Mental health institutions & care

Started by F_c_O, March 12, 2016, 02:30:57 PM

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F_c_O


Andrew McIntosh

Shikata ga nai.

oOoOoOo

Mental health care in our society is a joke.

Johann

Quite the article, it's impressive how extensive it is. Psychology is always fascinating, just last week I spent quite a bit if time listening to different talks on the subject when I came across a Ted Talk on depression by Andrew Solomon (should be easy to find for anyone interested). I'll put some of the transcript below, I laughed a great deal as I listened and again as I read, for an advanced society we sure seem to miss the simple things.

15:27
And yet, when I went to look at alternative treatments, I also gained perspective on other treatments. I went through a tribal exorcism in Senegal that involved a great deal of ram's blood and that I'm not going to detail right now, but a few years afterwards I was in Rwanda, working on a different project, and I happened to describe my experience to someone, and he said, "Well, that's West Africa, and we're in East Africa, and our rituals are in some ways very different, but we do have some rituals that have something in common with what you're describing." And he said, "But we've had a lot of trouble with Western mental health workers, especially the ones who came right after the genocide." I said, "What kind of trouble did you have?" And he said, "Well, they would do this bizarre thing. They didn't take people out in the sunshine where you begin to feel better. They didn't include drumming or music to get people's blood going. They didn't involve the whole community. They didn't externalize the depression as an invasive spirit. Instead what they did was they took people one at a time into dingy little rooms and had them talk for an hour about bad things that had happened to them."

16:30
(Laughter)

16:32
(Applause)

16:36
He said, "We had to ask them to leave the country."

F_c_O

Quote from: Johann on March 13, 2016, 12:34:18 AM
15:27
And yet, when I went to look at alternative treatments, I also gained perspective on other treatments. I went through a tribal exorcism in Senegal that involved a great deal of ram's blood and that I'm not going to detail right now, but a few years afterwards I was in Rwanda, working on a different project, and I happened to describe my experience to someone, and he said, "Well, that's West Africa, and we're in East Africa, and our rituals are in some ways very different, but we do have some rituals that have something in common with what you're describing." And he said, "But we've had a lot of trouble with Western mental health workers, especially the ones who came right after the genocide." I said, "What kind of trouble did you have?" And he said, "Well, they would do this bizarre thing. They didn't take people out in the sunshine where you begin to feel better. They didn't include drumming or music to get people's blood going. They didn't involve the whole community. They didn't externalize the depression as an invasive spirit. Instead what they did was they took people one at a time into dingy little rooms and had them talk for an hour about bad things that had happened to them."
Ha, exactly. Although I don't think its all because were so stupid and don't understand that the things we do arent helping, its probably once again money and governmental funding that is screwing things up. You ain't taking nobody to sunsine or to drum when you can't afford to do so. Instead you stuff people into small comparments and feed them drugs until they exist in some bizarre limbo between life and death, yet having little to nothing to really live for within dull white corridors.

Also, in such institutions it is really easy to exploit the patients turned into victims. Just recently it came out that here in Finland, city of Turku, the local inpatient system had turned into some bizarre algamation of titicut follies and one flew over the cuckoos nest. I guess nobody told them that those werent exactly guides how to run a mental healt institution? Either way, patients wen't through violence, being put wrongfully into forced isolation, drugged into zombie haze, having any basic rights and priviledges taken from them and so forth. The nurses nor the doctors gave two shits about the patients and worried more about their personal well-being.

All this was allowed by the great system where the inpatient clinics oversee themselves without any third-party check-ups and having patients with little to no rights to complain or drive their case. In what little ways they could do that, the diagnosis of doctor had to be included and they always told how the patient was psychotic and such, rubber stamped by other doctor, which basically meant that nobody would investigate because who the fuck would ever trust a psychotic person to tell the truth? Clearly, the doctors would never lie.

Now when this came out, theyve told that they will have internal investigation into the issue which surely will implicate all the doctors and nurses involved in this and fire them, right?

It keeps surprising me how little we value mental health in society, how little we value different forms of therapy, instead preferring to stuff people full of pills, pills that have tons of negative side effects and can be as useful as placebo. Not to say that they won't help some people but to me, therapy should be the first treatment, not pills.

Johann

There were a couple news articles in the last few years I clearly remember


This hospital in Guatemala
http://www.bbc.com/news/magazine-30293880

And this one in NAPA CA USA (where the cramps famously played!)
http://www.npr.org/sections/health-shots/2015/10/20/449200736/5-years-after-a-murder-calif-hospital-still-struggles-with-violence

There is some interesting video of protest about this on YouTube, heavy shit. This is more from the providers perspective and not as much the patient. but equally fascinating.

