Psychiatrist: Mass Shootings the Result of Broken Health Care System

[Andy9o8 3]

An interesting read, authored by a psychiatrist, about dysfunctions in the mental health care system in the US.

Note: despite its title, the article is about mental health care; it is not about guns.
Thus, this thread is about mental health care - not about guns.

http://www.psychologytoday.com/blog/the-kitchen-shrink/201101/its-easer-get-gun-mental-health-care

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Our current epidemic of mass shootings is but a symptom of our nation's broken health care system. Poor access to medical care jeopardizes an individual's health. But when the mentally ill or the seriously distressed can't access care, we are all at risk.
. *****
We as a society are only as stable as the least stable individual roaming our streets.
How many more tragedies need occur, before we conclude that our mental health care system no longer functions to keep us safe? When will we learn that everyone needs basic medical care, not just for humanitarian reasons, but for the safety of all of us?

[Amazon 7]

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An interesting read, authored by a psychiatrist, about dysfunctions in the mental health care system in the US.

Note: despite its title, the article is about mental health care; it is not about guns.
Thus, this thread is about mental health care - not about guns.

http://www.psychologytoday.com/blog/the-kitchen-shrink/201101/its-easer-get-gun-mental-health-care

Quote

Our current epidemic of mass shootings is but a symptom of our nation's broken health care system. Poor access to medical care jeopardizes an individual's health. But when the mentally ill or the seriously distressed can't access care, we are all at risk.
. *****
We as a society are only as stable as the least stable individual roaming our streets.
How many more tragedies need occur, before we conclude that our mental health care system no longer functions to keep us safe? When will we learn that everyone needs basic medical care, not just for humanitarian reasons, but for the safety of all of us?

Duh
No Shit Sherlock
But its far more important for them to have all their "rights" and live a miserable existence like the many thousands who live on the streets.

[lawrocket 3]

You are correct, Jeanne.

Are you going to be the first to volunteer to give up your rights? Remember, there is still one of Joe Kennedy's kids who is still alive. Think about how much longer she's lived than any of her siblings, proof that a lobotomy can lead to a long and healthy life. She may even be happier now - for she hasn't complained about it... Wasn't the country such a better place when lobotomies were being done in assembly line fashion?

Three cheers to shitting on people as a prophylactic measure against them shittinn themselves or others.

My wife is hotter than your wife.

[Andy9o8 3]

What do you think about the psychiatrist-author's points raised in the linked article?

[Amazon 7]

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You are correct, Jeanne.

Are you going to be the first to volunteer to give up your rights? Remember, there is still one of Joe Kennedy's kids who is still alive. Think about how much longer she's lived than any of her siblings, proof that a lobotomy can lead to a long and healthy life. She may even be happier now - for she hasn't complained about it... Wasn't the country such a better place when lobotomies were being done in assembly line fashion?

Three cheers to shitting on people as a prophylactic measure against them shittinn themselves or others.

Of course I am... BUT I suppose if real treatment is impossible and we only get wonderful handling of the probem like the good ole days, where abuse was rampant, then yes I do not agree with Mental institutions where the only solution the "expert" can come up with is Haldol.


It seems that is the only way you see the mental health field.

[billvon 3,132]

>What do you think about the psychiatrist-author's points raised in the linked article?

Dude, we don't discuss points here; we just list who is shitting on who, and who wants whose children dead.

[CanuckInUSA 0]

This shooting never would have happened if the US government had complete control over the lives of everyone living in the nation. If only the America government could take control of every baby who is ever born the moment they are born. This way government childcare experts can examine these children from the youngest age and determine what skills they possess and then channel these children into various educational institutions for the betterment of all society. People who show the slightest sign of mental issues can be segregated from everyone else. In a complete state controlled society where government has total control over what the citizens are allowed to do, there would be no guns (expect for those who were identified from the youngest age as ideal personalities for law enforcement personel) and there would be no shootings. It would be the nirvana socialistic state everyone dreams of where the betterment of society would trump all other rights. The sooner the world adopts global communism the sooner shootings like this would a thing of the past.

But there is one problem here. This isn't the line for food we are standing in. It is the line for shoes. Comrade, the line for food starts over there. - end sarcasm.

