Mental health... next public healthcare crisis

[JohnRoberts]

I have been watching this play out in slow motion for decades. Who remembers psychiatric institutions?  (AKA mental hospitals).  With good intentions and civil rights involvement the burden of long term (chronic) mental health care has shifted from state operated institutions to community shelters, who often fail these patients. This is further complicated by our inability to force patients to take their meds against their will. The dulling effect of these mood moderating drugs can be unpleasant so many forgo the medication that would help stabilize them. Perhaps we need better drugs but that is not an obvious short term option. 

These many challenged patients who fall through the cracks of community support often end up homeless living under roadway underpasses in warm climates. The liberal political climate (promising free sh__), legalized pot(?), and warm climate in SOCAL has been a magnet for them.

The politicians want to characterize this as a homeless problem, but that is just the most visible symptom, not the underlying cause which is untreated (mis-treated) mental health.

I do not see an easy solution for this but the negative consequences from doing nothing are growing. The dark ages sanitation (i.e. no sanitation) is creating an environment for medieval diseases to recur (like typhus, TB, etc). It will be far worse than a few people getting measles if a large enough fraction of the growing rat population get infected with plague and spread it to humans.

This sounds like a bad dystopian futuristic movie plot, but it is one modern reality.  Dr Drew Pinsky best known as a media personality is an actual mental health professional and very vocally warning about this.

Besides camping in underpasses, many of these challenged individuals end up in prisons, sometimes for their own good (but not a very good treatment option).

The low single digit fraction of our total population with mental health challenges did not magically heal when the mental health hospitals closed. IMO it is too late to be proactive about his, but we can reduce the potential harm from letting this run its full course to a dystopian catastrophe in some large cities.

Sorry this is a lot to digest in a single topic, and several different issues are conflated together, but mental health seems like a common thread.

JR

PS: Better identification and treatment of individuals with mental health problems might even help a few regain personal control before they shoot up another school or church.

 

[Tubetec]

You only have to look at the number of pharmacies here in Ireland over the last 30 years to see whats happened .
Year on year the legalised 'dope' business has grown , despite the economy generally having its ups and downs , the trade in legal mind altering substances has probably enjoyed double digit gains most years in the last 30 .
Someone I know in medicine guessed roughly 50% of the population were on some kind of daily med , contrast that to 50-60 years ago it was almost unheard of .

Ive seen plenty of people  branded mentally ill here by both family ,friends and the medics, if they didnt 'conform' or take their stupifying meds the threat of being carted off was always hanging over them  , in every case there was legacy issues of physical, emotional or sexual abuse within the family mostly ,but also perpetrated by church and state in the case of people who were at the 'pleasure' institutions of state .

Ireland, back in the days had one of the highest numbers of people 'detained without charge'  under various legislations , mental health  ,disease control ,anti state activity  . 
Now in modern times if you look at the demopgraphics, the teritories who held out longest in the civil war here , which also co-insided with some of the poorest places ,take a  disproportionately high amount of 'mental health' type meds and suffer higher rates of 'addiction' to illicit drugs . Ive seen this playing out for the last 40 years in the town I live .

Just in the last week here in Ireland ,its finally becomes possible for pupils of state schools to take a case against the department of education for sexual abuse ,uptil now some legal impediment prevented cases proceeding ,  the E.C.J. ruled this was wrong. 

In a sense I was one of the lucky ones, my dad had a job , I only had to watch other less fortunate kids being knocked about  , at the time it was portrayed as fun by the headmaster ,the rest of us were supposed to laugh at the misfortune. 
I think now that the law has being clarified by the courts of justice , I feel I need to say it to some of the lads I still see around ,who I personally saw humiliated  beaten and abused ,that I should at  least offer to support them as a witness  if they need to pursue justice.  Sadly for some its way too late,suicide  drink , dope and addiction finished them early .


