Emergency crisis intervention/mental health services for a Japanese citizen in NYC
March 30, 2011 1:49 PM   Subscribe

Are there any emergency crisis intervention/mental health services for a citizen of Japan with mental health issues whose family has been missing since the earthquake?

Much longer background:
a long-term girlfriend (I’ll call her Doris) of a close friend of ours (I’ll call him Chris) is from Japan. When Chris and Doris first started dating about 6 years ago, she was living in Brooklyn and supporting herself by writing articles about the NYC music and cultural scenes for a newspaper published in Japan. She’s a sweet person but the more time I spent around her, the more I suspected she was dealing with some extreme mental health issues which often manifested as an unhealthy preoccupation with her weight, my weight, and how much she ate. She’s convinced she’s fat (she’s not overweight) and I suspected some sort of body dysmorphia and/or bulimia.

Not being privy to their relationship, I was hesitant to bring my concerns up with Chris unasked because it was fully conjecture on my part, and I felt the opportunity to discuss my concerns directly with her would present itself at some point if she seemed in any way to be reaching out for help.

Flash forward a few years- she began to come out and socialize less and less and I fell out of contact with her. This year Chris’s mom fell ill and he moved back to the family home on Staten Island to care for her and his younger 40 year old brother who has a host of mental issues as well (and is on disability). Doris had been having ongoing drama with her landlord, so Chris and she discussed moving in together. Doris doesn’t drive, and Chris works long freelance hours doing manual labor in the city, so Doris became somewhat of a recluse when Chris was not at home.

Some months ago Chris’s mom died, leaving Chris’s brother in a tailspin where he lapsed into his old pattern of self-medicating before being ordered back into treatment by the courts. Meanwhile in the same house, Doris became more and more cut off from the outside world, and her behavior (according to Chris and his brother) was becoming stranger and stranger, enough so that Chris’s brother decided he could no longer stand to be in the same room with her and started retreating to one side of the house and never venturing out into common areas. He told Chris that Doris had to leave since he'd become a prisoner in his own home.

A couple of months ago, just before Chris left for a month-long music gig out of the country, Doris stopped getting her writing assignments done on time. She blamed Chris for not providing her with a quiet enough room to write in and and environment that was conducive to her being able to think clearly. Eventually she was fired.
While Chris was away he and Doris talked on skype a few times, during these conversations Doris blamed Chris for her inability to concentrate and for causing her to lose her only source of income. Chris was incredibly hurt and decided that:

a. Doris needed to move out, for her own sanity and for the sanity of his brother and himself

b. Doris needed a support system and psychiatric treatment above and beyond what he could provide (Doris has no close friends in NYC)

c. The best option for Doris would probably be to return to her family in Japan where she could get adequate mental health counseling, be around people who could monitor her mental state and who love her, be able to have a settled place to stay until she found a job, and have a better chance at finding a job in Japan than she would in NYC.

After a discussion when Chris returned, it was decided that he would save up a bit more money over the next two weeks and then purchase a plane ticket back to Japan for her.

A few days later the Earthquake hit.

Doris’s family did not live in the areas hardest hit, so at first her inability to reach her family to let them know she was coming home seemed to be due to the various documented problems with communication systems going down due to infrastructure damage. As the days passed and she was still unable to make contact, she grew more and more frantic. Two days ago she was notified that her nieces and nephews died when a building collapsed. Yesterday she was notified that her parents and sibling/s are missing and are thought to have perished in the same way, although their bodies have not been found.

It turns out that Doris’s mom had been sending Doris whatever medication she is supposed to be taking to stay balanced. That medication (I’m not sure what it is or what Doris has been diagnosed with) is running out. Neither Chris nor Doris have health insurance, and Chris is barely scraping by. Doris needs lots of trained help right now in the form of grief counseling, mental health counseling, and medication.

