An Insight into New Orleans’ Mental Health Facilities

By Nisha Kasturi

In February of 2021, 26-year old K.M. (we’ll use their initials to protect identity) voluntarily checked themselves into Ochsner Health’s psychiatric facility following a personal trauma and subsequent mental health breakdown. “I needed it to be in someone else’s hands”, K.M. told me. “I thought it would be better that way, that nothing else could be worse than what I was already going through. But I was wrong.”

At the time when K.M. walked into the hospital, they were in the midst of their mental health crisis, but that wasn’t enough to ignite a sense of urgency from the professionals around them. K.M. sat in a waiting room for over four hours before finally being told that because of an insurance issue as well as overcrowding, they were being transferred to a different facility over in Algiers. They were given a sedative for anxiety, told to fill out some forms- and that’s all K.M. recalls for approximately the next 24 hours.

“It’s a blur, from the time I was checked in and transported to- well, I think probably the next day- but I kind of remember, I was sleeping, and then they moved me with some other patients to a different facility”. 

The next thing K.M. recalls is being in a room at a new psychiatric facility, nauseous and hungry, with no information or contact from any of the doctors. Confused and disoriented, K.M. realized it had been over 24 hours since they’d been able to take their prescribed antipsychotics, of which there were 4 that they had been taking on a daily basis for the past year. K.D. walked up to the staff and asked to be given their medications, the prescriptions for which they had already disclosed to the medical staff upon initial arrival.

“And they told me ‘sorry, we’re not allowed to give you anything until the doctor sees you.’ And I was like- what do you mean, you can’t give them to me? They’re my prescribed medications. They’re heavy antipsychotics. Like, you can’t just pull me off of them against my will.’ But they refused. They wouldn’t even give me advil for the headache that I was having from my medication withdrawals.”

Staff told K.M. that despite their prescriptions and documented history of migraines, they could not give them any medication whatsoever until the doctor came in to see them. Withdrawal from K.M.’s antipsychotics was so physically exhaustive, they told me, that they spent the next few hours vomiting uncontrollably. “Finally, one of the volunteers felt so sorry for me that he actually snuck me two advil tablets. I couldn’t sleep. I just kept waiting and going up to the counter and begging them to let me talk to the doctor, and they just kept saying, ‘sorry, it’s not our call, he’ll be in as soon as he can’ ”. 

K.M. isn’t sure how long it was until the doctor finally came in to see them, but they recall not being able to sleep for at least 48 hours. When the doctor finally came in, K.M. was relieved: “I brought myself in because I thought a doctor could help me figure out the next steps and recommend to me what to do. Yeah, I don’t have the best insurance, but there has to be options even for people with Medicaid, right? Nope, wrong.” 

The doctor came in, asked K.M. a few standard questions about suicidal ideation, and left. Frustrated, K.M. went back to the counter and asked if they could have their medications now, to which they were told that they could have some of their antipsychotics, but that they were also being prescribed a new set of medications. “And I was like, forget this. I didn’t come here so you could mess up my entire system. You can’t withhold my medication from me and tell me I have to take something completely different. I want out.”

That was when K.M. found out that they couldn’t leave- not yet, anyway. Remember those forms K.M. filled out back when they had been given a sedative and not yet transported to the next facility? Turns out, those forms stated that the facility could hold K.M. for as long as they deemed necessary, even though they had checked themselves in voluntarily. K.M. says they never would have signed papers to that effect, but they had been sleep-deprived and sedated when those papers were given to them, and they had no idea what agreements they contained. “If I had been in my right mind, I would have never signed those papers and chosen to give away my autonomy. I walked in there of my own volition and I wanted to be able to leave the same way. They slapped those papers in my hands after I’d been sedated and could barely keep my eyes open. It’s heinous, is what it is.”

The next two weeks to follow had the exact opposite effect on K.M. than what they had intended when they voluntarily checked themselves into the psychiatric ward in the first place. “It was hell”, they told me, “plain and simple. No therapy, no continued doctor check-ins, nothing but like an hour of T.V. time and weekly permission to make a 20-minute phone call. There was virtually nothing done to actually improve my mental health state, other than shoving medications down my throat that I didn’t even really know what they were. But every time I complained about that, I got the same freaking run-around answer- ‘sorry, not my call!’ ‘sorry, you signed papers to this effect!’ ‘sorry, nothing we can do!’ “ The medications given to K.M. completely destroyed their appetite, and the more rapid weight loss they underwent, the more the doctors insisted that K.M. was not yet ready to be released. “I would try to eat whatever they were passing off as food that day and it was so inedible it would come right back up. And I couldn’t put on any weight, and because of that they told me that I wasn’t emotionally healthy enough to leave yet, no matter how much I begged to go.” That same orderly who provided K.M. the advil eventually snuck in a few pizzas for K.M. and some other patients who were having the same issue. 

It’s a tale that, unfortunately, isn’t all too uncommon to hear in the New Orleans area. In fact, Mordecai Potash, a Professor of Clinical Psychology at Tulane University, described the situation in mental health care in New Orleans after Hurricane Katrina as a “crisis”. More concerning still, in 2004 – the year before the devastating storm- the United Health Foundation had already ranked Louisiana’s health care system 50th.  Perhaps most egregious of all these facts and figures is the fact that Louisiana citizens, even today, are the most in need of quality mental health care: Louisiana has the second highest rate of adults with frequent mental distress, according to 2020 CDC figures. 

From these metrics alone, it’s no surprise that K.M. wasn’t alone in their frustrations with the shortcomings of New Orleans’ mental health facilities. They pointed me by way of a woman under the pseudonym ‘Miss B.’, a mid-40s patient in the Algiers facility at the same time as K.M. Miss B. had a lot to say- not only about the “prison-style” conditions that “made you feel like struggling mentally was a crime as bad as murder”, but about the lack of access to the proper tools to take care of oneself at the most basic of levels. “I don’t think I’m the only person who believes that if you look good, you feel good. If the goal is to improve my mental health, then tell me why I’m not allowed to take care of myself?” Miss B. prompted. 

During Miss B’s time at the facility, she was constantly struggling to take care of her hair. The hospital didn’t provide her with the basic hair-care products or tools needed for her hair type, and she described it as a “miserable feeling.. You could feel the filth on your body and you couldn’t do a thing about it”. Unalone in her dissatisfaction, she eventually took to helping other black female patients manage their hair, offering to braid others’ hair when she could during T.V. time “so at least it feels a bit more manageable”. K.M. told me Miss B. even helped them with their hair once, as the products given to patients were such poor quality they wouldn’t even work for K.M.’s much flatter and thinner hair. 

“It got me thinking, honestly. Maybe that was the only good thing to come out of the whole experience, was that it got me thinking”, K.M. reflected to me. “I think out of all the patients I was with, it was just me and one other girl that were white. Everyone else was Black. So why were there no proper hair-care products for the majority of the population the hospital was serving?” 

When K.M. was finally able to leave the psychiatric facility, they told me that they had never been more relieved, but that the experience had done nothing to help alleviate the problems that had brought them to the facility in the first place. All they know, they told me, is that they’d rather lean on family and friends than ever go back there for “so-called professional help”. In the end, all the system had to say in response: “sorry, it’s not my call”.