Mental health (in the USA and elsewhere)

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??

I wasn't talking about "normal care" at home but about the medical care/treatment.

Most of the psychiatric care for the mentally ill, who are too disabled to work, would be paid for by Medicare here, and, for others, who lack private health insurance and/or sufficient personal assets, Medicaid picks up the tab--so it's mostly government insurance that funds care for the seriously and chronically mentally ill.

People who are homeless frequently report health problems.
38% report alcohol use problems
26% report other drug use problems
39% report some form of mental health problems (20-25% meet criteria for serious mental illness)
66% report either substance use and/or mental health problems
3% report having HIV/AIDS
26% report acute health problems other than HIV/AIDS such as tuberculosis, pneumonia, or sexually transmitted diseases
46% report chronic health conditions such as high blood pressure, diabetes, or cancer

Between 250,000 individuals with schizophrenia or manic-depressive illness are homeless among the 744,000 homeless population (total homeless population statistic based on data from a 2007 national survey). These 250,000 individuals are equivalent to the population of such cities as Dayton, Ohio; Des Moines, Iowa; Fort Lauderdale, Florida; Grand Rapids, Michigan; Providence, Rhode Island; Richmond, Virginia; or Salt Lake City, Utah.
· A 2007 survey by the National Alliance to End Homelessness reported that there were approximately 744,000 homeless persons in the US. Among these, approximately two- thirds were single persons and one-third were families. One-quarter of the homeless persons were said to be chronically homeless. Numerous studies have reported that approximately one-third of homeless persons have a serious mental illness, mostly schizophrenia or bipolar disorder. The percentage is higher among those who are chronically homeless and among homeless women and is lower among homeless families. If overall one-third of homeless persons are seriously mentally ill, that means that there are approximately 250,000 homeless persons with serious mental illnesses in the US.

At any given time, there are many more people with untreated severe psychiatric illnesses living on America’s streets than are receiving care in hospitals. Approximately 90,000 individuals with schizophrenia or manic-depressive illness are in all hospitals receiving treatment for their disease.
The New York Times reported that in Berkeley, California, "on any given night there are 1,000 to 1,200 people sleeping on the streets. Half of them are deinstitutionalized mentally ill people. It’s like a mental ward on the streets

Most mentally ill individuals are not living on the streets.

gotta go...walter should do some digging, the picture is not pretty though.

That's a major difference between our systems, I think.

Any kind of medical care is paid by the health insurances.

Mentally ill, who can't work, get the same help from our "Federal Social Assistance Act" like anyone else, who is in a similar situation.

Usually, however, mentally ill work in a sheltered workshop, living with their family, in a home or an "assisted group".

And when they are old enough, they get retirement pay like anyone else.

Mentally ill, who can't work, get the same help from our "Federal Social Assistance Act" like anyone else, who is in a similar situation.

Usually, however, mentally ill work in a sheltered workshop, living with their family, in a home or an "assisted group".

We live in a country which routinely turns people down for disability claims, and many of the mentally ill don't have the wherewithall to even get to the rejection stage, much less getting a lawyer and appealing.

Thens let's talk about how much they get! It is enough to keep them in mad dog 20 and dollar menu McD's , but not much else.

