[MotownJohnny]

I wanted to ask opinions about this, but wasn't sure how to frame the question. Based upon my limited experiences, I feel that the MH system as-is isn't geared to working towards cure or even effective control of MH problems. It seems to me it is designed to keep patients dependent, even sick, for profit, under the guise of "it's an imperfect science".

I need to add this for context -- when I was railroaded into the day hospital program last year, I had a terrible attitude towards it, I basically viewed myself as a POW, in the hands of a hostile enemy, so I obviously was hostile to everything, at least initially.

What I saw astounded me, though. I felt like the system emphasized things that didn't work -- the drug-go-round, expensive therapy that lead no where, doctors who were uninformed and unconcerned and just going through the motions, an emphasis on very expensive drugs like Abilify without even considering cheaper options first. The results certainly aren't good, IMHO, patients with multiple admissions, who didn't function effectively on any level. In particular, I saw people who sat around looking like zombies from multiple drugs at strong doses. Nor was their an emphasis on setting the bar high -- things were discussed like obtaining emergency shelter, applying for disability, medicaid, etc. I never heard discussions about things like getting back into careers, normal functional lives. And this was at one of Michigan's "premier" healthcare systems.

I don't know, am I wrong about this?

[MoxieDoxie]

My insurance company keeps pestering my therapist to get me down to 1x a week. There not asking for me to be sent inpatient. They are wondering why I have not seen a psychiatrist.

[Odee]

I definitely agree with a lot of your points, but I don't believe the MH system has conspired to be designed exactly that way. I think it truly happens because it is an inexact science that's an extremely attractive job financially for people who are willing to get the degree. If psychiatry could actually organize itself in a system of mutual altruism towards solving the MH conundrum, well, that would be something!! Instead, the various fields and companies are competing for time, money, attention, etc allowing for no integration or collaboration.

IMHO, the system is flawed for the money. Like I said, it's all competition for patients and we're their money banks. What is profitable is ultimately what 'works.' So, to the rest of society, the system isn't flawed at all. Now, I don't think they intentionally keep us ill, but they will insist on more visits/appointments as much as they can.

Like I said, I don't think it's a big collusion on behalf of companies, it's just an unfortunate scenario where money takes precedence, something that is apparent in most of everything.

[possum220]

The board that runs the private mental health hospital near me are money grubbing vultures sucking every cent out of the health insurers while providing substandard food, not enough staff, broken facilities - until they are under review for accreditation. They make me sick. I would love to see how much their profit margin is.

[The_little_didgee]

I agree, although money isn't as big an issue here in Canada (for patients) as it is in other countries.

No one ever really helped me. All the support I was offered only made my despondency worse. The services I was offered were isolating and came with the label Didgee is nuts. I think a lot of that had to do with my misdiagnosis one that had a very poor prognosis.

Recovery comes from within and outside social support such as friends and family. Doing things like attending school, volunteering and/or working a few days a week definitely helps too. Activities like this should be promoted by mental health professionals rather than services that tend to isolate.

I am in university. Last year, my psychiatrist, an ACT team pessimist, asked why I was there. I told her then she replied, "You are very brave." What?! I then told her she had no right to determine my future. I fought hard to get where I am today and nobody is going to take that from me.

I wish more psychiatrists would promote meaningful recovery.

[splitimage]

I agree that many working in the mental health field see patient's limitations vs their potential. I know for years, my Dr's have encouraged me to only consider low stress jobs that are below my skill level. This left me feeling frustrated and angry.

I do understand the emphasis in programs though on basics such as income supports, and housing, since many people with MH issues require help in those areas, even if it is only temporary. I myself, through a series of bad choices found myself living in transitional housing, and now my caseworker is working with me, to help me find and get into affordable housing.

I find the recovery peer led model, as opposed to the medical model, seems to be much more focused on maximizing people's recoveries and potential, so any involovement in that movement can be helpful to recovery.

splitimage

[yellowted]

the big thing in the uk at the minute is to get as many people back to work as possible to save government money, they are assessing everyone on state benefits, telling them they are fit to work, sticking those who need support to find work on a programme of support where you have to go to certain places every week or lose your benefits. even the extremely sick, vulnerable and even some terminally ill have been forced into this. you only can get out of this if you appeal, are reassessed or go to a tribunal!

[dumburn]

Originally Posted by yellowted

.... you only can get out of this if you appeal, are reassessed or go to a tribunal!

You forgot die, it's a very sad state of affairs over here right now. It feels like the government is hoping to kill the sick off by making their lives so difficult either the stress kills them or they have no choice but to take their own life.

[MotownJohnny]

One thing that really bothered me big time, the case manager nurse was very nice, but she basically told me to quit my job because it was "too stressful". Stressful was getting set to a psych ward as bipolar because someone threatened me and I lost it. Stressful was thinking about emerging from said psych ward with no job, inelligible for even unemployment, an unexplainable gap in my résumé, an employer left in the lurch suddenly. Stressful was being misdiagnosed and not given the right treatment, not being prescribed any anxiety or depression meds when I needed them most. Stressful was NOT the thought of going back to the office and focusing on normal. Luckily, I worked only about 2 miles from the hospital, I went into the office for a few hours about every other night. I told them at first, and they were very dead set against it. So, after a couple of days I just lied and told them I quit going in to work. That office was a sanctuary and lifeline after hours, quiet and a lifeline to the normal me I thought I might lose forever.

