Mental Health services; Do you feel they're sufficient?

We all know of mental health issues; They're very difficult to address, since they're not only widely varied, but they're difficult to successfully diagnose. In addition to this, treatment for these issues can be costly, and many may deem it to be inefficient use of funds to attempt to treat these "invisible" diseases. These disorders can range from schizophrenia to depression, and can range from a mild inconvinience to a purely debilitating disorder.

I'm currently living in Canada, personally, and I feel the mental health system here is... Poor. We may have universal healthcare coverage, but it's exceedingly difficult and costly to actually see a therapist to deal with issues and learn proper coping skills. The current regimine for dealing with my major depressive disorder is going to the doctor, getting prescribed something to help with my depression, then waiting six weeks to see if it does anything. If not, we try again with another drug, the side-effects often being rather off-putting to these medications. One has made me sleep a good 12 hours a day, another has caused my depression to deepen, and I gave it up after recurring thoughts of suicide.

So, how do you, personally, feel the healthcare system serves those with mental health problems? Do you agree with financial resources being used to treat these people? At what point does a mental health issue become debilitating to the point that it merits treatment? Etc. etc.

This is a very, very complicated issue that will likely be different for every country involved. For example, I'm an American, born and raised, but I currently live in Japan, and having dealt with the mental health services of both countries personally, as well as hearing the experiences of others, I can pretty safely say that the US handles mental health much better than Japan. In some cases, Japan just seems to pretend that some mental health issues don't even exist. In the schools I've worked at, some teachers seemed to act as if ADD/ADHD was some new, strange thing and it wasn't just "really enthusiastic kids". Rather than finding support in their peers, something that usually Japanese culture is pretty good about, many people with mental issues like autism and depression are basically ignored or outcast, left to deal with their problems alone. This, of course, is likely to be a factor in the rather high suicide rate Japan still struggles with today. If they do acknowledge your mental illness, from what I understand, treatment isn't all that great either. For example, I went to see a psychologist about finally dealing with and overcoming my severe trypanophobia, the fear of syringes, that has honestly actually interfered with my life in major ways. After confirming I have it, their solution? Just take a couple pills before you see a needle to try to relax. That's not a solution, that's just mitigating some of the symptoms! And given the nature of my reaction to needles, it's likely the pills would do no better than a placebo anyway! And others with more serious mental issues have told me the Japanese response to their problems was similar compared to the more comprehensive treatments they got in their own countries. Give them some pills and hope they go away.

Though for the severe under-diagnosing and almost outright refusal in many cases to deal with mental health issues here in Japan, America probably has the opposite problem of over-diagnosing people and coming up with new "mental illnesses" every freaking day if someone is not a happy little clam perfectly content with the world they live in. Feeling a little glum lately? You must be struggling with depression. In the reverse of the Japan situation, it seems any kid who won't sit still for three hours at once is labeled ADD and handed a bottle of ritalin. You're often rude and socially awkward? Well, you poor thing, you must have Asperger's. Time for a good, long dose of therapy with a psychiatrist! You're gonna have this debilitating mental illness for life so we can make a hefty sum off of your insecurities when we may have actually treated your problem long ago! Or they'll just discover you have some new thing and keep stringing you along. Not to say that all or even most mental health professionals are like that, but given the trigger-happy diagnostic tendencies for mental illness I've seen lately, it wouldn't surprise me if some do that. Wouldn't be difficult to pull off.

There's something to be considered, IMO, with mental illness that is quite different than with physical illness that can affect allocating money towards the solution, and that is that the origin of mental illness isn't always physiological in nature. For example, from what I understand, not even half of depression cases are due to a chemical imbalance in the brain, and more from difficulty in coping with hard times or some psychological trauma that occurred in the patient's past. From what I gather, this is true for several other mental illnesses as well. As a result, the nature of treatment is going to be different, and tossing more money at it may not be the solution. Full disclosure: I tend to think that for this, or any other issue, wiser spending is always better than simply more spending. More money =/= less problems. You have to use that money responsibly if you want to improve your situation, and in some cases, the problems may not be money-related at all. I mean, really, to solve the problems with the American mental health system I outlined above, do you truly think more money is going to solve that? It's more an issue of standards and practices, not finances. Give them more money, and they'll likely come up with even MORE mental "illnesses" we're all plagued with.

Anyway, that's my 2 cents from someone who's taken one psychology class in his life.

Fawcks:
I'm currently living in Canada, personally, and I feel the mental health system here is... Poor. We may have universal healthcare coverage, but it's exceedingly difficult and costly to actually see a therapist to deal with issues and learn proper coping skills. The current regimine for dealing with my major depressive disorder is going to the doctor, getting prescribed something to help with my depression, then waiting six weeks to see if it does anything. If not, we try again with another drug, the side-effects often being rather off-putting to these medications. One has made me sleep a good 12 hours a day, another has caused my depression to deepen, and I gave it up after recurring thoughts of suicide.

I'm living in Canada and I think we have a solid system, at least in my provience. Most of the issues you list have nothing to do with the system, and everything to do with your particular doctor and your particular mental health issue.