American mental health system is broken, just like our prison system. most psychoanalyst appointments in USA aren't covered by insurance, many will work with a patient who is proactive in seeking them out and set a lower cost. But it's a catch 22 because a really ill patient will never put in the footwork instead ending up seeing a state psychiatrist who medicates and monitors, but never gets to the root of the problem. Most of which from what I can tell is enviorment, the average American spends 90% of their time in doors and never exercises, the effects of this lifestyle are no doubt catastrophic and to make matters entirely worse we try to thrust our western life on the rest of the world as well.

AMRadioWaveMessage

I think that I remember reading that someone here works in a mental hospital. That's kind of interesting. I generally don't believe in Psychiatry, but I believe in Psychology. I've read all of the DSMs, so I have near-encyclopedia knowledge of all of the disorders, as well as their variations and different degrees. If someone is probed, poked, and prodded enough, you're bound to find some characteristics that you can repackage someone as 'insane.' It just takes a pissed-off and clever psychiatrist.

With that being said, there are certainly individuals who are incapable of making any right decision for their own benefit / happiness. I just call it stupidity, but mental illness is the more trendy term to use these days. Kaczynski was placed on a hallucinogen trip, and questioned by authority, the legend is, and psychiatrists and doctors tried to make his will break, yet he had an above-genius level IQ, but apparently he was psychologically damaged afterwards.

I guess, even some of the brightest, can crack when the pressure gets too great.

holy ghost

I've worked in outpatient mental health for 10 years. That example in the article linked is obviously a really serious and clearly unique situation as I've never seen anyone under such intense scrutiny and that situation is clearly not common. I know the Norwegian system is pretty similar to the Canadian one in terms of treatment standards, most of the time people aren't able to be held under such severe conditions for long amounts of time because even if a psychiatrist determines that level of care is needed it still has to pass through a review board. Plus it costs so much to hospitalize people it's got to be pretty serious anyway or people start wondering why they're being admitted for so long.

It's pretty difficult to force people to have mandatory treatment unless they're through the forensic (criminal justice) system as well, so in many respects, most of the time treatment is voluntary unless they get so unwell they can't care for themselves.

I will say, I'm no shill for the drug companies but I've seen people's lives vastly improved with the right medication. I've also seen people change very severely with the wrong medication. We place a huge emphasis on helping people find meaningful activities, peer interaction, social and physical recreation etc as well as medication. That stuff all helps just as much. It's a flawed system but it comes from a medical model and the end result since deinstitutionalization is get people well and get them out into the community. That is more empowering but with it comes a huge host of other issues, poverty, addictions, obesity, isolation, substandard living conditions, bedbugs, cockroaches, crime, abuse etc. People talk about deinstitutionalization like people were treated like prisoners (in the early 80's, not the turn of the century) but at the same time people were given a place to live, not just dumped into the community and expected to live among everyone else which has its pros and cons too.

AMRadioWaveMessage

#8
Yeah, I can see it from your point-of-view (you obviously are a worker in the care center), and I would even agree, to a certain extent, with what you said rationalizing psychiatry (because some obviously depend on the care), but I think most of it is just industry, for the most part. This is a forum where people listen to Noise and static, paraphilia discussion hotbed, and I read about Mikko eating raw meat in one of these posts. My point, is, with such weak guidelines, things can be rearranged to favor a bias. Either that, or every poster here is a little insane (which may also be true).

Johann

Eating raw meat? Given the total lack of context I don't see the connection in the slightest. Was it spoiled? Very rarely will it ever get spun that you are insane (in USA), we tend to wait till our mentally ill commit a crime and if no one advocates (and if it isn't completely obvious, which often times it is not) for that individual proceed to strip them of whatever state assistance they have and put them in jail with the big boys, releasing them back to a society homeless until they are reincarnated. Unless you are bit actively engaging in behavior that is likely to harm others (and to a lesser extent yourself, in a serious manner) I'd say your concerned over nothing. We do not live in Franz Kaftas the Trial quite yet.

I think more so the problem is that you can get a prescription for any supposed problem, thanks be to our pharmaceutical lobbyists. I highly doubt your going to meet some pissed off Mrs Rachet style psychiatrist who is going to send you up the river styxs because you like weird porn or listen to strange music. Even if they thought you were off your nut there is nothing they could do to harm you or have you locked away.

