My father can't take care of himself. Who can?

November 9, 2012 1:57 PM

What resources for long-term mental health care exist in New Mexico? How do they happen?

My father has a long history of mental health issues. Last night he made his second, to my knowledge, suicide attempt, the first being before I was born. He's currently in the ICU.

My mother, in her words "did it [stayed with him after an attempt] once and ha[s] been paying for it for the last 30 years." Right now, she's planning on leaving him, and I expect her to follow through on that.

He cannot support himself. He certainly cannot hold down a job, and at this point I really don't think he's capable of basic self-care.

My understanding is that the old-school long term state-run mental hospitals ala Girl Interrupted don't exist. What does exist? I've done some looking, but most things seem to be targeted towards elders (he's only 56) with various levels of dementia or adolescents. Is there long term care for adults with other mental health issues?

Additionally, how does this get paid for? Does Medicaid fund such things?

(Obviously, this is a big and weird and awful and complicated thing for me. I am in therapy already for my own, much less severe, mental health issues, and have a fortuitously scheduled appointment with my therapist tonight. As complicated and ugly as my relationship is with my father, I don't want him to be the crazy homeless guy on the corner.)

posted by anonymous to Health & Fitness (6 answers total)

First, where are you in New Mexico? Albuquerque? Las Cruces? Santa Fe?
Second, is your father in any way eligible for Veteran's Benefits?
posted by pickypicky at 2:14 PM on November 9, 2012

You're right that those long term psychiatric care hospitals are pretty much fiction now. Usually a patient will receive acute care for up to 30 days (bipolar/schizo stops taking meds, suicide attempts, etc.) and will then be released to an outpatient treatment plan. Sometimes it's something like assisted living or a group home, sometimes it's living in your own place with social workers who check in to make sure you're eating, going to appointments, etc.

If he can't work or care for himself he should be on disability, where he would get Medicare and disability payments. He may also be eligible for Medicaid. Unless he had a spectacular job, his disability payments will not be stellar. I made very good money when I worked, and I live slightly above the poverty level now.

I don't want to scare you, but I will tell you that the mentally ill with no family support or health insurance do very poorly in this country. Without the support of my family, I would literally be living on the streets. Even with health insurance (I'm on Medicare) I've found it difficult to find adequate care in my region. The waiting lists can be very, very long. Some areas are much better than others.

You should speak with the medical personnel at his hospital to find out what programs are available that could help your father, and what his treatment plan should be.
posted by xyzzy at 4:49 PM on November 9, 2012 [1 favorite]

Since he is the hospital now contact the social worker on staff and get as much information and resources set up as you can. It sounds like he needs a caretaker and advocate and I worry that you feel obligated to be that person. If you do not currently have the (emotional/financial/temporal) resources to look after yourself AND full-time caretaking for an adult you cannot control then do not take on that role - instead of you saving a drowning man you will both go down. You must be very clear to all professionals you talk to that he has no support system once he leaves the hospital - they very much want to choose the easy path of least resistance and make him a family member's responsibility.

While he is in hospital he generally has access to more resources and often waiting lists are bypassed for in-patients as the hospital wants to discharge him into another setting (your mother should also be clear he cannot be discharged to her home or else she may have a lot of legal difficulty in extricating herself. Although it is unfortunate that your father is so unhealthy he is an adult and is responsible for his own self-care. I am so sorry you are going through this; the lack of medical and social care for the mentally ill is immoral.
posted by saucysault at 5:57 PM on November 9, 2012

Ask the hospital people about getting in touch with a social worker.
posted by rhizome at 5:58 PM on November 9, 2012

Mod note: This is a followup from the asker.

Thanks to all for the kind thoughts. My father was admitted to Mesilla Valley Hospital in Las Cruces last night, after three nights at the county hospital near my parents' home. If anyone has any particular knowledge of that facility they'd like to share, that'd be great.

Luckily for my own sanity and wellbeing, there's no question of me becoming his caregiver---the logistical issues are sufficient that the question of my ability to safely do so doesn't even enter. I'm not on the dock right in front of the drowning man, I'm on some observation deck across the lake.

saucysault: Can you expand on "she may have a lot of legal difficulty in extricating herself"? Are you referring to the general difficulty of removing someone from a home in which they are legally resident, or is there some other more specific issue here?

pickypicky: No vet status.

Again, thanks to all for their input. It's a damned shame that, between this thread, phone calls, and the google, it seems like my initial impression is right, but at least I checked it out.

posted by cortex (staff) at 3:48 PM on November 13, 2012

Yes, you had the right interpretation of what I meant. If he moves in with her she cannot just throw him out legally. And very few courts would force him out right away. I do not know if they own a home together or rent but usually it is legally easier to have both parties start over in new accommodations. I'm sorry, it is a tough situation to be in.
posted by saucysault at 6:22 AM on November 14, 2012