Op-ed: Michigan Medicine is one of the best, and can do better

Tuesday, September 17, 2019 - 2:41pm

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This July, the Michigan Medicine hospitals were ranked first in the state of Michigan and 11th in the country by U.S. News and World Report. As a recent University of Michigan graduate, this makes me incredibly proud. We call ourselves the Leaders and the Best, and it seems others continue to recognize our excellence on many fronts as well. However, these rankings also make me frustrated. If Michigan has one of the best hospital systems in the country, then why was my most recent experience at the hospital spending 22 hours in a chair while in a psychological crisis?

As an incredibly stressed-out undergraduate at the University and a resident of Ann Arbor until 2018, I was a frequent face at Psychiatric Emergency Services, almost always because of suicidal ideation. This specialty program behind the emergency room is meant to provide mental health crisis evaluations, treatment recommendations and screening for inpatient hospitalization. I’ve written before, in an effort to put a face to a psychiatric patient and reduce stigma, about how these countless PES visits and two hospitalizations helped stabilize my mental health. What I have written less about are some of the negative experiences that went along with being a patient.

To say I spent 22 hours in PES while already suicidal is not an exaggeration. I spent it sitting in an uncomfortable chair and had little contact with health professionals after the initial few hours of evaluation. The lights were constantly on, I was getting next to no sleep, and I was listening to House Hunters play on repeat until I felt so numb, I began begging to go home. This is not a unique experience. I’ve met and heard from countless others who spent similar spans of time, or longer — sometimes days — waiting in PES for a bed on a local inpatient unit, of which there is a nation-wide shortage. Doctors first and foremost take an oath to do no harm. How was this not harming my already fragile mental state? I could similarly talk of the time I was sent home from an inpatient stay with few resources besides a safety plan that I compliantly filled out without much else of a choice. I expressed with terror to my discharging nurse that I shouldn’t be sent home, only to almost attempt to take my life and end up back at PES a few hours later. 

Let me make this clear: I place little blame for my experiences on the doctors, nurses, social workers and other staff I interacted with at Michigan Medicine. They couldn’t conjure up more inpatient beds or create a more restful space in the PES waiting room. They were doing their best with the system, resources and training that existed. I do believe that their intentions were good, and at least most of them wanted the best for me. My point is that if Michigan is going to continue to lead as one of the best hospitals in the country, we need to lead in putting more resources into expanding and improving the quality of psychiatric services, and these changes need to be a priority. We need to expand and put beds in PES, so patients are not spending days waiting in a chair. We need to increase the number of inpatient psychiatric beds available, both statewide and nationally. We need to fortify discharge planning and resources, particularly for patients frequently going to PES, so others aren’t leaving feeling as lost as I did many times.

Michigan Medicine received national rankings (or high performing recognition for Rehabilitation) from U.S. World and News Report in every single department classified, except psychiatry. Michigan is eighth in urology, eighth in ophthalmology, 10th in pulmonology and lung surgery, 13th in cardiology and heart surgery, 15th in geriatrics and the list goes on to include every other department compared. However, psychiatry is “not ranked” on a national level. That is a disgrace to our well-known name on a national and worldwide stage. 

The Michigan Medicine website states that “this is the 27th consecutive year that Michigan Medicine has been nationally recognized for strong across-the-board performance.” Jeffrey Desmond, chief medical officer of Michigan Medicine, was quoted as saying, “Our priorities are providing the safest and highest quality of care to all our patients.” I can’t help but feel that a key field of medicine and a vulnerable sub-population of patients is missing or being forgotten in these statements.

At the end of the day, I am still a huge Michigan fan. I wear maize and blue with pride, cheer on the Wolverines on game days and look forward to visiting Ann Arbor again soon. I’m grateful for my time as a student there, though it was also filled with pain and difficult mental health issues. Importantly, I am doing much better now mentally, in part because of the staff I interacted with through Michigan Medicine. I love my alma mater, dearly, yet it’s because of this love that I want Michigan to do better. 

Morgan Rondinelli is a University of Michigan alum in Ecology and Evolutionary Biology. She is currently serving with AmeriCorps as a Mental Health First Aid Instructor.