Mental Health Services in the US

rp5x5 · 2021-04-12T14:31:21.955Z

zantax:

Except Lanza probably wouldn’t have been institutionalized even if they still existed. If I remember correctly he had contact with mental health professionals and none of them thought he was dangerous. Are we supposed to institutionalize everyone who has OCD or Aspergers? Neither of which populations are especially violent. Aspergers isn’t even a mental illness.

The word “autism” became. the magic word for. more funding. Speaking. of the funding “spectrum” you and your lawyers could get your poor little IQ-30 offspring, that sits and
spins, into a new autism diagnosis and get 20% more for your federal money. Of. course corruption would eat that. up internally. Big donors–you-- could even get a hospital wing named after you. Political dynasties could rise and fall off the money given for Developmental Disabilities and related lobbying.

Your normal, young son or daughter after a bee-sting at summer camp could become severely brain damaged–Swiss cheese brain-- and severely violent making extreme cases of paranoid schizophrenia look like a walk in the park and it was all about class and connections in Washington.

In the cases of extremely violent patients with penal code violations, the skies the limit for well connected families. Don’t waste it on a simple mentally ill diagnosis.

Nowadays the homeless wander about, thinking they are being gang-stalked and occasionally lash out at phantoms in their mind.

Konssurvative1 · 2021-04-12T14:42:34.587Z

One of the worst things that could have happened in Mental Health was the de-institutionalization of Mental Heath Facilities. There is a certain population of mental health sufferers who need to be in locked facilities. A great many of the homeless in our cities are among those who suffer from mental health and who are left behind by the community mental health system which replaced institutionalization. These people could not hold down jobs, they could not get to appointments, they had no money to pay for medications, they had no money to pay rent, they had no money for food, so they took to the streets, begging for money for food, living in tents, in shelters, under overpasses, where every. Which is worse, people getting proper care while being institutionalized, or people living in the streets with nothing?

Konssurvative1 · 2021-04-12T14:45:51.878Z

PurpnGold:

WuWei:

I don’t like the current “science” of mental health in the US. I believe it is being done completely wrong.

What’s wrong with the science? My wife is a LMFT

Your wife sees people who want to be there, who can pay for her services, and have a desire to get better.

The system does not have anything for those who cannot or will not get help.

It is not the science of psychology that doesn’t work, it is the system of mental health services that is broken.

PurpnGold · 2021-04-12T14:47:35.212Z

I agree with this. They should bring those facilities back with better protections. We have the technology to monitor patients better.

Konssurvative1 · 2021-04-12T14:51:46.686Z

They were not all “One Flew Over the Cukoo’s Nest” type of facilities.

There are some people in this society who need to be locked in and receive mental health services…medications and therapy before they can be re-integrated into society…and then when they back slide, they need to have some place to go when they need more help.

Kelby · 2021-04-12T17:52:29.259Z

Konssurvative1:

One of the worst things that could have happened in Mental Health was the de-institutionalization of Mental Heath Facilities. There is a certain population of mental health sufferers who need to be in locked facilities. A great many of the homeless in our cities are among those who suffer from mental health and who are left behind by the community mental health system which replaced institutionalization. These people could not hold down jobs, they could not get to appointments, they had no money to pay for medications, they had no money to pay rent, they had no money for food, so they took to the streets, begging for money for food, living in tents, in shelters, under overpasses, where every. Which is worse, people getting proper care while being institutionalized, or people living in the streets with nothing?

You can’t take away a person’s liberty because you don’t like the way they live.

Konssurvative1 · 2021-04-12T17:56:09.329Z

No I can’t. But a judge can. They had people committed. To protect the individuals. To protect their families, to protect the general public.

People were committed by families who requested it and judges granted it.

Kelby · 2021-04-12T20:16:44.067Z

Konssurvative1:

No I can’t. But a judge can. They had people committed. To protect the individuals. To protect their families, to protect the general public.

People were committed by families who requested it and judges granted it.

To be committed a person has to be an imminent danger to themselves or others.

Most homeless people, whom you describe in your previous post, do not meet that criterion.

CanadianJudo · 2021-04-12T22:10:17.916Z

Konssurvative1:

No I can’t. But a judge can. They had people committed. To protect the individuals. To protect their families, to protect the general public.

People were committed by families who requested it and judges granted it.

its extremely hard to be committed against your will, because patient have rights outside of a crisis 24/48 hospital

there are thousands of long term facilities in America offering treatment currently, most offer a starting package of 20-30 days.

the issue is these facilities are expensive.

offering tax credit or subsides for parent / adult with mental health would greatly help them get treatment.

CanadianJudo · 2021-04-12T22:14:45.449Z

Konssurvative1:

PurpnGold:

WuWei:

I don’t like the current “science” of mental health in the US. I believe it is being done completely wrong.

What’s wrong with the science? My wife is a LMFT

Your wife sees people who want to be there, who can pay for her services, and have a desire to get better.

The system does not have anything for those who cannot or will not get help.

It is not the science of psychology that doesn’t work, it is the system of mental health services that is broken.

You can’t help someone who doesn’t want to be helped.

if someone has PTSD they will only get though it when they are ready to deal with it,

the issue with forced inpatient care is locking someone up in a hospital doesn’t help them unless THEY want the help.

CanadianJudo · 2021-04-12T22:20:59.524Z

Kelby:

Konssurvative1:

No I can’t. But a judge can. They had people committed. To protect the individuals. To protect their families, to protect the general public.

People were committed by families who requested it and judges granted it.

To be committed a person has to be an imminent danger to themselves or others.

