Have there been problems with the mental health system?
Yes. The same problems with the overall health system, with the added stigma of mental illness and accompanying funding issues. Also, due to the nature of mental illness, those who are sickest lack the self-awareness to realize how much they need help and, due to abuses in the past and laws made to rectify that, it is very very difficult to force an adult into treatment before they've become an immediate threat to themselves or others. A lot of the people in our prisons and homeless shelters would be better off in a mental hospital, but those were closed back in the 80's. Law enforcement gets involved in many cases because either a crime is committed or the patient is causing harm to someone or themselves and the EMTs aren't trained to restrain (or even allowed to defend themselves). When I was riding ambulances, I saw my share of mental health calls. In one case, the patient knew he was falling apart, called 911, and asked the cop to cuff him because he knew he'd get violent. It's not necessarily standard procedure to apply cuffs when someone's going in willingly, but since he asked, the cop complied. I'm glad the patient asked. I'm glad the cop complied. I'm also glad that, when the cops cuffed someone, they'd ride in the back with us medics. I'm glad because, while we were on our way in, the patient did get violent. He thrashed around, screaming. He was big and burly. The back of an ambulance is small. I wasn't allowed to defend myself and I had nowhere to hide. Furthermore, the cabinets were glass and metal - imagine what your hand would look like after putting your fist through it. Never mind what could happen when someone goes berserk with in an enclosed space with heavy oxygen bottles at hand and other large, blunt objects. But, as I mentioned, he was restrained. And I felt rather sorry for him, really, because he had been taking his meds and he had been attending his therapy and he was coming undone anyway. This was after an ice storm, he'd been without power for a week, and he'd just found out his 12 year-old son had bi-polar disorder. I guess the stress was just too much.