-patient. Arrangements were made for my admission to the in-patient unit immediately. There, a variety of medications were administered, but none proved effective in combating my illness. It was then decided that electroconvulsive therapy should be used. In this treatment, the patient is anesthetized and an electric current is applied to the patient’s head. This produces a controlled seizure in the patient, who recovers consciousness a few minutes later.

This treatment came into existence following the observation that patients with seizure disorders were in some way protected from depressive illnesses. I was given several such treatments, which resulted in marked improvement in my mood. This therapy was continued on an out-patient basis. The side effects of electroconvulsive therapy include occasional headaches, confusion and sometimes memory loss, all of which are reversible with time. This form of therapy is considered to be among the most effective treatments for major depressive disorder.

Of immense concern during this difficult period of my life has been the challenge of finding a well-trained and caring psychiatrist to consult with on a face-to-face basis for ongoing care. Payment for such services seems to be a problem in that many caregivers do not welcome commercial forms of insurance and prefer cash payments. This is something the majority of patients can not afford. If my case is any indication, improvements in mental health care are solely needed in San Diego County. Time is of the essence. Legislation that provides for adequate training in mental health care (understanding root causes, how to communicate and interact with individuals that suffer from mental health disorders and effective treatments) and appropriate health care funding is required without delay for success in this much-needed and overdue endeavor.


This article was reprinted under the Fair Use Doctrine to help share this information more widely. Readers are encouraged to visit and subscribe to the San Diego Union Tribune to be both alerted and more informed about the topic of mental health issues and treatment in San Diego County.


Comments

This author submitted this comment to the original story published here.

“As the first person commenting said, I too am sorry to hear about your experience and glad you are finding relief! I sat on what is effectively the county mental health board (Behavioral Health Advisory Board or BHAB) for around six years and struggle as we may, it was very difficult to hear any critical feedback from consumers such as yourself. The narrative provided us by the BHS and providers was always rosy, a bit challenging, but never as dire a situation as you describe. This advisory board has a budget of approximately $11m this year to engage consumers and will only spend less than $500k. They believe it is enough, I have long argued tooth and nail, and to no avail, it isn’t. And now I’m off the board because I wouldn’t stop pressing… and given they guard their decision making authority heavily. That all said, and to be sure you are heard, I encourage you to submit a public comment via Zoom at the monthly meetings (1st Thursday 2:30 pm): ID: 940 5110 4767; Password: 383603 or, via phone or email-form here: https://www.sandiegocounty.gov/content/sdc/hhsa/programs/bhs/BHABcontact-us.html. Thank you and I wish you and your family the best!”

p.s. I look forward to reading your book!

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