You may need a new doctor. Ask for a referal if you don't like the approach of your doctor.

To the more specific concerns you raise, not sure what province you are in, but you can see therapists in most provinces (I think every) that are 100% covered if they are MDs. In some provinces, and in some circumstances, non doctors are also covered.

It should't take 6 weeks to judge a drug reation for most basic antidepressants. Many of those drugs do have a 4-6 week loading period, but you can generally see if it is right or not in 2-4 weeks.

All antidepressants have some chace of inverse effect and increasing suicidal thoughts. However, that reaction is exceedingy rare outside of teens and very young adults.

Your complaint that the doc switches you off drugs that don't work for you makes little sense. Not everyone's brain chemestry is the same, sometimes they can get the right drug for you right off, sometimes people don't respond well. It can be hard to predict.

Personally I had a major depressive state not so very long ago. I was put on two particular drugs (one to help with sleep, the other with depression), and I was seen weekly, then biweekly until I was stable (3 drug dosage changes in that time), at which point it became monthly, or more often if I had a problem.

To help me learn to deal better with things, there was a 4-6 week in hospital program availble if I wished, but I didn't choose that route. I'm now in 14 week CBT class designed to give me those tools.

I'm in America and have government healthcare. They paid for a therapist but the doctor refused to give me medication and eventually ended up trying to kill myself. Since then I have stopped going to the doctor and have to go to a mental health hospital once a month, get admitted and have them diagnose me so I can get my perscription.

Toriver:
There's something to be considered, IMO, with mental illness that is quite different than with physical illness that can affect allocating money towards the solution, and that is that the origin of mental illness isn't always physiological in nature. For example, from what I understand, not even half of depression cases are due to a chemical imbalance in the brain, and more from difficulty in coping with hard times or some psychological trauma that occurred in the patient's past.

I think there are errors in your understanding. Not everyone who says they are "depressed" is clinically depressed. In fact if many of those people took a depression test they would think the questons are bizzare or funny.

For those who are clincally depressed, it has been repeatedly shown in studies that they have chemical problems in the brain. Yes, some of these conditions were brought on by external factors, but its a bit of cycle in that such events can trigger chemical imbalances and lead to the classic depressive vicious cycle of bad brain chemistry ==> depression and negative feelings ==> bad brain chemistry ==> depression and negative feelings....and so on.

The cycle is generally broken by attacking oth the negative feelings that generate the chemical problems through life skills and councilling, and the chemical problems are dealt with through chemical treatment. Attacking one without the other is substantially less successful. Many patients for example can not be sufficiently motivated (or even awake) enough to address life skill improvements while suffering from the effects of the brain imbalance.

Once the chemistry goes wacky, many people can use drugs on a temporary basis while they stabilize and then learn coping skills. Others will need the drugs for life although dosage may be altered.

Thomas Guy:
I'm in America and have government healthcare. They paid for a therapist but the doctor refused to give me medication and eventually ended up trying to kill myself. Since then I have stopped going to the doctor and have to go to a mental health hospital once a month, get admitted and have them diagnose me so I can get my perscription.

You can't just find a new doctor?

Well, I live in Germany and here I guess it's sufficient. That said, I live in a city with a university clinic and as such my view may easily be warped. I honestly don't know how good the mental health coverage is in more rural areas, further away from a medical hub like this. Either way, the treatments are covered, so unless receiving it is particularily difficult in some places, I'd say we're good?

ravensheart18:

I'm living in Canada and I think we have a solid system, at least in my provience. Most of the issues you list have nothing to do with the system, and everything to do with your particular doctor and your particular mental health issue.

You may need a new doctor. Ask for a referal if you don't like the approach of your doctor.

To the more specific concerns you raise, not sure what province you are in, but you can see therapists in most provinces (I think every) that are 100% covered if they are MDs. In some provinces, and in some circumstances, non doctors are also covered.

It should't take 6 weeks to judge a drug reation for most basic antidepressants. Many of those drugs do have a 4-6 week loading period, but you can generally see if it is right or not in 2-4 weeks.

All antidepressants have some chace of inverse effect and increasing suicidal thoughts. However, that reaction is exceedingy rare outside of teens and very young adults.

Your complaint that the doc switches you off drugs that don't work for you makes little sense. Not everyone's brain chemestry is the same, sometimes they can get the right drug for you right off, sometimes people don't respond well. It can be hard to predict.

Personally I had a major depressive state not so very long ago. I was put on two particular drugs (one to help with sleep, the other with depression), and I was seen weekly, then biweekly until I was stable (3 drug dosage changes in that time), at which point it became monthly, or more often if I had a problem.

To help me learn to deal better with things, there was a 4-6 week in hospital program availble if I wished, but I didn't choose that route. I'm now in 14 week CBT class designed to give me those tools.

I'll have to ask about that; I've been on anti-depressants for awhile, and have tried contacting several therapy services, but frankly, they were all too expensive for me to attend regularly; I haven't found anything covered by my province-given insurance yet (I'm in New Brunswick, btw).

