Do you think psychiatric care is inadequate in the US?

  1. 4
    In this country a scene all too common is happening over and over in this country: a deranged man enters a public facility and starts shooting everyone. Its found out later in the news that he was suffering from XYZ Mental Illness...

    I wanted to start this thread after the tragic events that unfolded today in Connecticut (my condolences to all the families effected)

    Now it seems like some of these events could have been stopped had someone noticed, or if the person had adequate access to mental health services

    When i used to work in LA i did a lot of psychiatric transports on the ambulance (mainly 5150 holds). I've noticed a lot of these patients were given a couple meds and then thrown out on the street and forgotten till they act up again and go through the cycle again.

    I personally think there should be more public education on noticing and reporting the signs of a person who is a threat to others or them selves or unable to care for them selves.

    I also think there should be more funding towards mental health institutions as well.

    note i am only speaking from what i have seen with my experience on the ambulance, if anyone who works at a psychiatric/mental health facility please share your thoughts as well


    what do you think? is mental health/psychiatric care is inadequate in the US?
    VICEDRN, Hoozdo, lindarn, and 1 other like this.
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  3. 78 Comments so far...

  4. 9
    the body of evidence speaks for itself.....or should I say bodies
    enoRN, MsBruiser, nrsang97, and 6 others like this.
  5. 10
    I work in the field. Unfortunately there are many issues that still need ironing out. There's still a huge stigma surrounding psych that prevents people from seeking help- the labeling, denial of being sick , voices that tell people to do things- I've seen patients that couldn't be reached because they believed the voices they heard were real and didnt accept otherwise, insurance coverage, deinstituitionalization. While there was definitely some good that came out of deinstituitionalization I feel some people were hurt dramatically by it. Some just cannot take care of themselves and function whatsoever on their own. There was a person once with schizophrenia who came in infested with cockroaches and who we had to immediately send to the medical hospital with a GI bleed. The person almost died. Insurances don't want to cover mental illness, people start feeling good and stop there meds leading to the revolving door effect, people in our community are uneducated and still view mental illness as its portrayed in the movies. We need to educate, provide better health coverage and unfortunately the field still has a lot of growing to do and research to be done.
    doni718, kcmylorn, azhiker96, and 7 others like this.
  6. 6
    Obviously.
    nrsang97, canigraduate, myelin, and 3 others like this.
  7. 4
    I asked a similar question in the recovery forum, but specifically to the health care professionals who have mental illness. In short, the answer is yes, I think it is very inadequate.

    Can I add something? I want to mention that I don't think Autism or mental health issues should be the automatic reasoning behind heinous crimes. There are many people with these issues who don't do anything; if anything contribute wonderful things to society. People need to take responsibility. Also, think...is it scarier to think a "sane" person or someone who wanted revenge (remember, this wasn't a random school or random class he shot up--it was his mother's school/class) did this? The answer is yes. This isn't a problem only in mental illness (and Autism. I am seeing Autism starting to get the same stigma).

    But, in regards to funding, proper/adequate staffing, etc., yes, mental health needs an overhaul.
    Last edit by wish_me_luck on Dec 15, '12
  8. 7
    Well, duh.

    I think of it like this: how healthy would people be if there were only emergency rooms? No hospitals, no continuing care. That's how I think mental health is treated. It's awful.

    I also think it's seriously overlooked, ignored, and undiagnosed in the general public. If I had my way, signs of mental illness and pathways to receiving treatment would be taught starting at the elementary school level, along with basic health. I still remember being taught how to brush my teeth when I was in kindergarten, so the lessons learned that young can stick with you. Why not teach kids to tell an adult if they are having symptoms?
    jadelpn, BCgradnurse, nrsang97, and 4 others like this.
  9. 4
    I'm a Gen X'r. From what I recall, things took a serious nosedive during the Reagan era. I'm actually pretty conservative about government spending. That said, I remember a time when we did not see mental health patients roaming the streets unable to care for themselves and/or committing these heinous mass murders. Because the more seriously mentally ill were, if not institutionalized, at least having their needs met on an outpatient basis at these same institutions. It also decreased the tremendous stress that is frequently placed on families who deal with very serious mental illness.

    The last four or five paragraphs of this blog articulates it fairly well.

    Ronald Reagan: The Bad and the Ugly - The Daily Nugget

    p.s. Mental health care continued to roll back. In the late 80's working in psych, patients actually got a fairly long treatment time in residential care. Their families participated also, because frequently, changes in the family were necessary, not just in the person undergoing treatment. Now the patient may get two or three days in acute care. Mental illness simply no longer has ANY parity with other medical issues.

    p.p.s. Even in years prior to that, though, there were incidents that involved people with serious mental health issues. For instance, Charles Whitman had a brain tumor. Now, that would have been difficult to foresee unless someone had prevailed upon him to seek care (as I gather that he himself noticed and wrote about the fact that something was wrong with him).

