[Laura Adams]

sandorski wrote:

I remember the Clinton Admin suggesting addressing this issue. Was shot down pretty quickly.

Shot down...

I'm not surprised by the statistic, especially as the drug companies are upping the amount of different diagnoses in order to sell a pill that treats it.

If you are shy, you have social anxiety disorder. If you have no coping skills, if you are a douchebag, etc., you have one of an increasing number of personality disorders. The gifted are assigned various diagnoses including emotionally impaired and ADHD.

If this keeps up, everyone will have a psychiatric diagnosis, and be on meds for it. And there will be much rejoicing at the pharmaceutical companies.

On the flip side, some years ago I worked in a psychiatric facility doing admission paperwork and dealing with the insurance companies. The insurance companies determine the level of treatment. The worse were the HMO's, because the clinicians practically had to beg the gatekeepers after they finished doing an evaluation. It was very, very, very rare for them to admit someone as an inpatient.

Those people were usually brought in, in chains, by Sherriff's deputies or the police department.

Most people, including adolescents who had their parents absolutely terrorized and who brought their child in because they didn't know what to do, only that they could not live with them as they were, got sent home with a recommendation for group therapy.

In the rare cases of inpatient admission, they were usually for a few days. And then they'd go to jail.

I live near a few "adult foster care homes" one is for people with bipolar disorder and schizophrenic self-mutilators. They are heavily medicated, and I had to train the staff members not to stand behind the building and smoke pot all the time. Most are for people who are cognitively impaired, and not mentally ill. The people most in need of care in our town aren't under treatment, and are dual diagnosis because of drug/alcohol problems. Some are homeless, others live in crackhouses.

It's kind of scary, not because of the people we know are really crazy and possibly dangerous, but because of the people like the Arizona shooter, who didn't have a felony record and was thus able to buy a gun. I don't think anyone believed he would do what he did, that's normal. It's the people who go off the deep end and nobody realizes it until they open fire.

And they are almost always quiet and keep to themselves. Until they open fire.

[Khar]

I feel a lot of people tend to hype up the "drug company" aspect of modern psychiatry. While there are deleterious effects in the existing drug company set up, such as exclusion of generics from public access (or promoting brand name pharmaceuticals), I think general understanding and lifestyle changes play a larger role than the drug companies do.

For example, the major mental illness described in these papers was depression and similar disorders, like PTSD and PCS. The US, again, has the highest rates of depression amongst the developed world and many developing nations. Many of these disorders develop later in life more easily. It's expected that longer life expectancy would play a pivotal role in the development of further issues not experienced a few decades ago. Our society is aging as well, with an increased amount of people living in Canada of older age than a few decades ago.

Likewise, our diets, and our work-life impacts our mental health significantly. Canadians and Americans work a lot more than our European counterparts, and our diet is significantly worse. We live in a very fast paced, complex world and that does play a role in the potential for the development of neurological issues. Look at the ways depression can develop, or other problems, simply from having to deal with our modern education system in a post-secondary environment.

Plus, we live in an environment where we pressure our doctors into making diagnosis's on the safe side rather than on the right side. That doesn't help.

As a person who went through PCS after a concussive incident, I went without any drugs and simply tried the other methods described. Speaking as a person who has also gone through a number of treatments for things which would have been "nothing" 10 or 20 years before my birth has also makes me a bit skeptical about the response. For example, instead of having a glass eye, I have a partly functional eye that tracks with my other one since my disease was categorized and identified. Instead of having a minor jaw issue, I had it fixed shortly before I turned 19 with maxillary surgery without having to have a ton of teeth yanked out. My brother was diagnosed with a spectrum social disorder but leads a normal life because it was identified. The fun part of being a twin is we have tons of medical problems.

While I have no doubt that drug companies have played a deleterious effect on the rate of people being diagnosed, I also think there are various demographic, environmental and genetic factors which have played a role which have been ignored in favour of a good human interests story by modern media. I think too often people take depression to mean "sad" and RLS (which has diffuse symptoms so I have to admit to finding that one questionable, but it was not included in the study used here anyways amongst most other "questionable disorders") to mean "when I bounce my leg" when they'd get treatment for neither if that's how they describe it.

In the case of this study, it's not that people can't get treatment, it's that people won't get treatment or use alternative methods (which are described as methods which don't work, because they likely mean "homeopathy" and similar methods) to try and work through their disorder.

[kenmore]

andyt wrote:

We have the same problem as the US with de-institutionalization of the mentally ill. The idea to take them out of huge prison like places was a good one, but the idea to put them in smaller, more homelike settings was never done, 'cause it costs money.

BTW, abnormal psych taught me that the Quakers in the US were just as successful as modern psychiatry in treating mental illness. They did it by running farms where the mentally ill were housed, with a ratio of 1 caregiver to 4 patients. Now that we have drugs, mental hospitals might use 1 caregiver for 100 patients. A lot cheaper, but the patients have to deal with all the side effects of the drugs.

When I worked in the US, I had HMO coverage from my employer. I had to pay more per month than I do in BC for government health care, and my employer paid a lot more for me than I did. Yet I could not choose my physician, except one in contract with Kaiser, and to get treatment I had to be pre-approved by some uneducated numbnuts over the phone. Plus there would have been a co-pay. How many Americans actually have the full on Blue Cross type of insurance? And even there, you have to co-pay and can be refused for pre-existing conditions. Plus apparently sued to recover costs if they find any little thing you didn't tell them in the application form.

