How Do You Improve the Mental Health System of the US?
Audience question during our live calls segment came in asking wow would I improve the mental health system in the US?
I give some thoughts, but would love to hear yours in a reply
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David, I must commend you on your choice of topic for today. I appreciate that your conversation reflects the complexity the issue.
You mention the cultural aspect. The stigma attached to seeing a “shrink” is real. Personally, I’d prefer they be called “mind expanders”.
Gone are the days where you would lie for hours on the psychoanalyst’s couch to unload your neuroses à la Woody Allen. Now the model is medical and empirical, hence the necessity for a diagnosis which is required for reimbursements by health insurance. The flip side is that mental health treatment, precisely because it is covered by health insurance, is now accessible to a larger population than before.
The caveat of course, as you rightly point out, is that in order to be reimbursed, you need a bona fide diagnostic code contained in the current edition of the Diagnostic and Statistical Manual of Mental Disorders which is now in its fifth edition (DSM-5).
If the diagnostic criteria are helpful in pointing the healthcare professional in the direction of an appropriate treatment plan, and if putting a name to an individual's experience is often instrumental in helping them make sense of their experience (if you can name it, you can tame it), there is also a large amount of stigmatization involved with a diagnosis. Certain diagnoses are more stigmatizing that others, such as Bipolar Disorder and Borderline Personality Disorder, and the very fear of stigmatization does keep many individuals from seeking help. From “mental health diagnosis” to “mentally ill” to “crazy” it doesn’t take much in people’s minds.
In addition, the way the mental health system is run in the US is confusing for a lot of people, and complicated further by differences among the states.
I’ll take this opportunity to clarify a few terms for your public. Generally speaking psychiatrists prescribe medications. They don’t normally do therapy anymore. Psychologists, psychotherapists, social workers, counselors are the ones who do the “talk therapy”. Psychologists have doctorates and the others have at a minimum a Master’s degree. In my experience, their level of education impacts minimally, if at all, the quality of the therapy. In most states, the former (psychologists with a PhD or PsyD) are qualified to administer and interpret psychological tests forensically and the others are not.
By the way, you are correct about the least stigmatizing diagnosis. It is indeed Adjustment Disorder and it has several sub-categories.
The one thing I would have to add, is that mental health practitioners must make a correct and applicable diagnosis. On one hand they do not want to commit insurance fraud, and on the other hand they need to practice within the guidelines of their respective professional boards. They are kept on a tight leash and their licenses and livelihood are on the line. The declared purpose of these boards is to regulate the profession in order to protect the public from malpractice and harm, so here again we have two sides of a coin.
You mention the negative fallout of medical personnel in mental health treatment. The percentage of truly “crazy”, “off their rocker”, “insane”, potentially dangerous/homicidal people in mental health treatment is minute. Someone with a Major Depressive Disorder or Generalized Anxiety Disorder is not “crazy”, however these fairly benign diagnoses can and often are used against an individual, especially when it comes to government employment or, more painfully, in nasty divorce and custody cases.
Finally, it is a sad reality that a medical record is actually a legal document…
Thanks very much for the in depth comment. Very interesting.
I realy realy like that there wer this huge posts and discussions under the videos.
A side effect of getting payed for comments.
Ok I´m from German and it feels always very surreal that a country like the USA basicly had no socialcaresystems.
Realy? I can upvote my own post?
Invest heavily in the Research & Development. Move research centers to India to get the max outcome for your buck :)
True for that. The human brain is not well know yet whereas it is our main tool.
Majority of mental issues may not be 'mental' at the end of the day, but a physical 'imperfections' and we currently treat them wrong. There's some new research suggesting the ones like schizophrenia may be caused by faulty brain vessels. More research and completely new approach to treatments is needed, less focus on psychological aspects and more focus on flesh and bones. Take a quick look at this post, it's 2 months old, but that's a very fresh discovery in terms of mental healthcare. It's groundbreaking.
https://steemit.com/health/@voluntary-io/major-breakthrough-on-fighting-schizophrenia
Thank you mate, I am going to check right now. I have a friend working in the medical and I saw a few people having this kind of problems. You might be right but at the end of the story, I can assure you, psychadelics and even cannabis can be a shutter button to schizophrenia which is a good thing. Better know it at 15 that at 40 when you have kids and a wife.
Drugs can cause a lot of mental problems, especially in people who have genetic predispositions to be affected. Drugs are what they are drugs, they amend the way human body and brain works, if used wisely they may fix things otherwise can make a lot of damage.
Drugs or drogs ? Some drog are worst than some drugs and the inverse is true as well... Government is the biggest drog dealer in most of developed countries. Look how many people die from alcoohol, from tabacco, from canabis and then from paracetamole which is the most basic medicament.
Good
health is the essential thing as a human need, especially physically and mentally healthy when all that has been realized, everything we do will be perfect thanks @davidpakman
Personally I have come to Realize that mental illnesses can cause alot of damage to the society,especially among the youth.
So to provide an answer to the aforementioned,we need to understand some vices that can bring about mental health deterioration!
Your cohost brings up an excellent point. Mental health treatment has a stigma associated with it and the threat of the government getting involved in your life and taking away certain rights or putting you on some sort of list because of a particular diagnosis only deters people from seeking treatment.
I think another problem which gives the mental health industry bad rapport is the overuse of pharmaceuticals. So many children are prescribed medications to alter their brain - just for being rambunctious! This only reflects on mental health treatment in general as lazy and with the agenda to enrich drug companies. People like to attack gun rights whenever there's a mass shooting - but a commonality in all of these cases is that the assailant was using psychotropic medications. What does that tell you about the potential dangers of these mind-altering drugs?
good one
Hi, I see that you have a big DTube channel.
I upload my first Video today, please rate the movie, and give some tips :)!
Regards :)!
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good good
This content is very Good...
I like it very much...
Yeah, I will wait for the next Health content...
I am french and I think Canadian have one of the best health system in the world. USA should take them as an example !
Trying to make more use of DTube, over Youtube, need to get more channels on here, such as Secular Talk, also would be amazing if a huge name, such Phillip Defranco came on here