Mental health (in the USA and elsewhere)

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During all the years I've worked as a social worker, I frequently (better: usually) had to do with people who had some kind of mental illness.

And recently, I had use this knowledge in my private life (with may aunt and an elderly neighbour).

Psychiatric hospitals here are ... hospitals, with A&E departments as well as more specialised departments in a couple of wards (including usually at least a 'closed' one as well as closed for geriatric patients).

Psychiatric hospitals for children and youth are organised similar, but you don't find many of those. (In all Germany we've 94 psychiatric beds per 100,000 inhabitants and 32 per 100,000 for children and youth.)

Additionally, we've got day clinics and day care facilities - but much to few. (In our district, we've only 45 places in day clinics - for 300,000 inhabitants! [A bit more places in day care facilities.])

Due to some responses in a different thread I'm just wondering about the situation in the USA (and elsewhere),

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@Walter Hinteler,

Quote:

. In 1970, there were approximately 524,878
psychiatric beds in the United States, with about 80 percent of these beds
provided by state or county mental hospitals. By 2002, the total number of
psychiatric beds had declined to 211,199, with over 68 percent of inpatient capacity provided by the private sector

http://www.nhpf.org/library/issue-briefs/IB823_InpatientPsych_08-01-07.pdf

we decided that psych wards do not conform to our values, so they have mostly gone away. the promise was made that these people could live independently a get treatment in day clinics in their community,but we never had close to enough clinics and a lot of those who need treatment refuse to show up anyways. those who used to be (or should be) in the psycho wards are now a huge percentage of our homeless population.

AMERICA IS GREAT!

the problem is well known and well ignored. this is not something that we want to spend money on.

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@hawkeye10,

hawkeye10 wrote:

those who used to be (or should be) in the psycho wards are now a huge percentage of our homeless population.

Interesting. I've never thought that the homeless population should be patients in a psychiatric hospital nor is the percentage of those being there extremely high.

hawkeye10 wrote:

we decided that psych wards do not conform to our values

Values? Is a mental ill person not worth being treated according to latest medical knowledge? (Not all can be done in day clinics.)

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@Walter Hinteler,

Quote:

Values? Is a mental ill person not worth being treated according to latest medical knowledge?

confinement is unamerican....the left pushed to close the hospitals on this argument...promised that community day treatment would work fine, but then all parties refused to fund the needed day treatment. however, once the person is no longer committed we can no longer force them to get treatment. There was never anything but an assertion that this idea would work, there was never any evidence . it was soon clear that even when day treatment is avail it often does not work because people either never go or they stop going when they think they dont need it anymore (but do) and then they fall all the way down again.

in my opinion this wrong turn was taken at the hand of idealistic idiots and cheapskate liars....taken decades ago but we show no signs of being willing to reconsider. the mentally ill here are mostly invisible...we ignore them by choice.

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@hawkeye10,

Quote:

AMERICA IS GREAT!

Ain't that the truth, Hawk. So great that y'all elected Reagan, a borderline mental patient himself, twice, to lead this great country.

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@hawkeye10,

hawkeye10 wrote:

however, once the person is no longer committed we can no longer force them to get treatment.

You can't really force anybody to get any medical treatment - only a very low percentage of patients in our psychiatric hospitals is there on involuntary commitment.

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@hawkeye10,

Quote:

once the person is no longer committed we can no longer force them to get treatment...

As an alleged champion of individual liberty and "freedom" I'd think you'd wholeheartedly endorse that idea.

All people have the right to refuse medical treatment--including the mentally ill--unless they are an imminent danger to themselves or others.

Do you want anyone to force medical treatment on you?

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@Walter Hinteler,

Mental health care options vary state by state. The National Alliance on Mental Health gave an overall D grade to the US in 2009

http://www.nami.org/gtsTemplate09.cfm?Section=Grading_the_States_2009

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@firefly,

Quote:

Do you want anyone to force medical treatment on you?

if i am not of sound mind through a recognizable mental defect, absolutely. you seem to forget that I am in favor of limited forced sterilization as well, because my views on the mentally ill should not surprise you at all.

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@hawkeye10,

Then you're the police state adovcate.