I worked damned hard for a career, spent a small fortune on two college degrees and professional certification, invested a lot of time in continuing education to have a career, and they wanted me to throw it all away and do what, scrub toilets at McDonald's? Really?

They should have been happy that I was functional enough despite how messed up I was to still handle complex matters. And they should have encouraged me rather than discouraging me.

Set the bar high, not low.

[here today]

When I complain or feel upset about the poor treatment I have had in the past, my current private pay therapist here in the US says that the system is broken.

Basically, we’re on our own. Or maybe, that is everybody’s adult existential reality anyway, so to the extent that I had psychological defenses against perceiving that reality and adjusting to it – that was the source of the “mental illness”.

The source of those defenses I have finally been able to get to and bear, with the 1-hour a week companionship of the therapist – the pain of being “on my own”, not valued, not belonging when I was a child. That reality was overwhelming and produced unacceptable reactions when I was a child so, to protect the conditional nurturing that was available to me, my psyche apparently inhibited them down to almost nothing or something.

If the system is broken and the professionals aren’t doing much about it, except complaining while continuing to get their paychecks, then where will the change come from?

Logic says to me that it has to be from us – so I’m a fan of the peer movement, too, though it currently doesn’t seem to be having much effect.

[(JD)]

The system works only in that it is a "system"... other than that it is a failure of a system for mental health.

The good thing to remember is that it IS a system and not to take it personally when being shuttled along it's route. Said route is the only one most of the system providers know, or the only way they are allowed to "provide" any service. It does not work well for the patient. Nothing in the works coming up is better, either, so there is not much hope for mental health care improvement any time soon. Do what you can to work within the system...and it does allow for slight variations within it. That's up to your personal doctor to know the ins and outs and where they can--and care to--push the limits.

[MotownJohnny]

I really haven't even heard of peer support, what is it? I did go to three support group meetings right after, but they were damned depressing, and I had a lot of the same concerns. I decided I was better of hanging out in the real world and devoting my time and emotional energy to "normal".

[MotownJohnny]

Sorry, but when it's my life on the line I tend to take it pretty personally. Most of what I observed either terrified me or pissed me off big time. I guess part of the problem was I fell into the hands of a quack who cared only about the money and didn't give a damned about the patient.

[here today]

Peer support is often a part of the “alternative mental health” or “mental health recovery” movement. It started out with people who had similar experiences with the mental health system and thought there needed to be something more. If you can hang out in the real world and be normal without the risk of "losing it" again, then more power to you! If you want a little help and support, then maybe the internet could help you find something in your area. But maybe not, they're not real common.

Of course, there always this forum, too!!

[MotownJohnny]

Well, I have a few days when I worry about losing it, but it's mostly just being hypersensitive to it.

[(JD)]

Yes, I understand fully.... about taking it personally (because the situation is very personal) but the other people in the system only see someone acting out or misbehaving (behaving badly) over what they consider "the norm" of the process of waiting, filling in forms, etc. Doctors can also only see someone acting out rather than addressing the problem calmly.

It takes a lot of effort to breathe and try to discuss things calmly. It helps me to realize that (usually) the person to whom I am speaking did not cause the problem the system is giving me...and when I realize I'm upset or even angry, while calming myself down I also tell them that I'm sorry, I'm not angry at them but at the system...

sometimes that helps. Worrying, being angry and upset, or acting out only make the situation worse, and can cause others to not want to even help.

[here today]

Originally Posted by (JD)

Yes, I understand fully.... about taking it personally (because the situation is very personal) but the other people in the system only see someone acting out or misbehaving (behaving badly) over what they consider "the norm" of the process of waiting, filling in forms, etc. Doctors can also only see someone acting out rather than addressing the problem calmly.

. . .

Worrying, being angry and upset, or acting out only make the situation worse, and can cause others to not want to even help.

Sounds like it works great for you, JD, that you have adjusted to the system, but the problem for me has been like I’m having trouble with uncontrolled vomiting, so I need to go to the doctor, so the receptionist asks me to have a seat and wait, but then I have to vomit, so she says you can’t vomit here in the waiting room, that's against the rules and besides it bothers me and the other patients, so go away until you can control your vomiting. . .

Which brings us back to the topic of this thread: seems to me the MH system is set up to work for the people who work in the system, not the patients.

Ultimately the society suffers, too, because if MotownJohnny (or any of us, including me) doesn’t get help and continues to need something, then we may lose the participation of a valuable person – well-educated, motivated, etc.

[MotownJohnny]

I think some if it can work, but it takes seeking out the professionals who have the skill, knowledge, and ability to work with people who want "better" in their treatment. I hate to say this, but again, some of it, maybe a lot of it, is who you can afford to see. I have the utmost sympathy for those stuck in a community mental health nightmare. I can afford $80 a week for therapy and $125 an appointment for the psychiatrist. I am so grateful I was able to keep my job, it was 5 years last month that I started here, and my employment is very stable, so that helps. Still, I could make payments on a nice car for what it is costing me. I am lucky I found a therapist and now an MD who don't t talk down to me, are willing to work with me as partners in healthcare instead of dictators.