The vaccine trials that took place here in the state and church run institutions are still barely passed the 'conspiracy theory' stage , and the biggest most powerful influences are actively trying  to bury it , a country with a large 'captive' population is a very attractive proposition for medical research/testing especially, when the state can lock  people up without charge or a family have a vested interest and  branded them unfit for society for what ever reason, all manner of unethical testing becomes a possibility , theres quite a chunk of information about the methods and means of clearing the usual medical testing standards and ethical issues  in the files of 'MKULTRA' and other such projects.

There's a really great documentary on 'Bedlam Asylum' by Tony Robinson ,aka 'Baldrick' from Blackadder , details the interconnect between the Royal college of surgeons, body snatching and the exploitation of the poor for research purposes so 'cures' could be sold to wealthy clientele of the doctors involved , its a pretty scary indictment of the beginings  of the medical industry.

I think mainstream social media is probably the single worst thing for human mental health ever devised , its like their window shopping for their souls  by constantly comparing themselves , just a big recipe to become more unhappier with with what you do have as far as I can see . Is it gonna take another 'Jonestown ' type scene via Facebook to stun the world into action ?

Our governments 'light touch' regulation on what are now the 'superpowers' of the marketing world have allowed the big players in tech literally to 'data mine'  inside our heads , to the point that an AI can serve you what it thinks you want , Ive already heard of younger people ,who would be much more involved with the technology than me , say that more and more there noticing conversations can trigger specific product adds on social media for instance , let alone search history being data mined.
If 'big tech'  are allowed to set up a feedback path between the network and your mind ,Id call that tantamount to slavery , when you read the fine print details of many of the big players in tech, it reads  more like a waiver of your rights  .

 

[JohnRoberts]

You seem to be pointing at multiple bad guys without offering a practical solution.

For all the youts here who weren't born yet in 1966... https://duckduckgo.com/?q=stones+mothers+little+helper&t=osx&ia=videos&iai=MBuXyi_-t54

For many people the mood leveling drugs allow them to function, of course I suspect many of these are over prescribed. School kids being fidgety in class is normal, not a problem requiring medication.

Better drugs with less objectionable side effects might improve compliance for people with real issues.

Better mental healthcare could also reduce the incidence of suicide...

The list of things to improve/fix is long, but barely noticed by modern politicians. If anything they see big tech social media as the next cash cow to milk, and big tech will gladly pay the trolls living in the swap, to let them carry on.

JR

 

[Spiritworks]

If I watch an hour of television, say there are ten commercials ( Probably way more ) I'd guess four are for a fast-food company, and six are for some drug company product. Seems every day they are shilling some new drug for what appears to be some new disease which no one has ever heard of.

 

[Tubetec]

Theres a book here called 'Mims'
Its basically a list of the various prescription meds grouped by usage , and gives product info/dosage etc
20 or so years ago this book was  thin , more like the thickness of a magazine ,
over the years its grown in size by a factor of two or three times .
Theres an expectation by doctors now that by around the age of 50 people should be on a daily dose of something ,  cholesterol pills or blood presure meds seem to be the main two used to get the ball rolling ,
The cholesterol pills in particular have been shown to have some very dangerous side effects ,especially if you happen to be fit and take regular exercise  , again a moderate lifestyle/diet change might be all thats needed to fix the balance , and when the pills are thrown at you ,its not long before your back at the doc complaining about what might seem a totally separate issue ,most doctors are automatically biased against believing a pill they gave out  might be  causing a side effect . Even in the case of a medication being suspected in causing a problem , a stupid voluentary code of practise exists for reporting it . As you can imagine a Doctor who questions a big pharma product isnt going to win 'employee of the month' thats for sure .
As was mentioned previously by John , medicating children at a younger and younger age now seems to be what their doing , and why wouldnt they  , theres a very high likelyhood if someone is introduced to 'mind meds' to control behaviour at a young age , there going to be a life long customer .