I'm not really criticising my healthcare professional for the poor reaction I've been having to my medications, but really, I do not like the whole having to take a medicine for six weeks to see if it will actually work. Totally not his fault, but a general grievance for me. I know, whining pointlessly about stuff that doesn't matter.

I just really think I could benefit from some therapy, as opposed to merely drugging the "chemical imbalance". To be honest, all my symptoms point to depression, but it was originally onset when I lost my fiance of 2 years... I was working a full time job at the time, went to school full time for my Biological Sciences degree, when I lost her in my third year. Come my fourth year, I dropped most of my courses... Failed what I didn't drop... Got diagnosed with depression, I lost everything. Everything. My mother didn't believe depression was a real thing, thought I just became a lazy bum, kicked me out.

I guess I'm just venting, whining because of the shame and stigma I feel about this stupid disease. More than anything, though, I hate myself. I don't know what happened; what changed to make me fail so badly. I really need to see a therapist to work out these issues I have, and finish the relationship I had which I never recieved closure for.

I'm in the UK, am being dealt with them and in my area (Herefordshire) the mental health services at least are good (I judge that by still being alive and not being a corpse on a rail track).

Comando96:
(I judge that by still being alive and not being a corpse on a rail track).

I'm not sure the spectrum of quality on such issues is quite so... binary.

im in australia and even though people complain about it all the time its pretty good, at least for teenagers

Skeleon:

Comando96:
(I judge that by still being alive and not being a corpse on a rail track).

I'm not sure the spectrum of quality on such issues is quite so... binary.

That was just a very dark joke.

They are good in many more perspectives. The system does tend to pick a lot of people up, and when they are in the methodology of approach can be physiological or drugs but often the individual is diagnosed appropriately instead of rushed onto drugs.

Generally in the UK, if your in the system your ok(as ok as you can be considering). Dunno about issues of how big the net is. I was caught though.

I think the view can vary from person to person depending on their experiences with doctors. A GP might send you to a Psychologist first when you really need a Psychiatrist or the other way around. You might get one that suits you and have a good experience, or someone that does not suit you and have a bad experience.

There is the issue that many mental disorders can take years to diagnose properly. On top of that a lot of the development in mental health has been in the last 15 years or so, especially in recognizing that many mental disorders start at a very young age. Any of us that were born before the 90s did not have the luxury of having doctors keeping an eye out for mental problems that can be treated early.

The treating of children with mental disabilities is pretty close to me (and reonhato, he is my twin brother) as we have Aspergers (not the pretend kind that famous people have, the real kind). Now days a child that is diagnosed with a disorder like Aspergers that results in considerable problems with social skills can get treatment from a young age to specifically teach social skills instead of letting them develop like normal (I didn't speak until 2-3 years old, I was 13 before I could go up to a checkout and order fast food, to this day most of my social interaction is online as it is considerably easier for me).

To that end I think when you are looking at a mental health system a good indicator of it being sufficient is how good it is for children. It is significantly easier to treat mental disorders in children then it is an adult due to the development process that children go through. An adults brain is already developed and it makes it a lot harder to make changes in behaviours.

I think that within a good mental health system there has to be multiple methods of treatment as well. You are not going to be able to "fix" a lot of problems. Most adults with mental disorders do not get "cured", they simply learn to live life with them. This is what a mental health system should be geared towards in terms of adults. While options should be available for adults that want to try to be "cured" (I use that term in ""'s because I do not believe mental disorders can be cured, all we can do is use drugs to mask the symptoms), until we have sure fire ways of actually curing people, the focus should be on supporting the people with mental problems.

Fawcks:
I'll have to ask about that; I've been on anti-depressants for awhile, and have tried contacting several therapy services, but frankly, they were all too expensive for me to attend regularly; I haven't found anything covered by my province-given insurance yet (I'm in New Brunswick, btw).

I'm in Ontario so what exists may be different, but a Physician led program should be covered. Its the ones held by social workers or pycologists that all less likely to be covered. I'm also in a big city, that may be helping my chances of finding something.

That is actually one of my big complaints with our healthcare, I wish they covered more services in general that don't include an MD. In the end its cheaper to pay a psycologist than a pscyiatrist so they should cover both, dentists should be covered, etc.

I'm not really criticising my healthcare professional for the poor reaction I've been having to my medications, but really, I do not like the whole having to take a medicine for six weeks to see if it will actually work. Totally not his fault, but a general grievance for me. I know, whining pointlessly about stuff that doesn't matter

I just really think I could benefit from some therapy, as opposed to merely drugging the "chemical imbalance". To be honest, all my symptoms point to depression, but it was originally onset when I lost my fiance of 2 years... I was working a full time job at the time, went to school full time for my Biological Sciences degree, when I lost her in my third year. Come my fourth year, I dropped most of my courses... Failed what I didn't drop... Got diagnosed with depression, I lost everything. Everything. My mother didn't believe depression was a real thing, thought I just became a lazy bum, kicked me out.

