Waiting for patients begins after mental health crisis ends | Local news

Hernandez returned to his mother's home in Santa Fe and was placed on a waiting list.

Lovejoy said it took about four months before she was finally assigned a therapist last fall. By that time, it was already four days late.

Hernandez, who loved dancing, makeup, punk music and the rock band Black Veil Brides, died on October 6 of an overdose of methamphetamine and fentanyl at her mother's home.

now Lovejoy, 47 and the mother of three children, including Hernandez's twin brother and a younger son and daughter, still has an altar stacked with photos, gifts and memorabilia in her living room. has been done. Whether someone could have done something to save her daughter.

“I think if we had more resources and a little more prevention-oriented culture here, we would be in a different space,” she said.

Hernandez is facing what behavioral health experts describe as a frightening gap in services, a common scenario in an overwhelmed system with too few resources, leaving countless New Mexicans stuck in a kind of post-crisis waiting list purgatory. He is one of the residents of the state. State leaders and health care providers say advances in behavioral health are primarily focused on developing crisis care and increasing the number of health care providers. However, lack of migration resources remains a major problem.

“People finish one program and then are put on a waiting list for follow-up, and they don't understand,” said state Rep. Jerry Ortiz y Pino, an Albuquerque Democrat who has advocated for behavioral health reform. says the senator. “We’re just playing whack-a-mole.”

Lovejoy said she doesn't know if her daughter would have been saved had she received treatment sooner. After all, she had been seeking help for Hernandez for nearly a decade as her addiction and mental health issues snowballed.

Last year, Lovejoy said Hernandez seemed ready for a change.

Lupe Sanchez, residential services manager at Santa Fe Recovery Center, said she sees the disparity in services impacting many of her clients who come for detox and short-term residential programs.

“That's 1000% true,” she said. “We deal with people who have a lot of behavioral health issues. … As soon as they leave the house, it's like, 'Where are you going?'”

Betty Cisneros Schober, president of the National Alliance on Mental Illness in Santa Fe, said New Mexico's shortage of health care providers is often evident when patients try to make their first appointment with a therapist. He said it would be.

“Many people say they wait weeks to get evaluated,” Cisneros-Shober said. “Where our system breaks down is the subsequent care needed to keep people stable.”

Hernandez's path through New Mexico's behavioral health system seemed haphazard to Lovejoy, due to both gaps in service and her daughter's own mental health and choices.

Lovejoy said her daughter started using drugs in high school. First marijuana, then stronger drugs. As a student at the New Mexico School of the Arts, Hernandez struggled with anxiety, depression, body dysmorphic disorder, and conditions known as eating disorders.

Her mental health issues “seemed to make it increasingly difficult for her to enjoy the things she wanted to do,” Lovejoy said.

Hernandez met with two counselors at the school before dropping out at the end of his junior year. She was seeing a psychiatrist for a while, but that doctor changed jobs.

“So we lost that care,” Lovejoy said. “She just decided not to see another psychiatrist. … She was at a loss.”

Cisneros-Shober said she regularly hears about people falling off a stable path when they lose access to a therapist.

“one time [patients] “They feel safe and trust their provider. It's very difficult for them to move on to another provider. They have to tell their whole story again, which can be very traumatic. Some people do,” she said.

Lovejoy was a single mother on Medicaid at the time, and navigating the system was a major struggle, she said. Then, as other children began counseling, the out-of-pocket costs began to mount.

Lovejoy said that when Hernandez was 16 or 17, she intended to take Hernandez to a rehabilitation program in Pennsylvania, where Lovejoy is from. When Ms. Hernandez learned of her plan, she ran away from home and began sleeping on her friend's couch.

“I felt pretty helpless,” Lovejoy said. “Especially during the high school years…when your child doesn't want to go, when they don't even know who they are or what they want to do, you know you can't help them recover.”

Over the next few years, Ms. Hernandez sometimes stayed with friends and sometimes with her mother. She spent time in a transitional living program and was working well. But Lovejoy said she was devastated when her most recent ex-boyfriend died by suicide in February 2021.

Hernandez got back together with another ex-boyfriend and things started going downhill again.

At one point, she went to her mother and twin brother and told them she was using fentanyl and wanted Suboxone treatment. One clinic required patients to arrive early in the morning, and Hernandez's car sometimes didn't have enough gas. At another clinic, Suboxone was only available for a short time.

By January 2023, Hernandez and her boyfriend were living on the street, sleeping in their cars. She was arrested twice last year, once in Santa Fe and once in Albuquerque.

That seems like a tipping point, Lovejoy said.

“I think she was a little tired of her life,” she said.

Hernandez attended a 30-day program at the Santa Fe Recovery Center. She relapsed a few days after her retirement, and then she returned to duty again for 30 days. She was accepted into the center's 90-day program and left after completing about two-thirds of the program.

Lovejoy said she had become sober by then, but had not yet addressed the “underlying trauma” and mental illness that her mother believed were contributing factors to her addiction. Lovejoy said Hernandez believed she had an undiagnosed mood disorder in addition to her other mental health conditions.

While at the Santa Fe Recovery Center, Hernandez wrote down triggers and signs that could put him at risk for relapse, Lovejoy said.

“She was supposed to go over these lists with my brother and I,” Lovejoy said, adding that if Hernandez had completed his final recovery program, she would have gone over the lists with them. “We've never had that conversation.”

For many mental and behavioral health patients in New Mexico, the only alternative to treatment waiting lists is to turn to crisis care providers. The role of crisis management providers has expanded to include transition services in some cases.

Kate Field, director of crisis services at the Santa Fe Crisis Triage Center in Santa Fe County's Lasala Center, said the center's therapists are working to prevent patients from languishing on waiting lists that can be months long. He said he sees patients multiple times on a regular basis.

“The problem with the 'one and done' philosophy of a series of crises is that these people haven't been served for years,” Field said, adding, “'Now that we're in touch, the problem is over. It's not an easy process to say, 'We've solved it.' . “…If they're not stable, we're not going to discharge them. ”

Navigating waitlists through the labyrinth of available resources and eligibility rules can be confusing.

In addition to increasing the number of mental health providers, Ortiz y Pino said the state needs to develop ways to help patients find their way through the network of care.

“What we really need is a comprehensive system that can provide really good care for people treated in residential care, even after they leave the hospital. [through] “Follow-up 12-step programs, counseling opportunities, support services, navigators to connect you with the right resources. All of those things are desperately needed,” he said.

Housing is often cited as another missing piece of the puzzle.

Nami regularly receives calls from families looking for a place to go when their loved one is released from a hospital or prison, Cisneros Shober said. After a person has a mental breakdown or crisis, their behavior may prevent them from returning home.

Also, after a crisis, people may realize that their home environment is not healthy and find themselves in another crisis, she said.

“We don't have the housing to get people out of hospitals and prisons and into safe places until they can get permanent housing,” Cisneros-Shober said. “That’s really lacking in our state.”

Now, Lovejoy is trying to move on, taking care of herself and her other children.

Days after Hernandez's death, his mother was dissuaded when she received a text message informing her that Hernandez had been assigned a therapist. But so are all the texts and calls she still receives about her daughter. He received a recent call from the Albuquerque district attorney's office, which did not know of Hernandez's death.

“Things like that make you sick, especially for me who understand that my daughter is probably going through a hard time and hasn't told anyone,” Ms. Lovejoy said.

She also thinks Hernandez might have had an easier time staying sober if drugs weren't so easy to find.

“I feel like we're not really doing enough to curb what feels like a pervasive drug abuse culture,” Lovejoy said.

Reflecting on her daughter's death, she said, “I don't think it needed to happen.”