Help Please!! Psychiatric Care in your country.

epg_pei · Jan 23, 2007

Hi there! I hope that one of you would be kind enough to help me.
I am a nursing student in the United States and I am currently in Psychiatric Nursing. I have a project that is due in the morning and I am at my wits end. Yes I realize this is the last possible moment, but that is an entirely different story. :smackingf
I have to interview someone from another country about the Psychiatric care in that country. Could you help me? It would only take a few minutes of your time.
I just need to know how it works. What is your perception of care? is the care adequate? Who pays for it? If someone is committed to a hospital or institution, is there a stigma attached to them? Are they shunned from society or is help given to them and then they are introduced back into society after a period of time? Anything at all would help me out tremendously. Thank you very much
Cheryl

LOL ok, I work in psych in Canada. We have socialized care, which really means we pay health insurance premiums as parts of our taxes, but we never see what the individual premiums are, it's hidden, make sense?...we could have more resources for sure, but in general we have a good arrangement for the money available....mind you I didn't say system, I said arrangement....it's like a patchwork quilt that's a little threadbare in spots, but manages....I personally strive very hard to work with both patients and the general public to remove the stigma associated with mental illness, but it's still there, and since I live in a painfully small place, it has a definite effect... the goal is to achieve the highest degree of wellness for any particular patient, hat may mean short stay in acute care, or a detox program, or longer term care....if returning to community to resume activities is an expected outcome, well, I guess that answered itself....I dunno, anything else?....

Thoc_123 · Jan 23, 2007

Are there "state" institutions? If so, are most people with mental disorders committed to an institution, or are they treated via outpatient treament?

Are drugs prescribed readily for disorders? You stated that it is a Socialized care system that is paid via taxes. What if you are unemployable? Are there ones that do not receive care because they have never paid taxes?

I appreciate this!

Thank you!

Pediatric Critical Care Columnist · Jan 23, 2007

We have "provincial hospitals" here. They're usually reserved for the really intractable cases. Canada went through a reform of the mental health system about 20 years ago that wasn't really a reform. It was more of a "people with mental illnesses shouldn't be warehoused, so let's get them all out of institutions so they can live in poverty on ths streets" kind of plan. Community mental health services fall far short of the mark, but most people are still treated on an outpatient basis. Canada is a nanny state in a lot of ways, and the mentally ill can access all sorts of programs and funds if they know about them and know where to go. They fall under the heading of "severely handicapped" in Alberta, which gives them a monthly income of $1000, coverage for all prescribed meds, ambulance and emergency care, dental and vision care. However, the program is not user-friendly and requires the individual to have a bank account where the monthly cheque can be deposited directly and eligibility is reviewed annually. Recipients are mailed an 8 page questionnaire which is essentially a means test and confirmation that the person is still severely handicapped. Assistance with housing and community services have to be sought from other sources. See the problem with this scheme? Alberta is also the only province that charges health care premiums to the individual instead of using general tax income. If you don't pay your premiums ($44 a month, not a lot, but if you're living on the street...) they will refuse to cover your ongoing treatment. And these patchworked provincial programs are not seamless; if a person moves to another province to be closer to their family, they do not automatically qualify but must go through that province's processes, where perhaps they may not meet the criteria.

I know a young woman who is 34 years old and lives in British Columbia. She has been seriously depressed, with multiple axes diagnoses, for more than 7 years. When she had her breakdown she was living in the provincial capital, had a professional career and was building a life. But her parents lived in a smaller city some distance away and when it became obvious some four months later that she was not able to live alone anymore, she moved in with them. She was being seen three times a week by a psychiatrist in Victoria, but when she moved back home, the nearest psychiatrist who was taking on new patients was in a small town an hour and half's drive away through a mountain pass. She applied for and began receiving a disability pension including coverage for her meds. She has never recovered enough to work full time at any kind of job, although she no longer lives with her parents. She sees her psychiatrist every couple of months and in the interim her family physician fills the breach. Her mom and dad are older now and were thinking about moving to Alberta to be closer to their other children, who all live there. But they never made any serious inquiries about doing so out of concern that their daughter would not be able to receive the same level of care she's currently getting... It's a no-win situation.

Thoc_123 · Jan 24, 2007

Thank you for the responses that I received. They were very informative and helped me out tremendously. I also learned something new about your health care system. I had always assumed that your health care system was great, which I am sure it is 100 times better than the system in the US. I turned in my presentation and hopefully will receive feedback shortly from my instructor. Again, i thank both of you very much for your help.

Cheryl