I agree with you completely. All drugs do is take the edge of things so that you can address underlying issues and learn to deal with life better. Without those tools nothing is solved. Deep loss is a very common trigger of depression, you are't alone.

IMO, your doctor should be providing you with more than an Rx. If they aren't, I would seriously consider shopping around for a new one. There are many different styles of pysciatrist, you need to find the one that is right for you.

I guess I'm just venting, whining because of the shame and stigma I feel about this stupid disease. More than anything, though, I hate myself. I don't know what happened; what changed to make me fail so badly. I really need to see a therapist to work out these issues I have, and finish the relationship I had which I never recieved closure for.

I understand. It's frustrating to find yourself on that downward spiral, and it is so hard mentally to even try to seek help, if it doesn't work it would be very hard. Many more people go through this than will admit it publically. While I understand how you feel completely, its no more your fault than it is a cancer victim's fault they have cancer.

Nope. Here in the UK, and it's really atrocious, like most of the world. The topic is still seen as taboo by the public, and there simply aren't enough staff in the service, there are a lot of things wrong with how it's done. My experience in it has been good because my family has connections, but for most people it's terrible. For instance, there's a 2 year wait for under-18 services...so if you're 16 you're actually better off waiting for the adult services.

From what I've experienced personally the constant cut backs to mental health care have had serious consequences. My country has constant problems of families with severely ill relatives going bankrupt trying to care for them, people being partially treated in the community because hospitals simply don't have enough space (which results in sever accidents and even murder), and people simply falling to the wayside on the streets because they can't get the care they need.

Right now I'm strongly considering dropping out of school because going home and living with my parents may be the only way I can properly see a doctor. My school has had cut backs which has resulted in too few doctors and too many patients. It's hard as hell to get a proper appointment and even then they must only last around ten minutes or so. I had to fight to get a schedule more frequent then every two to three months. I have seen so many people drop out simply because they have mental break downs and can't handle the stress of their illness alongside the stress of school life.

The US has a terrible habit of just giving out drugs left and right with not nearly enough emphasis on how dangerous these drugs can actually be. Many people end up with worse symptoms or even committing suicide because of drug side effects or withdrawal from taking their meds. Many of the the meds I take can result in everything from dizzyness and nausea to full on comas and organ failure. Also suicide. That's pretty much a side effect I always see.

I personally worry about the effects of the over drug usage especially on younger people. Does anyone really know whether or not these drugs might screw up your development mentally or physically? I really don't feel they do.

where i live in australia there is exactly 1 individual properly qualified in my entire state of 500,000 people to diagnose adult aspergers/higher functioning autism. so no its not sufficient

I'm not sure about the general state of the system, but Community Mental Health seems to be pretty good with treating mental illness. America seems to be alright in treating it if you have the proper coverage. Community Mental Health will help you with affording to get treatment if you can get into their program.

The treatment seems to help except for treating depression, but that is only because I can't take anti-depressants.

The same problem the U.S. has with healthcare. It's generally pretty good if you can get it. However, there are plenty of people who need care and don't get it. The homeless in particular have a high percentage who are mentally ill and not getting any help.

As far as the kinds of treatment, I don't favor the use of pharmaceuticals like the current industry does. It seems like too quick of a fix for problems that may have taken years to develop.

Here in the Netherlands there's pretty good mental health services. It's an industry whose deeds often go unsung, as the best they can achieve is making people function normally.

One thing they've been developing and improving over time is what we Dutch call 'bemoeizorg', which could best be translated as some like 'harassing care'. Experience has taught that many with mental problems do not seek help, or only seek help when things really go wrong.

That's why they've invented this 'harassing care', which basically involves people heading into trouble being forced to work with aid workers or mental health workers. Think in terms of people being spotted as bad parents due to mental health problems by child protection services, or someone being on drugs because of mental problems, or on mental problems because of drugs of course.
The whole point is that the principle is no longer that people ask first and then receive, but are pro-actively helped when it becomes clear they need it. The results of this are rather positive, and a group of people known as 'care dodgers' because they didn't want any help, but caused a lot of problems, are now being helped level best.

I think that's really an invention.

Lucien Pyrus:
The treatment seems to help except for treating depression, but that is only because I can't take anti-depressants.

Isn't there any decent system-therapist, scheme therapist or someone working with ecclectic methods available then? Ussually anti-depressants and other chemical means are only a way to pull people back into reality by their hair, after which the real treatment can begin.

Nobody ever gets depressed for a prolonged period of time with a so-called 'negative scheme' being present. A line of thinking and acting that's grown during the time leading up to their depression and which erodes their happiness and self-esteem on a daily basis. Without adressing that, a cure is impossible and fighting off the symptoms is the best they'll achieve.
This can for instance be parents raising a child abusively and telling it time and again it's worthless and unwanted. This idea then settles in and becomes a basis for that person's life, more than likely causing them a very low self-esteem and depression-like problems. Without adressing that underlying 'scheme' of thinking one is worthless, a cure is not possible.

