the harsh reality

America is a country of individuals. There is little sense of a collective identity.  Yes we are "proud to be an American" ad nauseum, but it is more a feeling of proud to be an individual American.  Its no accident there are more guns here than in any other country in the world. Its to protect us from our fear of each other.

Americans are supposed to be strong, personally responsible, able to take care of themselves and their families. If we can't do that we are considered weak, somehow defective. Whiners. Loafers.

With all that in mind, the mentally ill are considered defective. We fear them. We loathe them. We expect them to just get it together, snap out of it. Hey life is tough for all of us, buck up. So they are treated as what they are: outcasts. We pretend we care, but not really.

Having worked in the ER a long time, I have seen a big increase in mental health patients in recent years.
. It is common to have 5 or 6 at any given time. There are more and more adolescent psych patients. These days they spends hours, sometimes days in the ER.  There is a shortage of beds and psychiatrists.

They spend hours in bare rooms, stripped of the usual ER clutter, due to concern for their, and the staffs, safety.They are placed in special clothing, all of their possessions taken.  They stare at walls for hours. Most are suicidal, others are psychotic, hallucinating.  Little attention is paid to them in a busy ER. The patients with physical problems take priority.

Many times there are no beds at the hospital they have chosen to come to. Sometimes beds can be arranged at other local hospitals.  Sometimes they are sent hundreds of miles away to outstate hospitals, far from their home and family. In the last few years, commonly, there is no where to go.  They sit for hours, days waiting for a bed to open up.

So imagine this: You are psychotic, perhaps bi polar or schizophrenic. You sit on an ER cart for hours, occasionally being given a meal, being watched by a camera or security.  You are hallucinating. You are alone. Your family ain't coming. Eventually, you lose it. You get out of control, shouting, perhaps threatening. Maybe you will be restrained. You will most definitely be sedated.  You are now in a stupor, no longer a problem.

Like an animal, you are tranquilized because in the end, we don't really care.  Its easier for us when you are quiet.  We don't want to deal with you anyway, as a society or an ER.