When hospitals release seriously mentally ill patients too soon without outpatient follow-up, the patients can end up homeless, jailed, harming others, or even dead. When patients are deemed suitable for inpatient care, they can languish for weeks in hospital emergency departments before placements become available. Meanwhile, patients who fake the need for care are smoothly and swiftly moved to inpatient settings. Breakdown opens a dialogue with anyone interested in improving the system of care for the seriously mentally ill population. This book helps to answer questions such as:
Using vignettes based on real interactions with patients, their families, police officers, and other mental health providers, Lynn Nanos shares her passion for helping this population. With more than twenty years of professional experience in the mental health field, her deep interest in helping people who don’t know how to request help is evident to readers.
Breakdown uses objective and dramatic accounts from the psychiatric trenches to appeal for simple and common-sense solutions to reform our dysfunctional system. This book will benefit anyone interested in seeing a glimpse of the broken mental health system way beyond the classroom. It can guide legislative officials, family members, mental health professionals, and law enforcement officers toward a better understanding of the system.
GUEST: Where was your favorite spot to work on the book?
LYNN: In a very comfortable chair in front of a large computer screen, with plenty of coffee and water.
GUEST: What inspired you to write the book?
LYNN: I had done mental health advocacy work on a national scale for years and was very inspired by stories of family members of the seriously ill. Their stories motivated me to try harder at what I do, and I didn’t feel that my employment was enough of a difference in the world, and had come across so many dramatic shocking stories that all of a sudden it dawned on me that the world has to know these stories. They’re so shocking that very few people are aware of the population and what they struggle with.
GUEST: How long did you work on your book every day?
LYNN: Well most of the work was done on the weekends because my employment is Monday to Friday. I decided to write the book in December of 2016. I gave up most of my hobbies. I found it a love of labor. It might sound odd to some people, who, as my brother said, you know most people - they want to forget about work when they go home - they don’t want to do work. But I have felt so passionate about caring for the sickest of the sick, that it was something that I truly loved doing.
GUEST: Does your boss know about your book and how will it impact your career?
LYNN: The bosses are aware of the book. They are aware that it’s controversial. It’s controversial because it requests a revision of the current commitment laws. It also gets into detail about the rights of patients and whether patients have the right to be psychotic. A lot of administrative staff, and even clinicians, often say that they cannot help this population because they have the right to be psychotic and do bizarre things, and that the civil commitment law should only be enforced if someone is about to imminently die. But the problem with that is it’s not a preventative approach and there have been many instances, including two that I detail in this book, in which people have been killed because of the poor laws..the lack of laws that exist. How will it impact my career? I still have a job. Let’s put it that way.
GUEST: If you ever got distracted, how did you get back to work?
LYNN: Well I’ve always been very good at organizing myself and prioritizing, and when I was at a point where it was just too much for me, and I felt too tired, I watched a funny show on TV to get my mind off of it, and then returned to work.
GUEST: What was your favorite part of the process, and least favorite part?
LYNN: My favorite part was running into technological difficulties (everyone laughs). My favorite part was writing the case vignettes and doing the research. My least favorite part was making sure that all the citations - all the references at the back of the book - there are approximately 350 of them, were good - that was very painful to do. I also found waiting for other people - for example waiting for the formatting professionals to come through, waiting for the illustrator to finish, prompting him to ensure that the illustration is perfect. So depending on other people was the hardest.
GUEST: What advice would you have to anyone who is interested in publishing a book, given now that you’ve gone through it?
LYNN: Being organized is critical. I don’t believe that anyone who’s disorganized, unless they have billions of dollars and can hire someone to do it for them - I don’t believe it’s possible to do it without being very organized and disciplined, and truly wanting to do it is a key factor.
GUEST: Why did you want to become a social worker?
LYNN: The key difference between being a psychologist and a social worker is that psychology is more narrow and considers more what’s going on in the person, whereas social workers consider a wide variety of factors when deciding what kind of treatment someone needs. I found because I have a broad interest in a variety of social sciences, that that suited me better. I found that the variety of social work settings are immense. And I like helping people.
GUEST: Was writing this book a challenge?
LYNN: Yes, it was a huge challenge. Again, I found it a labor of love. That means that, although it was difficult, I felt very rewarded every step of the way. It was certainly a chore and a lot of frustration in the process - for example, when I ran into technological problems.
GUEST (psychologist): I wanted to say that, it takes a lot of courage to do what you just did - especially while you’re still a young career person actively working in the very field and trying to illicit a change in the system that can feel larger than life on a day to day basis, and sometimes thankless, although very rewarding career. So thank you for sharing this with society and I hope it benefits it.
LYNN: Thank you.