The Stigma in Our Health Care System

MAY. 31, 2017

By Kathryn van Roosendaal


I was in the hospital for seven days this past March—and it never happened.

I’m 45 years old, and I live with schizophrenia. To be specific, I have schizoaffective disorder combined with clinical depression and generalized anxiety disorder. I work very hard to stay as stable as I can. I take my medications despite a paranoia about pills being poison. I keep my appointments with my psychiatrist, my therapist and my general practitioner. On good days, I can drive and meet someone for coffee. On bad days, it is an accomplishment just to get dressed and feed myself. If I’m lucky, I have more good days than bad. If I’m not, I have very bad days.

I was having a bad day and one of my stronger delusions started to take over. I recognized that it was getting too bad for me to handle and my mom got me to the ER just in time for it to blow up into full psychosis. I took emergency medications to calm me down, and then I was admitted to the Behavioral Medicine Department.

This is where I disappear.

You see, the Behavioral Medicine Department (B-Med for short) is really a short-stay psychiatric lockdown ward. And you are invisible to the outside world when inside. No one—not even doctors—can call in or even know you’re there unless they have a code. It is an isolated bubble designed to keep patients calm and get them the specific treatment they need. It really does work, and I left a week later with my medications tweaked and my mind back under my control.

A few weeks later, I had an appointment with my general practitioner. He had no record of the medication change—which was strange. I mentioned that my anxiety was still up after the hospital stay, and he had no idea what I was talking about. He checked my patient records and all it said was “ER visit.”

I mentioned that my stay had been in B-Med and he just nodded. Psychiatric hospital stays, he said, are never put in general patient records. B-Med records are separate from all other medical records, and he had no access. Further, he wasn’t allowed to add anything about it to his record, even though we were talking about it in our visit.

Let’s think about that for a moment: My general practitioner has no access to my psychiatric treatment records. During Mental Health Month, there’s always a lot of talk about breaking the stigma surrounding mental illness. Well, it seems like we’ve still got a long way to go. If doctors can’t even talk about mental illness to other doctors, how are we going to talk about it in public? How are we ever going to get integrated health care if my hospital visit essentially never happened?

I have schizophrenia. I want all my health care providers to know that. And so should anyone else with a mental illness.


Kathryn van Roosendaal is a former newspaper and magazine writer and editor. She now maintains a blog and a Facebook page dedicated to breaking the stigma surrounding mental illness by sharing her own experiences of living with schizophrenia and depression. She can be found at and


SEP, 20, 2017 10:10:24 AM
I was recently in the psychiatric unit for severe depression and suicidal ideation. Just got out Monday (yesterday). In addition to lack of communication, I feel us mentally ill patients are stigmatized by the hospital staff. I felt unsafe and unwelcome the whole time as an inpatient. My attending physician labeled me a drug seeker from the start and complained about be "being in the hospital too much" accusing me of "not helping myself." I have been attending therapy since I was eight and rarely miss a session, always calling if I need to rescedule. I have been taking meds since I was 12, always compliant because I wish to get better. I engage in using all the coping skills I can and am eager to learn more. When poor physician staff manages the unit, their prejudiced attitudes trickle down. It did not help that I was born with XX chromosones and the staff let the male patients (usually recovering drug/ETOH addicts) bully the female patients, and then react defensively when we report said bullying. Change needs to start from the top. I can only do so much to fend for myself. I am ill, not a troublemaker. Treat me like a patient, not a fly you want to swat.

JUL, 31, 2017 10:46:58 AM
Nancy Morgan
My 47 year old daughter has a Dx of Schizoaffective.Disorder for many years having been on different combinations of medications but never behavior therapy. I am now realizing in order to have some progress in treatment you can not have one with the other.

JUN, 10, 2017 03:48:48 PM
Hazel B
Would a medical alert bracelet help? I wonder if we can provide our own access and undated details like the info I add to my personal ICE info on my phone.

JUN, 06, 2017 08:18:30 AM
Dawn Lillard
Yes, if we want to de-stigmatize mental health AND substance use disorders, we must end the secretiveness, especially within the health care world. I am not saying that the total record needs to be shared but certainly diagnosis and medications and aftercare plan should be shared with all who are treating a particular patient. We insist on that with other physcial illnesses, and isn't brain disease a physical illness?

JUN, 05, 2017 02:20:53 PM
Our daughter is going through this now , very disturbing, for her and all of her family, just need her out of there to get her mind back to normal,

JUN, 02, 2017 08:29:39 PM
I've wondered the same thing. Yes, all it does is promote the stigma. I never asked for privacy because of my treatment.
Makes me doubt myself - am I ill, or am I a whiner? It's not healthy for me to doubt myself like that.

JUN, 02, 2017 06:46:58 PM
I agree with most of this on a personal level, but I think it should ultimately be the choice of the patient whether or not to disclose mental health records. I disagree with the statement "And so should anyone else with a mental illness." I would support education for patients on benefits of sharing mental health records, but I would never tell them they "should" want what I want.

JUN, 01, 2017 08:23:53 PM
My son has schizoaffective disorder also and I am also a nurse and you are right, psych hospitalizations are locked and often the diagnosis is not even on the patient's list of diagnosis which is scary because in an emergency treatment situation, medical personnel don't have the info they need. Hopefully with increased awareness this will change. There are more and more of us in the medical system pushing for this change but unfortunately change doesn't happen fast.

MAY, 31, 2017 10:07:07 PM
Dear Kathryn:
Thanks for you post. You made me think..what's the mystery around B-Med ? I'll do some research !

MAY, 31, 2017 06:41:53 PM
Great point - good to know that !!!!

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