The mentally ill are entitled to the same civil rights, and civil protections, as everyone else.

Refusing psychiatric treatment is no worse, or more self-destructive, than people who chose to smoke cigarettes, or drink excessively, or eat their way into obesity, or lots of other things that people do that aren't in their best self-interest.

Most mentally ill people are not homeless and living on the streets. Most live at home, others are in group homes or independent living programs. If they are more "invisible" now, it's because they now better blend in with their communities, and they are able to live fuller and less restricted lives.

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@Walter Hinteler,

Walter Hinteler wrote:

hawkeye10 wrote:
however, once the person is no longer committed we can no longer force them to get treatment.

You can't really force anybody to get any medical treatment - only a very low percentage of patients in our psychiatric hospitals is there on involuntary commitment.

a lot of the rest have been manipulated into treatment by loved ones and mental health pro's. once people are out of the institution it gets to be extremely difficult and time consuming to find them again, or to get them to listen.

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@firefly,

Quote:

The mentally ill are entitled to the same civil rights, and civil protections, as everyone else.

i do not agree....the health needs of the collective comes before the desires of those not of sound mind.

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@firefly,

Quote:

Do you want anyone to force medical treatment on you?

Do you want anyone to force their ideas on how you should live?

Do you want anyone to install a dictator so that another country can steal your wealth?

Do you want anyone to torture and murder your countryfolk to help and aid them in stealing your country's wealth?

Do you want anyone to use Operation Bomb The **** Out of Everyone to save you from yourselves?

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@hawkeye10,

Quote:

i do not agree....the health needs of the collective comes before the desires of those not of sound mind.

Most mentally ill people don't bother the "collective" in any way.

Smokers were a much bigger health hazard to others who had to inhale their second hand smoke. People who show up in their offices when they have the flu pose more of a danger to the "health needs of the collective" than do the mentally ill.

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@hawkeye10,

Quote:

.the health needs of the collective comes before the desires of those not of sound mind.

Would you say, Hawk, that those of the collective who studiously ignore the terrorism and the horrors their governments inflict upon innocent people are of sound mind?

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@JPB,

The situation varies here, too, from state to state. And certainly, it's better in larger towns and cities than in a the more rural region.

Thanks for that link, JPB! I'd looked up there before I started this thread ... and got a bit confused by what I'd read there.

In 2008, mandatory health insurers paid for psychiatric care roughly 60% for hospital stays and 38% for ambulant costs in doctor's practises; 2% was paid for care in acute day wards of the psychiatric hospitals.

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@firefly,

firefly wrote:

All people have the right to refuse medical treatment--including the mentally ill--unless they are an imminent danger to themselves or others.

I certainly agree.
But usually, someone with a broken arm looks for help at a doctor's surgery or in a hospital. As does someone, who is depressed or suffers from some other kind of mental illness.

Much can be done outside of hospitals - that's why you have to wait here a couple of days to get a date at a psychiatrist's practis.

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@Walter Hinteler,

i have not seen any studies on this but my sense is that a critical flaw of the advocates was in assuming that those needed treatment would live with loved ones for an extended period. After all loved ones will always tell the pros that they will take the needy in, we are almost not allowed to give any other answer. but having a majorly mentally ill person in your home is a major burden, and the ill know that they are a burden, dont want to be a burden, and often leave ending up on the streets. some of these people can live on their own, so we can set them up with an apartment, but that would of course defeat the purpose of the cheapskates.

we could provide services for those who care for the mentally ill, again though someone needs to pay the bills.

1 Reply

@hawkeye10,

The bill is paid here by the insurance companies - be it the mandatory and a private one.

And the mentally ill stay of course at home ... after they got their treatment in a hospital (which usually lasts doesn't last longer than a couple of days up to three weeks) or from a psychiatrist in the practise - they visit this one like any other doctor.

1 Reply

@Walter Hinteler,

Quote:

The bill is paid here by the insurance companies

it has been a major decades long struggle to get insurance companies to pay for basic mental health care, and now you expect them to willingly pay for services provided to loved ones who care for them?? Drunk

besides, those on the right insist that families should do this for loved ones out of love, they can get behind yet another raid on the public coffer for this.

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Mental health (in the USA and elsewhere)

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