Try not to worry about the things you have no control over

[Andy9o8 3]

Cool.
So what do you think about the author's points? Or are you just dismissing her as a socialist, and that's that?

[CanuckInUSA 0]

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Cool.
So what do you think about the author's points? Or are you just dismissing her as a socialist, and that's that?

ROFLMAO ... I am dismissing you as someone who wants to give the already Big government bureaucracy even more power than it already holds. Yes comrade you need government mental healthcare bureaucrats segregating people who show the slightest sign of mental healthcare issues. But who gets to say what is acceptable "they are allowed to circulate in the public pool" behavior and who must be removed for the betterment of society?

Too bad parents stop raising their children. Of course there has always been some people who have fallen through the cracks, but the real cause for many problems seen in modern society started when parents stopped raising their children. A few decades ago parents stopped raising their children to be respectful, hard working self reliant individuals. Instead now we have BIG government who tells us they can save us with their empty nanny state promises. Why bother taking responsibility for your lives when BIG government promises to take care of you from the cradle to the grave.

Try not to worry about the things you have no control over

[Andy9o8 3]

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I am dismissing you

I'm not the author of the article.

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Yes comrade

You really are ranting. Lots of slogans. If you don't want to address the author's points maturely, then don't.

[airtwardo 7]

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I am dismissing you

I'm not the author of the article.

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Yes comrade

You really are ranting. Lots of slogans. If you don't want to address the author's points maturely, then don't.

I know it's a problem, but I also know that I have an old jump buddy or rather 'acquaintance' that I've known for many, many years, who is about my age and has some serious mental health issues.

Functional and successful at one time he was even a cop for a while until his demons caught up. In & out of the puzzle factory for the last 20 some years I see him now & again in L.A., we have some mutual friends.

He's basically on the street, he does however get regular meds and monthly ECT treatments...all at UCLA medical center and none of which he pays for.

I find it hard to believe someone with 'serious' mental issues get completely ignored unless that's what they want...yes the system has many holes and needs to be better, but I think the article is basically taking a very tragic event and trying to relate it and consequently the blame on a volatile political issue. Nothing more.

~ If you choke a Smurf, what color does it turn? ~

[mnealtx 0]

Well said, Jim.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[billvon 3,132]

>I find it hard to believe someone with 'serious' mental issues get completely
>ignored unless that's what they want...

Agreed, and that's one of the problems. The people most in need of mental health care are also often the ones convinced that the system is out to get them, that they want to put microchips in their brains etc. That's a tough position to be in, because it keeps them from getting care when they need it the most.

[kelpdiver 2]

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Note: despite its title, the article is about mental health care; it is not about guns.

It was really more about health care in general.

However, she did not establish that violent shootings have actually increased, just stated it as a given. We can show how obesity and diabetes has increased in prevalence. It wouldn't be that hard to do the same for crazed shootings.

It may be difficult to show the true change in mental health disorders, given the moving targets in definitions (see autism) and the increased rate in which people are actually seeking care. I'm not sure that it really was better for the profession 30 years ago when people wouldn't even talk about the subject.

[Andy9o8 3]

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>I find it hard to believe someone with 'serious' mental issues get completely
>ignored unless that's what they want...

Agreed, and that's one of the problems. The people most in need of mental health care are also often the ones convinced that the system is out to get them, that they want to put microchips in their brains etc. That's a tough position to be in, because it keeps them from getting care when they need it the most.

Is the solution to go back to the old system (say, pre-1970s) when involuntary commitments were a lot more prevalent? The author seemed to be expressing the idea that psychiatry has not one, but multiple roles, which often are at tension: a duty to the patient individually, and a duty to protect society.

[rehmwa 2]

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>I find it hard to believe someone with 'serious' mental issues get completely
>ignored unless that's what they want...

Agreed, and that's one of the problems. The people most in need of mental health care are also often the ones convinced that the system is out to get them, that they want to put microchips in their brains etc. That's a tough position to be in, because it keeps them from getting care when they need it the most.

and why should they be afraid of the microchips

....as long as they have nothing to hide. Right?

...
Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[airtwardo 7]

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>I find it hard to believe someone with 'serious' mental issues get completely
>ignored unless that's what they want...

Agreed, and that's one of the problems. The people most in need of mental health care are also often the ones convinced that the system is out to get them, that they want to put microchips in their brains etc. That's a tough position to be in, because it keeps them from getting care when they need it the most.