Medications are effective for some/ineffective for others, the poorer the insurance the worse the doctor. I know that anti depressant are used very effectively in the treatment of individuals with cancer and other long term illness not because the individual is depressed but because it helps manage the pain far better then any narcotics

AMRadioWaveMessage

So, you say that pharmaceutical lobbying is the problem, but then don't think it would be likely that in order for that industry to grow, there wouldn't be a favoring of biases to get people on the medication?

I am personally not concerned for my well-being, but I've known and known of others getting meds thrown at them for far less than I suggested, as well as for the  things I suggested.

Johann

#11
I assumed you we're talking about being held a facility,  if you voluntarily go to the doctor and tell them what you're experiencing and they suggest you take medication or go as far to write a script, it is ultimately your decision to take it or not.  There is no doubt some doctors over prescribe, if a patient is concerned they should seek a second opinion. Unfortunately many people go for quickfix solutions or do you not read up on the drugs they  are taking.

the likeliness of forced medication however is unlikely unless you commit a serious enough offense.  The only concern should be for pediatric population, it is often in a sense forced to take medication because the doctor prescribes it for so-called disorders such as ADHD. As well as those with developmental disabilities and uninformed  or absent care providers. In which case we should expect more of our medical professionals to operate in the best interest of their patient.

AMRadioWaveMessage

Yeah, problems seem to be mostly about youth, who will get older, but probably will still be on the same medication. I've known of involuntary cases, in facilities of adults even, that are largely the result of some kind of domestic dispute or misinterpretation / miscommunication, and these people are tricked into taking medication, even if it is not for them. Just like the youth. Stupid people can be tricked into taking what they shouldn't. No one is forcing meds down their throat, but people are just consumers in the name of business.

holy ghost

My clinic is for people with psychotic disorders (schizophrenia, schizoaffective d/o, bipolar disorder as the primary diagnosis, so typically these are easier to diagnose. I don't have the same experience with child and adolescent mental health or anxiety and depression. But for people diagnosed with a psychotic disorder I don't think many outside the anti-psychiatry movement would say that medication isn't incredibly beneficial for their recovery. Like you can't fix that with more holistic methods, although those things can really help. You do see an improvement with the right meds, keeping busy, establishing positive social relationships.....

I'll mess this up, but something like 80% of psychiatric meds are prescribed by family doctors. There simply isn't enough access to psychiatrists for diagnostic clarification and medication consults and this is in Canada. I can't even imagine what it's like in the US or that other first world country without health care. Oh wait, it's just the US?

F_c_O

Quote from: holy ghost on March 14, 2016, 03:31:31 AM
My clinic is for people with psychotic disorders (schizophrenia, schizoaffective d/o, bipolar disorder] as the primary diagnosis, so typically these are easier to diagnose. I don't have the same experience with child and adolescent mental health or anxiety and depression. But for people diagnosed with a psychotic disorder I don't think many outside the anti-psychiatry movement would say that medication isn't incredibly beneficial for their recovery. Like you can't fix that with more holistic methods, although those things can really help. You do see an improvement with the right meds, keeping busy, establishing positive social relationships.....

I'll mess this up, but something like 80% of psychiatric meds are prescribed by family doctors. There simply isn't enough access to psychiatrists for diagnostic clarification and medication consults and this is in Canada. I can't even imagine what it's like in the US or that other first world country without health care. Oh wait, it's just the US?
Had to add the closing parenthesis to your msg. That shit just annoys me so much, hehe.

The issues you mentioned tend to be the ones that require some medication to keep person stable, unlike for example depression or anxiety or such (although theres always a degree and you probably want to feed pills to the more extreme cases). Still, no matter whats wrong with the person, I believe that therapy should always go hand in hand with pills, as in my belief the pills are there to take the edge away from the symptoms, not to fix the actual issues. Sometimes the issues can't be fixed, of course, but at least one can learn to tolerate the symptoms and live semi-normal life.

One thing I can't get over with people who suffer from psychosis is that I still find them kinda creepy. Think its the fact that I will never be able to understand how they see the world or what is going in their head and they remain alien to me in a way that 'normal' people don't. Whereas I can connect with most people on some level, it always feels that with them, theres this fundamental disconnect that exists between us.

While this isnt particulary about mental healthcare, I think it fits the topic https://www.youtube.com/watch?v=UQZ-ERQczj8