Failure and Delay in Initial Treatment Contact
The study documents the long delays between the onset of a mental disorder and the first treatment contact, as well as the accumulated burden and hazards of untreated mental disorders.
These pervasive delays in getting treatment tend to occur for nearly all mental disorders, though they vary according to specific diagnostic categories. The median delay across disorders is nearly a decade; the longest delays are 20-23 years, for social phobia and separation anxiety disorders. This is possibly due to the relatively early age of onset and fears of therapy that involve social interactions.
Shorter delays between onset of disorder and treatment seeking — still a protracted 6–8 years — are seen for mood disorders, and are likely attributable to public awareness campaigns, the marketing of newer therapies directly to consumers, and expanded insurance coverage.
While approximately 80 percent of all people in the U.S. with a mental disorder eventuallyseek treatment, there are public health implications from such long delays in treatment. Untreated psychiatric disorders can lead to more frequent and more severe episodes, and are more likely to become resistant to treatment. In addition, early-onset mental disorders that are left untreated are associated with school failure, teenage childbearing, unstable employment, early marriage, and marital instability and violence.
"The pattern appears to be that the earlier in life the disorder begins, the slower an individual is to seek therapy, and the more persistent the illness," said Dr. Kessler, a professor of health care policy at Harvard Medical School. "It's unfortunate that those who most need treatment are the least likely to get it."
Treating cases early could prevent enormous disability, before the illness becomes more severe, and before co-occurring mental illnesses develop, which only become more difficult to treat as they accumulate, according to the researchers.
Severity and Comorbidity of Mental Disorders
The second paper reports that even though mental disorders are widespread throughout the population, the main burden of illness is concentrated in those with a severe disorder - about 6 percent. A "serious" disorder involves a substantial limitation in daily activities or work disability, or a suicide attempt with serious lethal intent, or psychosis. The serious group reported a mean of 88.3 days — nearly 3 months of the year — when they were unable to carry out their normal daily activities.
Unfortunately, say the researchers, individuals with one mental disorder are at a high risk for also having a second one (comorbidity). Nearly half (45 percent) of those with one mental disorder met criteria for two or more disorders, with severity strongly related to comorbidity. This finding supports the suggestion by a growing portion of researchers that the boundaries between some diagnostic categories may be less discrete than previously believed.
Use of Mental Health Services
The study indicates that the U.S. mental health care system is not keeping up with the needs of consumers and that improvements are needed to speed initiation of treatment as well as enhance the quality and duration of treatment. For instance, over a 12-month period, 60 percent of those with a mental disorder got no treatment at all.
The good news is that the proportion of people who reported 12-month mental health service use is higher now - at 17 percent - than a decade ago in the baseline NCS survey, at 13 percent. The expansion was mainly in the general medical sector, with more primary care physicians providing psychiatric services.
People with mental or substance abuse disorders were more likely to get treatment from a primary care physician/nurse or other general medical doctor (22.8 percent), or from a non-psychiatrist mental health specialist (16 percent), such as a psychologist, social worker, or counselor, than from a psychiatrist (12 percent), though the survey did show that the adequacy of treatment — measured by number of visits — is best when provided by mental health practitioners. About 9.7 percent sought help from a counselor or spiritual advisor outside of a mental health setting; and 6.9 percent used a complementary-alternative source, such as a chiropractor or self-help group. This held true even for those with severe mood disorders. Traditionally underserved groups, such as the elderly, racial/ethnic minorities and those with low income or without insurance, had the greatest unmet need for treatment.

Serious mood and anxiety disorders, including depression and bipolar disorder, are being missed in troublingly high numbers, Canadian research suggests, leaving patients to go without treatment and suffer with symptoms for years.
For their study, the researchers interviewed 800 patients who were sitting in the waiting rooms at seven different family doctors' offices in Ontario, Nova Scotia and British Columbia.
The patients were given a survey known as the Mini International Neuropsychiatric Interview (MINI), a 15-minute test designed to help doctors diagnose various psychiatric disorders.

Of the patients who met the criteria for a psychiatric illness, many had never been diagnosed, including:
65.9 per cent with a major depressive disorder
92.7 per cent with bipolar disorder
85.8 per cent with panic disorder
71.0 per cent with generalized anxiety disorder
97.8 per cent with social anxiety disorder
The researchers classified patients as having been "misdiagnosed" if they met the criteria for a psychological disorder but there was no evidence of a diagnosis in their medical charts

Despite those challenges, the trappings of Lanza's life in Newtown were comfortable. When she and then-husband Peter Lanza moved to the central Connecticut community in 1998 from southern New Hampshire, they bought a brand new 3,100-square-foot colonial set on more than two acres in the Bennett's Farm neighborhood. Nancy Lanza had previously worked as a stock broker at John Hancock in Boston and her husband was a successful executive.
When the couple divorced in 2009, he left their spacious home to Nancy Lanza and told her she would never have to work another day in her life, said Marsha Lanza of Crystal Lake, Ill., Lanza's aunt. The split-up was not acrimonious and Adam spent time with both his mother and father, she said.
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Guns were her hobby," Dan Holmes, who got to know Lanza while doing landscaping work for her, told The Washington Post. "She told me she liked the single-mindedness of shooting."
But while trips to shooting ranges gave Lanza an outlet, she returned home to the ever-present challenges of raising a son with intractable problems.
At Newtown High School, Adam Lanza was often having crises that only his mother could defuse.
"He would have an episode, and she'd have to return or come to the high school and deal with it," said Richard Novia, the school district's head of security until 2008, who got to know the family because both Lanza sons joined the school technology club he chartered.
Novia said Adam Lanza would sometimes withdraw completely "from whatever he was supposed to be doing," whether it was sitting in class or reading a book.
Adam Lanza "could take flight, which I think was the big issue, and it wasn't a rebellious or defiant thing," Novia said. "It was withdrawal."
The club gave the boy a place where he could be more at ease and indulge his interest in computers. His anxieties appeared to ease somewhat, but they never disappeared. When people approached him in the hallways, he would press himself against the wall or walk in a different direction, clutching tight to his black briefcase.
Marsha Lanza described Nancy Lanza as a good mother.
"If he had needed consulting, she would have gotten it," Marsha Lanza said. "Nancy wasn't one to deny reality.