In the US it's customary to go at it with only chemical means and some cognitive behavioural therapy, but the underlying problem remains, and in 5-10 years, people crash again. That's why it's best to find someone of a different approach.

Current mental health services are nominally sufficient overall. Although some kind of standardization of treatment, preferably light on the drug prescriptions, is in my opinion necessary.

Current mental health research is badly behind, partly because of the complexity of the human mind, and partly because properly studying these conditions would require a very large number of human guinea pigs to mentally torture with little to no ethical oversight. A situation which for some odd reason is frowned upon.

It's way better than it was in the 1600s where they'd lock the crazy person up for being possessed

It depends entirely..

Schizophrenia is almost certainly treatable, so there's really no excuse for it not being treated well.

Clinical depression, for example, is just not that well understood. It used to be attributed to seratonin deficiency (hence SSRIs) but actually there isn't a great deal of evidence that seratonin deficiency even causes depression, there just seems to some effect for some people. What you really have for depression is a wide range of drugs which work in different ways and have quite severe side effects, and it's almost impossible to tell simply from diagnosis which will be effective and which won't.

So yes, obviously it's going to be very difficult to treat.

Add to this that 'talking cures' will always be expensive, simply because it involves interacting with extremely vulnerable people. It's difficult to become a recognized CBT practicioner, psychoanalyst or even counsellor. It's not a job you walk into after getting your psychology degree, it takes many years of specialization and experience and people expect it to pay accordingly. Obviously, this causes issues with cost, especially since it's quite a time-intensive treatment, and again, not universally effective.

The technology is well behind the need, at the moment. Until that changes, people are just going to be left doing what they can. Provision for high risk patients is generally about as good as it can reasonably get at the moment, but unfortunately unless you are going to kill yourself in the next 24 hours there isn't a whole lot which can be done for you.

CBT might actually come to be very important in this regard because while it's not demonstrably effective in all cases it is a lot easier and quicker because it's based on techniques which the patient can easily learn. Heck, you can learn basic CBT from a book or a computer program, and I think ultimately that will start being a very big thing in a few years time.

Until then, we're all kind of stuck with what we have. Depression can't be cured in any genuine or reliable sense, so the emphasis has to be on management. You can't stop people getting depressed, but you can maybe keep depressed people from becoming suicidal or high-risk long enough for them to develop their own coping mechanisms, and most people do. Heck, even I have, and while I recognize that I'm still 'depressed' and am just waiting to implode as soon as something goes wrong, I already manage myself better than I ever could have hoped.

evilthecat:
It depends entirely..

Schizophrenia is almost certainly treatable, so there's really no excuse for it not being treated well.

Clinical depression, for example, is just not that well understood. It used to be attributed to seratonin deficiency (hence SSRIs) but actually there isn't a great deal of evidence that seratonin deficiency even causes depression, there just seems to some effect for some people. What you really have for depression is a wide range of drugs which work in different ways and have quite severe side effects, and it's almost impossible to tell simply from diagnosis which will be effective and which won't.

So yes, obviously it's going to be very difficult to treat.

Add to this that 'talking cures' will always be expensive, simply because it involves interacting with extremely vulnerable people. It's difficult to become a recognized CBT practicioner, psychoanalyst or even counsellor. It's not a job you walk into after getting your psychology degree, it takes many years of specialization and experience and people expect it to pay accordingly. Obviously, this causes issues with cost, especially since it's quite a time-intensive treatment, and again, not universally effective.

The technology is well behind the need, at the moment. Until that changes, people are just going to be left doing what they can. Provision for high risk patients is generally about as good as it can reasonably get at the moment, but unfortunately unless you are going to kill yourself in the next 24 hours there isn't a whole lot which can be done for you.

CBT might actually come to be very important in this regard because while it's not demonstrably effective in all cases it is a lot easier and quicker because it's based on techniques which the patient can easily learn. Heck, you can learn basic CBT from a book or a computer program, and I think ultimately that will start being a very big thing in a few years time.

Until then, we're all kind of stuck with what we have. Depression can't be cured in any genuine or reliable sense, so the emphasis has to be on management. You can't stop people getting depressed, but you can maybe keep depressed people from becoming suicidal or high-risk long enough for them to develop their own coping mechanisms, and most people do. Heck, even I have, and while I recognize that I'm still 'depressed' and am just waiting to implode as soon as something goes wrong, I already manage myself better than I ever could have hoped.

Well said. Since we do not have guaranteed treatments or cures, we don't even know for sure what the cause is, the focus area for patient care should be supporting the patients, not loading them with drugs and telling them to go fit in with everyone else. Meds only reduce the symptoms, people with no support system around them are just going to get worst.

Another problem with treating mental disorders, especially depression (which often comes along with other disorders) is apart from the fact that different people react different to the drugs, you build up a tolerance for the drug because you are taking it every day for years on end. Some people can take the same drug for 10 years and have it still work, others can have reduced effects after 1 year. This is where a support system comes in as well. It is rare for a patient to know when the effects of the drugs are not as good as they used to be. It is easier for people around them to notice the changes in behavior though.

