Restaurants Must Serve Mentally Ill Diners

Diner abandoned

If you’re anything like me, and I hope for your sake and the sake of your children that you are not, you’ve wrestled with your mental illness secure in the certainty that society cared about you only to the extent that it fervently wished you would excuse yourself from the room and be scarce in the way voles are scarce; that is to say, demonstrate your respect for “nice” people by remaining invisible to them.

Frankly, there is something soothing about looking at the ladder which leads up and up to society’s golden promises only to realize that the first few rungs of yours have been sawed in half and you won’t even have a chance to fall off, much less climb. Soothing because, in life, it is comforting to know where one stands, or, as is the case here, doesn’t stand.

If you aren’t shocked and surprised by every disrespectful snub and injustice, you cannot be disappointed and consequently, will harbor no resentment. (To put it differently, it is the illusion of a just world that causes heartache, not the sting of an unjust one.)

Having said all this, I will admit to slight pangs of bitter jealousy as I watched the PC-Police catch up with one social inequity after another, leveling the scales by means of bare-knuckled intervention and, in some cases, even legislation. The foot in the door arrived when restaurants were divided into Smoking Sections and Non-Smoking Sections.

Suddenly, non-smokers, who up to that point had languished in a social lagoon reserved for the insufferably sanctimonious and self-righteous, were accepted and treated, albeit begrudgingly, like regular members of society.

Curb cuts, aisles wide enough for Buicks, much less wheelchairs, and ATM keypads in Braille followed soon thereafter until it seemed like everyone, everyone, had been accommodated – everyone but us, that is.

That is why I am so happy to report that, starting in September of this year, all restaurants will be required by law to provide designated areas reserved exclusively for the mentally ill. There will be booster chairs for anyone suffering from low self-esteem and, instead of asking if a dish was satisfactory, wait-staff will always inquire, “How did that make you feel?” Other compensatory features will be discussed as details become available.

How Managed Care Is Changing Mental Health

Gin Lane Hogarth

Those with an interest in the history of American medicine will recall how the delivery infrastructure has evolved through the years, from careless care to poorly managed care to mismanaged care to the paradigm currently in vogue, managed care.

Seems simple enough, and yet, there are as many definitions for managed care as there are for quincunx, so let’s cut through the clutter and have a look at what it actually means, especially in a mental illness/mental health context.

Historically, care could only be denied on a case-by-case basis, which was very time consuming for care providers. Insurance companies struggled with tremendous overhead because it was necessary for them to maintain large departments staffed by professionals skilled at denying claims one at a time.

Then, in the 1980’s, computer technology changed all that when the first integrated health networks were formed. These sophisticated health delivery systems linked hospitals, physician practices, labs, rehab facilities and other participants with insurance providers creating a vertically integrated continuum of care! For the first time, all members of the healthcare delivery infrastructure were able to communicate on-line real-time, sharing vital patient information and updating the data pool on an ongoing basis.

Suddenly the healthcare denial process was brought into the digital age, and with it, a whole new level of care inaccessibility. For the first time in many years, health insurance companies were able to offer a truly inspiring panoply of mental health care options since they could be certain there was no chance they would be delivering them.

Muckrakers, malcontents, and professional whiners complained about this, calling managed care a “devious, disingenuous, deleterious, dastardly dupe designed to fatten the pockets of capitalist bloodsuckers by draining the life from unsuspecting hod carriers.” Managed Care industry spokesman Reginald Entwhistle responded thusly.

“The human body is an astonishing mechanism. Chief among its virtues is the ability to heal itself. Indeed, as that government which governs least governs best, so that healthcare delivery system that heals least heals best. Now, specifically how does this work? Let’s start with a real life example.

“You are overcome with an attack of Munchausen By Proxy. Panic stricken you hop a cab to Holy Guacamole Hospital where you are denied admission because, thanks to access to your Online Medical Record, it is revealed that your plan, Criss-Cross of America, only covers regular Munchausen’s – without Proxy.

“They refer you to Whassamatta U., (a teaching hospital), which sometimes takes on psychiatric cases pro bono as long as patients don’t mind participating in studies.

“On the long cab ride across town you have plenty of time for your body’s natural healing process to take place and you arrive at Whassamatta U fit as a fiddle, sound as a dollar, strong as an ox, and healthy as a horse. With luck, your insurance company picks up 85% of the cab ride, after you have met your deductible.

“Elegant in its simplicity and made possible by the magic of computers!”