"Something really needs to be done about our mental health system..."

[gwynne]

and, here we go...

I'll let that train leave the station, empty.
Now, back to our scheduled programming....

 

[Goofy_Disney_Dad]

FWIW, I think both groups should have access to therapy. (Those on meds, as well as those that are not.)
Having some support and gentle encouragement toward behavior modification would go a long way in helping work/family relationships for many of these folks.

My father in law, til he sold his practice, required therapy for any patient prescribed medication. I was not on the treating side of things there, but most actual mental health providers have the same requirement. Now, your family doc prescribing psychiatric medication is a whole other ball game.

 

[kamik86]

I agree that forcing people to go would be less of an issue if there was less of a social stigma attached to mental health issues.

I'll be honest even if I thought I might need to see a mental health professional I am sure I would hesitate... because when I went to get the clearance I needed for my job one of the questions is if you have ever been counselled by a mental health professional for anything other then marital counseling. Now I know in my head that probably all that would be required if I said yes would them to contact my doctor to get a yes or no answer to if there is anything they are treating me for that would make me unable to perform my job duties. However the idea that I would have to disclose to both the security and HR departments at work the moment I first went for a visit does somewhat scare me.

 

[lovemygoofy]

I feel sometimes that I have such a different opinion than others and hate to even voice it anymore.

We do need to change access to mental health BUT in addition to just passion out the meds treatment MUST be insisted and consistent for effective treatment for those needing help. Medicine simply cuts off the flower bloom but doesn't kill the root weed. People will have to be hospitalized against their will and that will never happen in this country.

Now, every single time there is someone out there causing all kinds of hell killing people, we want to justify that this person had a condition. You know what? Some people are just really ****ty people. There are real, cruel, ugly people that just want to cause harm.This guy yesterday seemed like a real *** where it was everyone's problem and not his. Do you think he was going to go seek treatment?

We also have glorified killing in this country. It has become a sensationalized time filler and prime time ratings maker. There are dozens upon dozens of shows and "real" movies glorifying these people. This has become acceptable culture in our country. We will be shocked and incensed and then forget about until it done again until we have to point the finger and find justification for the senseless violence to make us feel better.

 

[gwynne]

.

 

[Goofy_Disney_Dad]

Totally agree with you. A dear friend's adult son has very serious anxiety. The son sees a GP, is on various anxiety meds, and has never gotten therapy. This has been going on for literally years. Frequent job loss, all sorts of problems, it's a mess. Referral to a psychiatrist? Nope. Therapy? Nope.
His Dr says he has a medical condition...and that is treated with medication. I am amazed a GP would feel comfortable "treating" this for years without an expert opinion (psychiatrist) and therapy support.

You'd be absolutely amazed at the conditions and medications some family doctors feel qualified to treat with medication only. Amazed actually isn't a good word to use, terrified would be a better choice.

 

[kimblebee]

Sadly, it's the same up here. My husband has severe depression and I'm pretty sure some PTSD from his moms death that is going untreated because his doctors solution to everything is to throw more pills at him. We can't afford therapy and the waiting lists for 'low cost' therapists are ridiculous. It's a no win situation and it's so frustrating because I hurt to see how much he suffers.

 

[gwynne]

Sadly, it's the same up here. My husband has severe depression and I'm pretty sure some PTSD from his moms death that is going untreated because his doctors solution to everything is to throw more pills at him. We can't afford therapy and the waiting lists for 'low cost' therapists are ridiculous. It's a no win situation and it's so frustrating because I hurt to see how much he suffers.

That must be so difficult.

 

[cabanafrau]

Totally agree with you. A dear friend's adult son has very serious anxiety. The son sees a GP, is on various anxiety meds, and has never gotten therapy. This has been going on for literally years. Frequent job loss, all sorts of problems, it's a mess. Referral to a psychiatrist? Nope. Therapy? Nope.
His Dr says he has a medical condition...and that is treated with medication. I am amazed a GP would feel comfortable "treating" this for years without an expert opinion (psychiatrist) and therapy support.

That's sad. And unfortunately it's a situation that may come to a very sudden halt, which would be very, very traumatic for the patient. There is a large crackdown taking place regarding the go to treatment commonly used in these cases because of the widespread epidemic of substance abuse. The doctor's hand may be forced at any time.

 

[cabanafrau]

Sadly, it's the same up here. My husband has severe depression and I'm pretty sure some PTSD from his moms death that is going untreated because his doctors solution to everything is to throw more pills at him. We can't afford therapy and the waiting lists for 'low cost' therapists are ridiculous. It's a no win situation and it's so frustrating because I hurt to see how much he suffers.

I hope a better option becomes available soon. Best of luck to you!