Fawcks:
We all know of mental health issues; They're very difficult to address, since they're not only widely varied, but they're difficult to successfully diagnose. In addition to this, treatment for these issues can be costly, and many may deem it to be inefficient use of funds to attempt to treat these "invisible" diseases. These disorders can range from schizophrenia to depression, and can range from a mild inconvinience to a purely debilitating disorder.

I'm currently living in Canada, personally, and I feel the mental health system here is... Poor. We may have universal healthcare coverage, but it's exceedingly difficult and costly to actually see a therapist to deal with issues and learn proper coping skills. The current regimine for dealing with my major depressive disorder is going to the doctor, getting prescribed something to help with my depression, then waiting six weeks to see if it does anything. If not, we try again with another drug, the side-effects often being rather off-putting to these medications. One has made me sleep a good 12 hours a day, another has caused my depression to deepen, and I gave it up after recurring thoughts of suicide.

So, how do you, personally, feel the healthcare system serves those with mental health problems? Do you agree with financial resources being used to treat these people? At what point does a mental health issue become debilitating to the point that it merits treatment? Etc. etc.

If the doctor is just going to prescribe you drugs, go to a different doctor. You'll have a way bigger chance of curing depression by smoking weed than by taking pills.
The thing is, healthy meals, proper rest and talking to your close ones about your problems and worries cures most depressive states. Even talking to the doctor helps more than prescriptions. Most good psychologists however, work in the private sector because it pays better so the ones who work for public health care aren't usually the best ones.

From what I have heared from others, the US likes their pills way too much, but the specialists are very well trained. I think it depends on what kind of help you are seeking.

Toriver:
This is a very, very complicated issue that will likely be different for every country involved. For example, I'm an American, born and raised, but I currently live in Japan, and having dealt with the mental health services of both countries personally, as well as hearing the experiences of others, I can pretty safely say that the US handles mental health much better than Japan....

I hear you on the Japan issue. Another phenomenon that seems strange to me in Japan is that people will work themselves to the point that dying from overwork actually has a Japanese word, stressing themselves to the degree that they jump in front of trains, etc. But then I've seen people also get copious amounts of time off for stress. Like months. And this appears to be kind of consequence free. I don't know if it was because they were government employees, and I don't know if there is a penalty to this when contract renewal comes around.

Paradoxically, I feel much less stress in Japan than I do in the US. Perhaps it's that I'm foreign and thus freed from a lot of social obligations there, but I find Japan to be a much easier country to live in. Good public transportation and safety, a wide variety of food options available (in cities anyway), and a standard level of politeness make Japan much more desirable for me.

Though for the severe under-diagnosing and almost outright refusal in many cases to deal with mental health issues here in Japan, America probably has the opposite problem of over-diagnosing people and coming up with new "mental illnesses" every freaking day if someone is not a happy little clam perfectly content with the world they live in.

I disagree with this. The problem in the US is not that we over-diagnose. It's that we over-medicate without trying to get at the causes of the problems.

I've told this story on here before, but about 10 years back I was going through a personal crisis, and started experiencing some serious depression. Now I have had a tendency toward depression for much of my life, but until a serious problem hit with a loved one I had always been able to deal with it. I went to my GP and talked with her about it and while she did give me a number for a local counseling service, she also recommended I get on a prescription for an SSRI. She handed me a sample of pills in a brown paper bag with no documentation whatsoever and the dosage scribbled in pen on the bag. Try these and see how you do, she said.

I have never in my life been as much as a wreck as I was on the three days that I took those pills. My anxiety skyrocketed. I was only able to get like 3 hours of sleep a night. I would have panic attacks just from looking at every day objects that reminded me of certain people. I quit taking the pills on the third day when after reading up on them on the Internet and seeing there are cases of people committing suicide after starting on that medication.

I went to the counselor, had a nice chat with them, and resolved to get my life in order. They didn't recommend any more pills and left me to do what I need to do, commenting that I had an unusual self-awareness of my own feelings. I have had my moody moments when life tosses me a curve ball, but I have never been depressed since. Now lots of people have said if I would have continued taking those anti-depressants under the guidance of a psychiatrist the side-effects would have stabilized. But the thing is, I clearly didn't need them. When she gave them to me, the GP commented that her husband also had depression and takes those particular SSRIs and so I shouldn't feel ashamed of it. And while a person shouldn't be ashamed of taking SSRIs if they need them, it sounded to me like she was a bit too concerned with relating me to her husband and not enough concerned with doing her fucking job.

So it's not diagnosing that's the problem in the US. I was depressed. But not every diagnosis requires a pill to fix. Some do. Some of us just need a kick in the ass.

HardkorSB:
If the doctor is just going to prescribe you drugs, go to a different doctor. You'll have a way bigger chance of curing depression by smoking weed than by taking pills.

I know this is hyperbole, but it's also negligently untrue.

Smoking weed is pretty much the worst thing you can do if you have a pre-existing mental health problem, particularly a 'psychotic' disorder like depression. The same goes for heavy alcohol consumption or any drug with a psychoactive effect.