Most homeless people, whom you describe in your previous post, do not meet that criterion.

and those people committed on a 24/48 hold are only there to deal with the current suicidal episode, its not a solution for mental health is a safety net to stop people from killing themselves.

there are thousands of long term facilities mostly private which offer amazing services but they are expensive, which make them out of reach for majority of American.

basic package inpatient community housing, you staying around 30 days in a shared house with people similar issues with in house doctors, you do several group and one and one session during the day.

but this will set you back a lot of money.

Konssurvative1 · 2021-04-13T01:52:40.621Z

If they lived with people, family…they would be…and would meet that criteria.

CanadianJudo · 2021-04-13T02:40:12.600Z

Konssurvative1:

If they lived with people, family…they would be…and would meet that criteria.

Rarely, its very hard to commit someone against their will for longer then 48 hours.

zantax · 2021-04-13T11:15:48.120Z

CanadianJudo:

Konssurvative1:

No I can’t. But a judge can. They had people committed. To protect the individuals. To protect their families, to protect the general public.

People were committed by families who requested it and judges granted it.

its extremely hard to be committed against your will, because patient have rights outside of a crisis 24/48 hospital

there are thousands of long term facilities in America offering treatment currently, most offer a starting package of 20-30 days.

the issue is these facilities are expensive.

offering tax credit or subsides for parent / adult with mental health would greatly help them get treatment.

Already covered.

from https://www.hhs.gov/answers/affordable-care-act/does-the-aca-cover-individuals-with-mental-health-problems/index.html

Does the Affordable Care Act cover individuals with mental health problems?

Yes. The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage. The law requires that most individual and small employer health insurance plans, including all plans offered through the Health Insurance Marketplace cover mental health and substance use disorder services. Also required are rehabilitative and habilitative services that can help support people with behavioral health challenges.

janer · 2021-04-14T15:54:48.420Z

First we should ask why health care for the mentally ill is so difficult to access. A good look into the “why” should precede any discussions about a solution, IMHO.

For many people going into the medical fields, psychiatry is a very unsatisfying and poorly compensated specialty. Not many medical students going in, too many practitioners feeling early burnout.
The term “mental illness” used to be confined to serious mental issues - schizophrenia, bipolar, clinical depression, post traumatic stress,debilitating anxiety disorders. The field of psychiatry then expanded to include compulsions/addictions - alcoholism, compulsive gambling, sex addiction. Some would even include autism and intellectual disabilities under the heading of “mental illness.” Now, with limited resources for long-term treatment (including the limited number of practitioners), and the expansion of what exactly may be defined as a mental illness (which is often difficult to diagnose because you cannot clinically assess a mental state (can’t take X-rays, do MRIs, etc), and because treatment may be long-term, even lifelong, the insurer is faced with the issue of whether it is possible to offer rational, justifiable, affordable coverage and whether mental illness, which cannot be as clearly defined or diagnosed as a physical illness can, should be incorporated into a policy.
So , assuming one’s answer to the cost issue is that it should be covered under some sort of universal policy, would there be any limits on reimbursement for a condition that may defy a specific diagnosis, for which there are limited treatment options (doctors, hospitals, outpatient clinics) and which may be a lifelong ailment?

rp5x5 · 2021-04-14T17:53:08.436Z

Kelby:

Most homeless people, whom you describe in your previous post, do not meet that criterion.

This is not true at all.

It’s not , “most” homeless just had bad luck and lost their job, nor is it true they were all winos or drug addicts …although they do self-medicate.

In general, most people have zero idea, the extremes of mental illness or developmental disabilities. People who need 24/7 care for their entire life.

zantax · 2021-04-15T13:37:41.171Z

janer:

First we should ask why health care for the mentally ill is so difficult to access. A good look into the “why” should precede any discussions about a solution, IMHO.

For many people going into the medical fields, psychiatry is a very unsatisfying and poorly compensated specialty. Not many medical students going in, too many practitioners feeling early burnout.

The term “mental illness” used to be confined to serious mental issues - schizophrenia, bipolar, clinical depression, post traumatic stress,debilitating anxiety disorders. The field of psychiatry then expanded to include compulsions/addictions - alcoholism, compulsive gambling, sex addiction. Some would even include autism and intellectual disabilities under the heading of “mental illness.” Now, with limited resources for long-term treatment (including the limited number of practitioners), and the expansion of what exactly may be defined as a mental illness (which is often difficult to diagnose because you cannot clinically assess a mental state (can’t take X-rays, do MRIs, etc), and because treatment may be long-term, even lifelong, the insurer is faced with the issue of whether it is possible to offer rational, justifiable, affordable coverage and whether mental illness, which cannot be as clearly defined or diagnosed as a physical illness can, should be incorporated into a policy.
So , assuming one’s answer to the cost issue is that it should be covered under some sort of universal policy, would there be any limits on reimbursement for a condition that may defy a specific diagnosis, for which there are limited treatment options (doctors, hospitals, outpatient clinics) and which may be a lifelong ailment?

Am I the only one who knows Obamacare already made mental health mandatory to cover, with the same rule against coverage caps that apply to regular health coverage?

Konssurvative1 · 2021-04-15T13:41:39.877Z

No…but I think that most people don’t know it…and employers and insurance companies are not talking about it, or more people would use it.

zantax · 2021-04-15T13:43:15.836Z

Konssurvative1:

No…but I think that most people don’t know it…and employers and insurance companies are not talking about it, or more people would use it.

My point is, people in this thread keep saying we should do something, that has already been done.

Guilds · 2021-04-15T15:07:08.647Z

WuWei:

I don’t like the current “science” of mental health in the US. I believe it is being done completely wrong.

Can you elaborate on this?