 

[iomegaman]

SOCAL has a number of issues with homelessness...and a ton of that is related to mental health...I cannot see a path out of the mess that does not trudge through even more income inequality, which of course will lead to higher violent crime and more defined boundaries between the rich and poor neighborhoods...which of course will become local zoning wars...

My son lives in San Jose...which is catching the overflow of a lot of the homelessness issues...entire camps set up next to strip malls on the roadway medians next to malls...and the mall owners raising rents because land prices are ridiculous...these people are looking for isolation next to dumpsters/food sources...

Frankly I have never bought into the idea that our planet is overcrowded, but some of our cities are way past the breaking point of human population...

One of the first cases my daughter got as a DA in N. California was with a homeless guy who kept huffing paint and masturbating in public...when she took the case and saw the mental breakdown issues she realized he was not nearly as broken as he appeared but he was in fact a victim of a system where just a little bit of care could have turned his life entirely different...she works in the sex crimes division now and considers that guy a saint compared to the predators she hunts down.

I would like to believe that some of this is related to american consumerism and diet and a lot of other blame targets, but honestly I think its always been with us we just stopped caring...

Growing up it was not uncommon to refer to elders in care as people with "Old timers disease" (what we now call Alzheimer's)...and I distinctly remember there being actual mental institutes where "incurables" were kept...

We like to judge society by our accomplishments but history will judge us by how we treat the fragile.

 

[Scodiddly]

There's a pretty surprising number of homeless military veterans out there.  Very serious problems with PSTD in many cases, which should be expected when we've been continuously at war for a few decades and many military personnel keep getting sent back on more and more tours of duty. 

 

[JohnRoberts]

There's a pretty surprising number of homeless military veterans out there.  Very serious problems with PSTD in many cases, which should be expected when we've been continuously at war for a few decades and many military personnel keep getting sent back on more and more tours of duty.

Even worse the veteran suicide rate is 20-25% higher than normal population.  Going to war sucks.

I hope better access to mental health support could help veterans and civilians both.

JR

 

[Scodiddly]

I hope better access to mental health support could help veterans and civilians both.

Actually funding the VA would be a good start.  Politicians love to talk about how they support the troops, but that and $5 gift card to Starbucks will only get you a grande mocha latte.

 

[gyraf]

I hope better access to mental health support could help veterans and civilians both.

Yes, there's simply too much unnecessary pain out there.

When I was in LA in '17 - my first trip to the US - I was surprised to see just how many clearly psychiatric cases were wandering the streets. At the time I deducted that I'd chosen some extreme neighborhood. When returning the following years, I found that they are everywhere, a significant part of any streetwiev

Here in Denmark it's going slowly in the same direction: Psychiatric beds are expensive, and a lot of money can be saved by closing some of them. Every year. And the ones that are hurt by the lack of treatment aren't the ones that are likely to complain loudly, so they're easy to ignore politically. That is, until some gross crime is comitted - but then it's a individual's fault  :

As you say - it's really hard to figure out how to solve this, because it will be very very expensive to get right. Again, we must remember that these expenses are what has been cut down progressively for many  years in the pursuit to save public money.

Jakob E.

 

[Scodiddly]

There used to be a whole system of government-funded psychiatric hospitals that did a lot of this work.  My Dad worked in one for a few years.  Ultimately they were basically shut down to save money, and the patients mostly ended up on the streets.

 

[JohnRoberts]

There used to be a whole system of government-funded psychiatric hospitals that did a lot of this work.  My Dad worked in one for a few years.  Ultimately they were basically shut down to save money, and the patients mostly ended up on the streets.

Exactly.. but it gets worse. Laws have been written protecting their privacy and right to refuse treatment. The civil rights movement was also involved IIRC.

Without the old safety nets they end up on the streets and/or in prisons. I agree that people deserve privacy and rights, but when they literally are harming themselves and causing public health hazards like in several large cities already from homeless encampments, we need to make some adjustments. The libertarian perspective is to leave them alone as long as they don't harm others, but the growing public health hazard defeats that argument. The politicians prefer to characterize this as a wealth inequality homeless problem, but IMO it is a mental health care problem.