People might feel that it helps them because of a process called 'dissociation', whereby people try to limit the damage of traumatic experiences by basically shutting themselves down one way or another. I think we've started to recognize that dissociation is a necessary process for a lot of people, particularly those with stress disorders or anxiety, but there are much, much healthier and more controlled ways to do it than smoking weed.

Anyone who even suspects they have a mental health problem needs to avoid recreational drugs and alcohol like the plague.

pyrate:
Well said. Since we do not have guaranteed treatments or cures, we don't even know for sure what the cause is, the focus area for patient care should be supporting the patients, not loading them with drugs and telling them to go fit in with everyone else. Meds only reduce the symptoms, people with no support system around them are just going to get worst.

Drugs do work, I think I can attest to that.

You're completely right about tolerance, of course, and we can never assume that drugs will work on everyone anyway. The problem is that if you tell depressed people their drugs might not work most will give up at the first sign of side effects. Firstly because they're depressed and secondly because anti-depressants have an exceptionally long side effects period during which they won't seem to work at all. The placebo effect is very powerful with anti-depressants, as with any drug with strong side effects, and I think doctors do try to use that as much as possible to get people through the initial month when it only seems to make them feel worse.

And like you said, as a patient you don't know what effect something is having anyway. You can remain convinced that things are still horrible even when you're actually behaving and being much better.

Unfortunately, I think 'fitting in' is actually quite important. The ability to do so is a better measure of whether something is actually wrong than how you feel. So I can see the point there as well.. my CBT practitioner spent a lot of time essentially telling me I needed to force myself to go out even if I knew it would be shit. It took me a while to understand that I was usually wrong about it being shit, and when I wasn't it's only because I would make it shit myself by acting out. Not acting out, even if it meant forcibly throwing a spanner into my thought processes = no shitness, and ultimately no fear.

What I mean is that if noone else can cure you, not a doctor and certainly not a friend or a partner, you need to look after yourself. The best these people can do is to teach you how, and sometimes that does mean tossing you in the pool and waiting to see if you drown.

Blablahb:
Isn't there any decent system-therapist, scheme therapist or someone working with ecclectic methods available then? Ussually anti-depressants and other chemical means are only a way to pull people back into reality by their hair, after which the real treatment can begin.

Nobody ever gets depressed for a prolonged period of time with a so-called 'negative scheme' being present. A line of thinking and acting that's grown during the time leading up to their depression and which erodes their happiness and self-esteem on a daily basis. Without adressing that, a cure is impossible and fighting off the symptoms is the best they'll achieve.
This can for instance be parents raising a child abusively and telling it time and again it's worthless and unwanted. This idea then settles in and becomes a basis for that person's life, more than likely causing them a very low self-esteem and depression-like problems. Without adressing that underlying 'scheme' of thinking one is worthless, a cure is not possible.

In the US it's customary to go at it with only chemical means and some cognitive behavioural therapy, but the underlying problem remains, and in 5-10 years, people crash again. That's why it's best to find someone of a different approach.

I go to a psychologist also. Which seems to help. And some mood stablizers do help. Specifically Lithium Carbonate and Lamotrigine.

Right now I have nothing to be unhappy about or to have a low self-esteem. I should be very happy, yet I still feel depressed. Something is causing me to be depressed that is outside my control. Therepy and exercise help some, but it doesn't fix everything.

I happen to have schizoaffective disorder. The schizophrenia part is pretty well treated, but bipolar seems to be difficult to treat. The whole manic part is treatable, but it makes treating depression difficult. I don't think much is really understood about the depressive end of bipolar. For some reason, it can't be treated directly.

It makes me think that depression itself is not very well known and even with therepy it is hard to stop

In the UK...

You can have a bit of a lottery with GPs. Plenty aren't good on mental health, especially the psychological rather than medicalised end, and can be a little unresponsive to patient needs.

Service is good in that mental healthcare recognises and takes seriously a lot of problems big and relatively small. If you've got severe mental health problems, resources are generally okay; likewise there's rarely a problem when the doctor wants to go for pharmaceutical solutions.

For actual psychological therapy, the funding falls down pretty badly. Psychological services in many areas of the country for non-critical treatment have huge waiting lists (6 months not unusual), and this then causes pressure to deal with them that can mean insufficient time allocated to patients.

That's on the NHS anyway; you can always find private psychologists if you've got the money. That said, my suspicion is that the government has an eye on booting mental health services out the NHS for anything but critical cases.

Fawcks:
We all know of mental health issues; They're very difficult to address, since they're not only widely varied, but they're difficult to successfully diagnose. In addition to this, treatment for these issues can be costly, and many may deem it to be inefficient use of funds to attempt to treat these "invisible" diseases. These disorders can range from schizophrenia to depression, and can range from a mild inconvinience to a purely debilitating disorder.