The fact is many can not live in the community no matter how much support they receive. There are those in the population with mental health issues who require 24- 7 care. Funding ( lack of) is a major issue. The current recovery model being used in Canada sounds nice in theory, but in reality falls far short of what is needed to support mental health clients and provide them with meaningful lives.
I have attended the national forums on Mental Health issues for years and I have listened to Senator Kirby advocate for more funding and resources every year and we fall short and have a long long way to go before all clients with mental illness can be sustained in the community.

[andyt]

kenmore wrote:

The fact is many can not live in the community no matter how much support they receive. There are those in the population with mental health issues who require 24- 7 care. Funding ( lack of) is a major issue. The current recovery model being used in Canada sounds nice in theory, but in reality falls far short of what is needed to support mental health clients and provide them with meaningful lives.
I have attended the national forums on Mental Health issues for years and I have listened to Senator Kirby advocate for more funding and resources every year and we fall short and have a long long way to go before all clients with mental illness can be sustained in the community.

The majority can live in the community if they have somebody who ensures they take their meds and don't go off the the deep end otherwise. Ie small residential settings run by a psych nurse. Others of course need to be fully institutionalized, some in forensic settings. All of that costs money. All of that saves money downstream in policing and health costs, but governments can't think that far ahead. Just cut taxes for the yobos who bitch about unions and welfare bums is the way to stay in power. To the detriment of our society.

[kenmore]

Well fact is you can't make sure anyone takes meds and you can't force them. Community treatment orders are only good as long as the client agrees to them. To support mental health clients in the community takes mega bucks and the funding is short. There are also issues of mental health services for youth(which is being ignored) and people who are in the work force working with mental illness. Lost days because of things like depression and bipolar illness is unreal and there is no government funding for that. Mental illnes is not over prescribed its under recognized as a debilitating disability. Even though it is listed as such under human rights of Canada. PTSD in the military is another swept under the carpet illness.

[GreenTiger]

Scape wrote:

They have a national sex offender registry in the US don't they? Why not a mental health one?

The national sex offender registry reports convicted criminals, a mental registry would get close to violating Dr-Patient eprivacy laws unless they were convicted of a crime involving that mental illness.

I'm not sure how we could set that up without gutting DR-Patient privilege. If we did fewer people would seek mental Health treatment if they think this information can become public.

[Scape]

GreenTiger wrote:

Scape wrote:

They have a national sex offender registry in the US don't they? Why not a mental health one?

The national sex offender registry reports convicted criminals, a mental registry would get close to violating Dr-Patient eprivacy laws unless they were convicted of a crime involving that mental illness.

I'm not sure how we could set that up without gutting DR-Patient privilege. If we did fewer people would seek mental Health treatment if they think this information can become public.

To circumvent the privacy all that would be required is that they need to register in order to receive state sanctioned benefits. This would be voluntary of course and free, however extended private benefits packages offered by employers or offered directly by private insurance would compel registration with such a program for their coverage to to take effect as this program would be set up as a 1st payer. As free market forces will naturally defer to having coverage payed for by the state 1st and they pick up whatever the state does not to lower their costs and make them more profitable while not denying much needed coverage to the client. A win-win for the state and the private insurance industry.

Also, a Doctor that diagnoses someone with illness could also authorize temporary coverage on their behalf. This non-registered version of coverage would have a sunset period and expire annually if they decline the registration process because of free will or mental incapacity but if they do decide to register then the coverage would continue in perpetuity. Non-registered coverage on the authorization of a licensed practitioner could be reestablished as many times as required but will lapse otherwise.

In this way low cost drug coverage could be offered for those diagnosed with serious mental health issues that require treatment. Not registering with the program would mean that they would be paying out of pocket for such meds but entrance to any treatment facility would recommend that they do in order for such meds to be payed for. Once on the program this would act as a red flag for someone buying a gun or ammo as they would use these records to cross reference. Being on this list would not be the same as a 'no-fly' list but it would require that they have an added level of scrutiny in place to prevent impulse buying by someone on a mission from god. It won't catch them all but it is far better then what is in place now... nothing.

[Mr_Canada]

Quote:

One-quarter of all Americans met the criteria for having a mental illness within the past year

"Are you saying 1 in 4 Americans are retarded?"
"Yeah, at least 1/4th."
- South Park

[Khar]

Mr_Canada wrote:

Quote:

One-quarter of all Americans met the criteria for having a mental illness within the past year

"Are you saying 1 in 4 Americans are retarded?"
"Yeah, at least 1/4th."
- South Park

I know you mean it in jest, and South Park was using the slang definition, so this is not a response to you. I just wanted to post a quick response about this.

Mental "retardation" (synonymous term should be used as various organizations are trying to limit this word's use) is rather different from mental illness, and it only impacts about 2-3% of the population of the United States. Someone with a mental illness can sometimes still function independently, but their ability to function may be impacted or altered in some way. Others have a condition which was not present their entire life which does result in a loss of independence. Someone who is mentally "retarded" is unable to function effectively on their own due to an intellectual deficit or is syndromic mental "retardation" for the long term.

It also does not encapsulate "dementing" conditions, which occur later in life rather than a problem at birth, such as Alzheimer's disease or Creutzfeldt-Jakob disease. Someone with depression, or anxiety problems, is hence not retarded -- just ill.