 

[Tiggeroo]

I have had very good health insurance for years. When two different family members needed mental health treatment I found that almost no therapists took our insurance because the pay was too low. In fact most of the better area therapists took no insurance and wanted you to pay and see what you got reimbursed. The only place that accepted the insurance was a clinic staffed largely by students that was also where you went if you had no insurance because they had a sliding scale fee. Wait times were very long and services were lacking. There are no guarantees that better access, mandatory true insurance coverage and an easier time getting a 72hour evaluation would hep but it certainly wouldn't hurt. If mandatory coverage isn't the solution then it wouldn't really cost much more because according to that mind set most mentally ill people wouldn't take advantage of it.
It saddens me to think of the disproportionate number of people in prisons who are mentally ill and/or drug addicts. I know you can't leave criminals on the street but if a mentally ill person commits a crime I don't believe it is with the same intents as a fully sane person. I also believe that many of our crimes that horrify us are in fact committed by people who just don't think normally.

 

[gwynne]

That's sad. And unfortunately it's a situation that may come to a very sudden halt, which would be very, very traumatic for the patient. There is a large crackdown taking place regarding the go to treatment commonly used in these cases because of the widespread epidemic of substance abuse. The doctor's hand may be forced at any time.

Thank you so much for the heads up. I will think a bit about a way to mention "there may be changes down the road" to my friend.

 

[cabanafrau]

I feel sometimes that I have such a different opinion than others and hate to even voice it anymore.

We do need to change access to mental health BUT in addition to just passion out the meds treatment MUST be insisted and consistent for effective treatment for those needing help. Medicine simply cuts off the flower bloom but doesn't kill the root weed. People will have to be hospitalized against their will and that will never happen in this country.

Now, every single time there is someone out there causing all kinds of hell killing people, we want to justify that this person had a condition. You know what? Some people are just really ****** people. There are real, cruel, ugly people that just want to cause harm.This guy yesterday seemed like a real *** where it was everyone's problem and not his. Do you think he was going to go seek treatment?

We also have glorified killing in this country. It has become a sensationalized time filler and prime time ratings maker. There are dozens upon dozens of shows and "real" movies glorifying these people. This has become acceptable culture in our country. We will be shocked and incensed and then forget about until it done again until we have to point the finger and find justification for the senseless violence to make us feel better.

I agree in large part. However I don't think it's as simple as saying that raising the issue of mental illness is justifying that someone had a condition. Do I think this guy would have gone easily into treatment? Nope. Do I wish that access to good treatment was better? Yep. Do I wish that the culture and atmosphere around people like him were different and perhaps made it easier for them to hear, you need some help, and not hear it as a criticism but concern? It may not convince everyone to reach out for help, but if it stopped even a single tragedy it's worth it.

 

[NotUrsula]

What we need is to rebuild a residential treatment structure. There are some people who just cannot manage on their own in the world without getting into trouble, and they do need 24-hr support. I'm not suggesting a return to the days of warehousing the mentally ill, but the "everyone is an outpatient" model simply does not work, especially in the case of schizophrenics. Yes, it's expensive, but there are some people for whom this is necessary in order to protect others.

Schizophrenia is the most likely mental condition to cause a violent "break" -- most likely, but by no means inevitable. We don't need to lock them all up. We do need to look very hard at group home settings and at pump-type medication administration for these folks if at all possible. For that we also need research funding.

My mother was a paranoid schizophrenic, and yes, she did get violent on occasion if she went off her meds, which was often -- the paranoia made her believe that the meds were disguised poisons. She was a SAHM because she couldn't hold down a job after ECT -- not the best situation for her kids, I assure you, because she was primarily being treated with anti-psychotics; she slept 18 hours a day. My father was able to force her to continue treatment, but he died when I was 12. My mom did get residential treatment back in the 60's, but it was rough and it scared her badly, so once she was able to refuse to go, she always did refuse.

I personally believe that GPs should not be allowed to dispense psychotropic meds. If you need them, you need to see a licensed psychiatrist, at least for an evaluation. Here's a fun bit of nonsense for you: my insurance will let you see a psychiatrist indefinitely as long as you are on meds. If you are not on meds, you are supposed to see a psychologist instead, but that's limited to 6 visits per year. So, if you really need therapy, you need to go to the more expensive provider and take expensive meds even if you don't really need them.

 

[cabanafrau]

What we need is to rebuild a residential treatment structure. There are some people who just cannot manage on their own in the world without getting into trouble, and they do need 24-hr support. I'm not suggesting a return to the days of warehousing the mentally ill, but the "everyone is an outpatient" model simply does not work, especially in the case of schizophrenics. Yes, it's expensive, but there are some people for whom this is necessary in order to protect others.

Schizophrenia is the most likely mental condition to cause a violent "break" -- most likely, but by no means inevitable. We don't need to lock them all up. We do need to look very hard at group home settings and at pump-type medication administration for these folks if at all possible. For that we also need research funding.