I'm currently living in Canada, personally, and I feel the mental health system here is... Poor. We may have universal healthcare coverage, but it's exceedingly difficult and costly to actually see a therapist to deal with issues and learn proper coping skills. The current regimine for dealing with my major depressive disorder is going to the doctor, getting prescribed something to help with my depression, then waiting six weeks to see if it does anything. If not, we try again with another drug, the side-effects often being rather off-putting to these medications. One has made me sleep a good 12 hours a day, another has caused my depression to deepen, and I gave it up after recurring thoughts of suicide.

Im canadian and had the same problems. My doctor had me come back in in 2 weeks with constant updates, as well as recomending me to a therapist in the public system. Your province might be differant, but in mine I was told I could go to walk in therapy at any time during my 6 week wait.

Fawcks:
We all know of mental health issues; They're very difficult to address, since they're not only widely varied, but they're difficult to successfully diagnose. In addition to this, treatment for these issues can be costly, and many may deem it to be inefficient use of funds to attempt to treat these "invisible" diseases. These disorders can range from schizophrenia to depression, and can range from a mild inconvinience to a purely debilitating disorder.

I'm currently living in Canada, personally, and I feel the mental health system here is... Poor. We may have universal healthcare coverage, but it's exceedingly difficult and costly to actually see a therapist to deal with issues and learn proper coping skills. The current regimine for dealing with my major depressive disorder is going to the doctor, getting prescribed something to help with my depression, then waiting six weeks to see if it does anything. If not, we try again with another drug, the side-effects often being rather off-putting to these medications. One has made me sleep a good 12 hours a day, another has caused my depression to deepen, and I gave it up after recurring thoughts of suicide.

So, how do you, personally, feel the healthcare system serves those with mental health problems? Do you agree with financial resources being used to treat these people? At what point does a mental health issue become debilitating to the point that it merits treatment? Etc. etc.

As someone dealing with mental problems stemming from brain damage (I'm disabled and collecting social security as I mentioned before) I can say I have mixed opinions. I've had to get treatment from the local Community Health Center due to the coverage I get from the goverment for the moment, and to put it bluntly the treatment has been a mess. Among other things I'm required to see a Therapist so I can see the actual psychiatrist who prescribes my pills as a matter of policy, which is a waste of my money (Co-pay) and their time, because there isn't anything counseling can do for me because my problems come from actual physical damage to the brain. I see the therapist like once every six weeks to two months and all she does is pass along a message to the other doctor if that. I mean I'm in there for like 5 minutes tops for purely bureaucratic reasons. "What's wrong with you?" "Well Doc, I have this giant dent on top of my head as you can see, and the brain underneath that isn't working the way it's supposed to".

That said, I've played around with lots of differant kinds of medications, and I know where your coming from. The best compromise has me sick all the time without any of the symptoms being totally deabillitating, and has caused me to gain tons of weight since I stopped working. I was always a pretty solid guy (which helped with my job as Casino Security), but I'm currently 70 pounds overweight and made of mashed potatos. I can empathize with your situation in playing with meds.

In a general sense though mental illness is a touchy subject, to put it bluntly the world sucks. We're overpopulated to the point where human life and contact has absolutly zero value, and pretty much everyone is mercenary to everyone else 100% of the time. Competition to have a good life is unbelievably brutal, and we have guys with 4 and 8 year degrees flipping burgers or starving out in the streets. In this enviroment, depression is a given, there is absolutly no reason for any sane person in the rut 99% of the population is in to be happy. Our school system telling kids "your special, you can do anything" and giving all these positive messages about friendship and the inherant goodness of people, even ones you don't know, also doesn't help as it leaves people emotionally unprepared for the crappy dead end job your typical person looks forward to, never mind the possibility of being stuck on the street without even that.

In short, depression is more or less normal, anti-depressants have mixed results I think because terminally depressed is simply normal for the situation a lot of people find themselves in, and really in a world like this the only way your going to get a happy population is for the goverment to start pumping SOMA into the water supply (Kudos for
those who get the referance).

The other issue here is simply that in cases where people have serious problems, we're looking at long term treatment, psychological problems are not something that you just treat and see go away, no matter what their cause. This is what makes them so daunting and expensive to deal with. You can argue about human rights and the right thing to do, but the bottom line is that all those doctors need to be paid, and those drugs need to be manifactured and distributed and so on, the cost of dealing with the mentally ill, especially in large numbers, is absolutly staggering. That is why there have been so many atrocities committed through the years through asylums, or the system stuffing them into the regular prison system (which still happens) and so on.

I wish I had something upbeat to say on this subject, but really I don't. The point is that I have first hand knowlege of the system mismanaging it's resources when it deploys them, and even so there just aren't enough resources to deal with all the problems. What's more I think that when it comes to things like depression in paticular, your simply looking at normal reactions to reality, it's a situation where society is sick rather than the people. A person without hope or a viable chance of self improvement, who gets to watch other people with the things he wants 24/7 while constantly going without and making due is not going to be happy person no matter what. Nobody gets everything they want, but some people wind up never getting anything they want the way they want it (so to speak). Sadly there are no easy solutions for that.

 

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