    Richard Chase had schizophrenia. I believe that WAS known prior to his crime, but he was not receiving regular care.

    But it does seem that now, with so many untreated/under treated individuals, the potential for psychotic episodes is much greater. And sometimes, these episodes will include violence.
    Last edit by Sadala on Dec 15, '12
    rninme, MsBruiser, nrsang97, and 1 other like this.
  10. 3
    Cani, I agree. I think mental health needs to be taught in schools. Sexual education is taught, mental health needs to be taught.

    I don't know if under diagnosed is a good term though. Mental illness/health issues is becoming this relative thing, which is not good. It seems like if someone has a problem with someone else, they automatically label them as mentally ill. Wrong. Anger, sadness, happiness/joy, etc. are normal emotions. Mental illness occurs when extreme emotion occurs that affects one's life/others around them over a set period of time. Then, you have to consider expected grief--death of a loved one, divorce, etc. It's okay to go through grief and it's okay, to be numb/feel nothing at all when something like death happens. After a period of time of grief (1-2 yrs depending on the source you look at) and not getting over something, then that's complicated grieving. That can set you up for long term problems, especially if genetically you are predisposed to mental health issues.

    "Genetics loads the gun, environment pulls the trigger."--Judith Stern

    The whole idea behind mental health issues/illness is that those people have abnormal thought processes/actions. If you have criteria that there's the slightest emotion in someone and they are considered mentally ill, that becomes normal, not abnormal, because most people in the world would be considered mentally ill.

    In the overhaul on mental health issues, there needs to be better criteria in diagnosing mental illness and zero self diagnosing. I love the internet, but I think people are trying to figure out what is wrong with themselves or others, and they diagnose something that may not actually be true.
  11. 4
    Sadala, I agree in treating the whole family. Yes, there may be one member with mental health issues, but usually enviroment plays a big role. I have BPD and in most cases, not every case though, there is a history of abuse--physical, sexual, or emotional abuse. I feel like I was put down a lot as a child and it continued into adulthood. I am supposed to sit there and take it? I think not. If you provoke someone, you will get a reaction. I don't randomly go off on people, that is a huge misconception with BPD. You need to work on the abuser as well. You may actually find more issues in them than you find in the patient that was intended to be given care to.

    I also try and be happy...sometimes, I do cry though. It's okay though. My parents always ask me why I smile, laugh, etc. Simply put, I am happy. It used to be that I didn't smile and people would say "smile, be happy". I am finally there and this what I get. You are darned if you do, you are darned if you don't. And I am at the point where I don't care about other peoples' opinions. They are just that--opinions. Not fact.

    But, yes, 100% agree. Every member of a family/household must thoroughly be looked at. Nothing will ever get better unless you get to the root of the problem.
  12. 3
    Quote from wish_me_luck
    Cani, I agree. I think mental health needs to be taught in schools. Sexual education is taught, mental health needs to be taught.

    I don't know if under diagnosed is a good term though. Mental illness/health issues is becoming this relative thing, which is not good. It seems like if someone has a problem with someone else, they automatically label them as mentally ill. Wrong. Anger, sadness, happiness/joy, etc. are normal emotions. Mental illness occurs when extreme emotion occurs that affects one's life/others around them over a set period of time. Then, you have to consider expected grief--death of a loved one, divorce, etc. It's okay to go through grief and it's okay, to be numb/feel nothing at all when something like death happens. After a period of time of grief (1-2 yrs depending on the source you look at) and not getting over something, then that's complicated grieving. That can set you up for long term problems, especially if genetically you are predisposed to mental health issues.

    "Genetics loads the gun, environment pulls the trigger."--Judith Stern

    The whole idea behind mental health issues/illness is that those people have abnormal thought processes/actions. If you have criteria that there's the slightest emotion in someone and they are considered mentally ill, that becomes normal, not abnormal, because most people in the world would be considered mentally ill.

    In the overhaul on mental health issues, there needs to be better criteria in diagnosing mental illness and zero self diagnosing. I love the internet, but I think people are trying to figure out what is wrong with themselves or others, and they diagnose something that may not actually be true.
    I do also really agree with this. If you go back and watch films from the 70's and 80's you can see how our tolerance for emotion has changed dramatically since that time. It's almost as though people are now expected to be automatons or else it is considered that something is wrong with them.

    It's more that I think that people with lifetime serious mental illness (and their families) don't have the support and services they used to be able to access. And also people with less serious mental illness. Certainly they deserve tx too. But I do agree that people are overdiagnosed these days as well when they are actually just emotional or dealing with life changes.
    VICEDRN, nrsang97, and lindarn like this.


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