If this was easy or cheap we would have already handled it. We will have to deal with it eventually as it festers and grows worse.

JR

 

[Gold]

Reagan closed the mental institutions. There was good reason to.  Some of them were houses of horrors. The problem is that they weren’t replaced with anything.  It’s the streets or jail.

I see a lot of people in their early 20’s on the streets.  They are in my non professional opinion developing schizophrenia. It usually happens around that age. They should be getting care. Not reduced to living on the streets.

 

[JohnRoberts]

Reagan closed the mental institutions. There was good reason to.  Some of them were houses of horrors. The problem is that they weren’t replaced with anything.  It’s the streets or jail.

I see a lot of people in their early 20’s on the streets.  They are in my non professional opinion developing schizophrenia. It usually happens around that age. They should be getting care. Not reduced to living on the streets.

or perhaps their schizophrenia is why they are living on the streets.

I have shared this before but last century I made the mistake of traveling over to Frankfurt for a trade show when  I was clearly too sick to travel... Starting out dehydrated and with a fever was only made worse by a long ride in coach. By the time I got settled into the hotel I was clearly incapable of handling the scheduled rep meeting. Peavey is cheap (like me) so I was sharing a room with another product manager. I bailed on the scheduled rep meeting and went to my room.

When he returned hours later he was kind of freaked out by me, as I was him... I thought he might harm me, and he checked out of our shared room as fast as he could manage.  It took me several hours of forcing water down my throat to regain a sense of normalcy... My temporary condition gave me an interesting insight into mental illness... Paranoia can be very real to people with unbalanced brain chemistry. I wasn't close to getting violent, but I definitely felt threatened and my roomie didn't stick around to see what I might do.

JR

PS: In hindsight if you have a high fever, do the right thing and stay home in bed, don't travel across the ocean to work a distant trade show while health impaired. 

 

[Gold]

or perhaps their schizophrenia is why they are living on the streets.

Yes, of course. And their families can’t afford treatment. That’s the only way to get help.

 

[Scodiddly]

So John, what's your solution to this issue?  That doesn't involve any kind of socialism?

 

[JohnRoberts]

So John, what's your solution to this issue?  That doesn't involve any kind of socialism?

I'm afraid we are already a little pregnant with socialism, so it's just a matter of how socialist we become, because we are unlikely to abort the existing socialist programs. The congress just passed a record budget/spending bill so IMO the best we can do is do the best (sorry).

#1  a moonshot is to hope for better drugs that, people with mental issues are willing to take... but that cannot be expected.

#2 Rationalization of privacy/civil rights rules/laws that make it so hard to force people into care. Of course this invites the nightmare horror story of people being committed against their will.. I'm sure there are people here who think I'm crazy.

#3  Mental health support... some of this is common sense. Returning military are at high risk, etc. Simple data analysis reveals the at risk populations that need more effort. Of course this cost money, but this is better use of taxpayer money than subsidizing Tesla purchases.

===

The situation in LA and several other large cities is a local government mismanagement problem, where they don't even recognize it as a mental health crisis... You can't fix it if you don't recognize it.

Sorry, no easy answer, but this is not the only one on my list. I just had to talk about it before the melt down. 

JR

 

 

[boji]

I'm sure there are people here who think I'm crazy.

I've dusted off my old straitjacket. Whenever you're ready, JR. 
It's one-size-fits-all, right?

 

[desol]

I think a lot of mental health problems stem from family upbringing, poverty and a lack of support to counsel people in need. There's simply not enough in the way of resources. It's good to learn to be introspective and take action in terms of self care.

If ya wanna make a difference ya gotta be willing to help people, for nothing.

 

[Scodiddly]

I just had to talk about it before the melt down. 

Er, what?  You're expecting things to get worse?

Actually so am I.