What resources if any exist for someone with Doris’s background and in her situation? Is there any sort of crisis intervention/ therapeutic intervention resources available to her through the Japanese relief organizations? Also, are there any social services organizations that can help find her a place to live within the next few weeks if she can’t return to Japan, or is returning to Japan as soon as possible, even if she has no place to live when she gets there, still the best option for her to finally get the professional help she needs?

I apologize for the length of this question. I'm concerned that Doris may try to hurt herself given all of the trauma and turmoil in her life right now, and I'm concerned that Chris and his brother are hurtling toward nervous breakdowns. Any leads that I can pass on to either Doris or Chris would be very much appreciated.
posted by stagewhisper to Human Relations (7 answers total) 1 user marked this as a favorite
If Doris' language skills are fine, I'd get the mental health issues addressed right away in NYC without worrying about her background. For Japan-specific help, have you tried talking to someone from a Japansese organization like the Japanese American Association of NY? They likely have many members in similar situations (family members missing).
posted by benzenedream at 2:33 PM on March 30, 2011

Best answer: Call 1-800-Lifenet. If they think she needs crisis intervention, they can send a mobile crisis team to her home to assess her. If they don't think she needs that level of intervention right now, they can refer you to places she can contact for out-patient treatment. If she's uninsured, she will probably end up at an HHC hospital or community mental health clinic.

I am not aware of any social services organization that can find housing in a few weeks, but there may be resources available to her through Japanese community groups.
posted by Mavri at 2:48 PM on March 30, 2011

I read this quote recently: serve humanity so that people will feel we are kind to them. Doris needs someone to be kind to her right now. I don't think calling the mental health SWAT team is a good idea at all. They will likely institutionalize her, force medicate her, and she will have a difficult time ever getting out. Could you talk to her? Let her know you're concerned?
posted by Ventre Mou at 3:44 PM on March 30, 2011

The OP does need to know that mobile crisis can hospitalize her involuntarily if they determine that she is a danger to herself. OP may think that is a good thing or a bad thing. As for having a difficult time "ever getting out," that is incredibly unlikely. Involuntary psychiatric hospitalizations are for acute, life-threatening conditions. As soon as a person is stabilized, they're out the door. In my experience, in NYC, this can be days, a couple of weeks, but rarely longer. Long-term (months, years) psychiatric hospitalizations are very rare post-deinstitutionalization. I have had extremely ill clients assessed by mobile crisis teams (not at my request) who were not hospitalized by the team. Really, if this person might hurt herself, she needs to be assessed by experts. If she's not a danger to herself, she needs referrals to places that can help her.
posted by Mavri at 4:57 PM on March 30, 2011 [1 favorite]

and she will have a difficult time ever getting out

Yeah, this is just plain not true. Most states have laws that a person can only be involuntarily hospitalized for a specified period of time--in CA it's a 72 hour hold, for example. Here is actual information on the rights of a person in inpatient treatment in New York: http://www.omh.state.ny.us/omhweb/patientrights/inpatient_rts.htm, in case someone reads this thread and needs to know what might actually occur if a person is hospitalized in order to protect them from harming themselves. Because blatant misinformation like "omg they might never get out" could lead to someone being dead.
posted by so_gracefully at 11:27 PM on March 30, 2011

I worked in state psych hospitals in NYC as a legal advocate. It is the case that people who are found to be a danger to themselves or others can be and usually are force medicated for long periods of time, in spite of protective legal precedent (Rivers v. Katz). Under a newish law, psych patients can also be subjected to Assisted Outpatient Treatment, AOT, after release from the hospital. AOT means a state employee visits you at home and ensures that you take your medication. Once a state doctor confirms that a person is a danger, it is difficult to be free from court-mandated psych treatment. In NY, rights of individuals with mental health issues and little or no money or support are pretty badly trampled. Please consider this before asking the State to help her.
posted by Ventre Mou at 3:29 PM on March 31, 2011

Response by poster: Thank you everyone, I have passed all of the the information and links on to them, along with the cautionary tales and the link to patient's rights that have been provided. Knowing that there might be some help out there is a huge relief for all involved.
posted by stagewhisper at 4:08 PM on April 1, 2011

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