My mother was a paranoid schizophrenic, and yes, she did get violent on occasion if she went off her meds, which was often -- the paranoia made her believe that the meds were disguised poisons. She was a SAHM because she couldn't hold down a job after ECT -- not the best situation for her kids, I assure you, because she was primarily being treated with anti-psychotics; she slept 18 hours a day. My father was able to force her to continue treatment, but he died when I was 12. My mom did get residential treatment back in the 60's, but it was rough and it scared her badly, so once she was able to refuse to go, she always did refuse.

I personally believe that GPs should not be allowed to dispense psychotropic meds. If you need them, you need to see a licensed psychiatrist, at least for an evaluation. Here's a fun bit of nonsense for you: my insurance will let you see a psychiatrist indefinitely as long as you are on meds. If you are not on meds, you are supposed to see a psychologist instead, but that's limited to 6 visits per year. So, if you really need therapy, you need to go to the more expensive provider and take expensive meds even if you don't really need them.

Things really did deteriorate when it all became outpatient. You are absolutely correct that we need to come up with a better plan for that.

Many insurance plans are intervening with GPs dispensing the psychotropics, which I think is a good thing. It is tricky to treat psychological issues with meds and takes a lot of work to come up with the correct ones in the correct dosage. My insurance has some similar provisions to yours, although therapeutic counseling is required, paid on subscriber's dime, with what I recognize as a very bottom of the barrel list of providers participating in our area. I often wonder what would happen if we needed to utilize the treatment.

 

[Unas]

Therapy is clearly helpful for many psychiatric conditions but it is not the first line treatment for schizophrenia. Medication is, without question is the treatment of choice for that. Mix in supportive services and therapy and people with schizophrenia can be pretty darn functional. Unfortunately our payment systems are biased towards mess and away from other treatments in combination. What's real unfortunate is that even for conditions where therapy is the treatment of choice the payment systems are still biased towards medication and away from other therapies.

 

[eh24fan]

There is a HUGE problem with the mental health treatment in our country, which we all seem to agree on. One of the major issues I see are the individuals who are self medicating their mental health issues with illegal drugs, or, overusing prescribed medication. Then we end up with not only a person who is having mental health problems, but also an addict. What often happens is that they are treated for each problem individually, without communication on both sides of the problem. Dual diagnosis is a relatively new concept, which I find unbelievable. Unfortunately, there are few facilities in this country that are equipped to handle both issues in one stop so to speak.

 

[chiefmickeymouse]

I have been in the position of having to find care for a couple of family members, and let me tell you, it isn't easy, even with insurance. There aren't nearly enough providers and there is usually several months long wait to see someone. It would be near impossible with no insurance and no money. No immediate help is available unless the person has threatened harm to themselves or others.

 

[AddictedtoDoleWhip]

I think there needs to be less stigma for those who have mental health issues because I believe that sometimes that can contribute to people refusing to get help that truly need it.

 

[Wendy31]

However, while family members in this thread had & have the support & help of their family members, many people w/ mental & emotional problems don't have that same kind of support.

There's no one watching to be sure the meds are taken. There's no one there w/ financial support. There's no one there researching doctors & programs & filling out forms & applications & making all the necessary phone calls & arguing w/ insurance reps. Someone who's depressed & can barely make it out of bed is not going to be able to handle any of that. I'm not depressed (although I do have some anxiety), & the thought of trying to figure out the insurance & the billing & having to make the hundred different required phone calls makes me twitchy.

If someone who needs help doesn't have sane & steady support, he/she is going to fall through the cracks. Often, the family & friends of the person needing help are messed up & unstable themselves. But, even w/ good family support, how far should a family member go to help someone who's not willing?

I think, like in the case of Adam Lanza, there are often red flags which are ignored or excused. And, from several accounts, both the doctors & Rusty Yates himself failed Andrea Yates & her children.

I don't know what the answer is, & I don't think there's any one "easy-fix" answer that fits every situation. However, I do think our mental health care system needs improvements like easier access & more checks & balances. Thankfully, I haven't had to seek out any kind of mental health care, but I know a couple who are in marriage counseling. They didn't have any problems finding a counselor, there wasn't a waiting list, & they pay $50 each visit until their insurance kicks in - I'm not sure when that it is. Anyway, from what I'm reading in these posts, it's easier to get into marriage counseling than it is to find counseling & therapy for mental illnesses, & it shouldn't be this way.

I also agree w/ Lovemygoofy. Sometimes, there really are just bad people who do evil things. And we are a society which glorifies violence, the media & Hollywood sensationalizes it, &, instead of treating these kinds of events like the tragedies they are, we turn them into "gun control" talking points. In this most recent event, I don't think the shooter ever really thought he needed "help" - he was just your average guy w/ a chip on his shoulder who one day snapped.