On February 5, 2009, the Post-Standard published a letter that read in part “[CPEP]was filled way beyond capacity, with patients lying on chairs, floors, anywhere they could find space. It was quickly clear to us that it was understaffed, dealing with an extremely difficult, diverse population.” Despite repeated notifications, the NYS Office of Mental Health fails to properly oversee St. Joseph’s Hospital’s management of CPEP.
There was an old lady who was taken to CPEP after being raped. CPEP is the Comprehensive Psychiatric Emergency Program that is maintained by St. Joseph’s Hospital under the jurisdiction of the New York State Office of Mental Health. I don’t know why they took the old lady to CPEP. If I were an old lady—oh, gosh, according to the Onondaga County Department of Youth and Aging, I am an old lady—so, speaking as an old lady, if I get raped then I want to be taken to a hospital emergency department for a rape kit and I want the Rape Center to be called. I don’t want to be taken to CPEP, nor, I imagine, would the other old lady if she’d had the slightest clue what she was getting into.
When I met the Old Lady, she was announcing to everyone within earshot that if she ever got the urge to go to CPEP again, she would go out and get drunk instead. Way to go, Old Lady! All present nodded in agreement. What brings her to mind right now is that I’m thinking about CPEP and I’m drinking. It’s the only thing you can do.
CPEP is in a small, free-standing building that was constructed near St. Joe’s for the sole and solitary purpose of housing CPEP. Inside it has a “front” and a “back.” The front of CPEP is a waiting room and treatment area; the back is sort of an inpatient unit. One has to qualify it with “sort of” because “inpatient” in any other area of the hospital means you are being treated; in CPEP, it only means you are on hold.
Neophytes and other naive kinds of people have this vague notion that psychiatric emergency care is, well, care—nurturing nursing attention. Nothing could be further from the truth. Immediately disabuse yourself of the notion that emergency psychiatric care bears any relationship to compassionate treatment.
For starters, once you pass through the door of the waiting room, you cannot leave. If you go to a medical emergency room, you can walk out whenever you want to. You can walk out when you’ve been there six hours and still haven’t been seen by any treating professional and you have, consequently, decided you’re not really that sick and you’d just as soon go home to bed. You can walk out when the bleeding has stopped and you’ve had a chance to calm down, get a grip and decide you really don’t need stitches. You can walk out after you’ve sat there for four hours, watched and listened to four other people who have the same symptoms you do, and have become aware that there’s a stomach virus going around and you don’t actually have an ulcer.
In short, if you go to a medical emergency room, you can rest, reflect, come to your senses and go home. Get up and walk out. Be a free and independent agent. Live your life as you see fit.
At CPEP, from the moment that you enter, you are locked down until a psychiatrist sees you. The receptionist—behind a Plexiglas window—orders you to sign in. She does not tell you that once you have done so, you will have surrendered all your rights of independent decision making. She also does not tell you that (a) you cannot smoke in CPEP and (b) you cannot go outside to smoke. The minute you enter CPEP, you are instantly treated to nicotine withdrawal—as if you didn’t have enough problems already.
The second thing that happens in CPEP is that you are strip searched. The average American goes through his or her entire life without ever being strip searched. The millions of human beings who go to medical emergency rooms every day are never, ever strip searched. Cardiac crisis, broken leg, asthma attack—you aren’t strip searched. Mental meltdown—which is to say, trouble with your psychological state consequent to the crippling of your endocrine, neurological or immunological systems, or environmental stress—and you get stripped and searched. Hey, is this fun, or what? (To be continued)