I don't know that for a fact, certainly there are those types but I have a feeling it's more of a degree of unknown availability, or being SO disturbed or depressed they just can't/won't seek whatever available help there is on their own.

In my 'buddys' case I've heard him say things like 'it helps and it's free, so why not' ...it sometimes bothers me to hear him brag about the various ways he 'works' the California system of healthcare, heck he gets as good or better than I do paying for it...but I remind myself, the alternatives are rather dark in his case and I'm glad he realizes he has a problem and is addressing it with the available resources he has.

~ If you choke a Smurf, what color does it turn? ~

[Amazon 7]

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Cool.
So what do you think about the author's points? Or are you just dismissing her as a socialist, and that's that?

I think you have a firm grasp on that one fer sure eh.

[Southern_Man 0]

I read the article. I also may have a different perspective from some, since I work in a Community Mental Health Center. I work primarily with people with intellectual disabilities not mental illness (although quite a few of the persons on my case load have both). I'm not an expert, specifically because services differ in different places and I am really only familiar with the services available in my local area. I am a little familiar with general trends in the field, however.

I find the article based on a lot of anecdote and stated premises that I am not sure are correct:

1. I do not believe that it is hard to get psychiatric care. Every state has an agency or agencies devoted to provide care for people with mental health, intellectual disabilities, and substance abuse services. Often this is through a department of social services but there are other arrangements as well. These agencies receive public funding and serve people with Medicaid as well as private insurance. For those without insurance there is sliding scale. For most people at my local agency this amounts to a fee of $6 a month. For people with higher incomes it may be more. These agencies may offer many different programs such as: case management, psycho-social rehabilitation programs, psychiatric services, emergency services, counseling in various modalities, mental health support services, residential services, and crisis stabilization programs. Not everybody qualifies for every program but there is a wide array of services available for people with little resources. Also, public mental health may be quite a bit different from private mental health. Overall I think it is quite a stretch to state that it is harder to get a gun then it is to get psychiatric care--it is certainly not difficult to find psychiatric care if you really want it.

2. I think the author overstates the power of insurance companies. There is quite a bit of paperwork involved and I would not want to defend the system as being in any way efficient but we do not run into problems with insurance companies denying hospitalizations. Getting drugs approved can also be a pain but we have a very, very high success rate on getting pre-authorizations approved when we need to prescribe something that needs it. Also, the drug companies have generous indigent programs for people without insurance. In any case, this is provided as anecdote--there is just a naked assertion and no facts to dispute.

3. It is still more than possible to get somebody committed when they show that they are unable to care for themselves or that they are a danger to themselves or others. This is a fairly straightforward process in VA (and in the wake of the Cho tragedy we made the criteria easier to hold them), I am not sure about the process in other states. It takes the willingness of friends, community members, and psychiatric professionals to make reports when appropriate.

4. I think I have a huge philosophical difference with the author. I do not believe it is appropriate to restrict people's rights when there is no proven threat. I am glad that we do not institutionalize people with mental illness for long, long periods without adequate safeguards. I am glad that we do not routinely force people to receive treatment against their will (again, this can be done through court orders when there is a demonstrated need but the bar is high). Yes, our system is not perfect--in particular it is difficult to predict who might become violent--of course this is difficult in the population at large as well. I do not think large-scale denials of people's human rights is appropriate. I do know a lot about the history of the field and anybody (including the author of the article) who believes that the old system was better displays a huge amount of willful ignorance of the horrors of institutionalization and the de-humanization of people with mental illness. It was an absolutely horrific system and what we have today is orders of magnitude better.

"What if there were no hypothetical questions?"

[Coreece 190]

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The people most in need of mental health care are also often the ones convinced that the system is out to get them, that they want to put microchips in their brains etc. That's a tough position to be in, because it keeps them from getting care when they need it the most.

Welcome Home (Sanitarium)
http://www.youtube.com/watch?v=WElvEZj0Ltw

Welcome to where time stands still
no one leaves and no one will
Moon is full, never seems to change
just labeled mentally deranged
Dream the same thing every night
I see our freedom in my sight
No locked doors, No windows barred
No things to make my brain seem scarred

Sleep my friend and you will see
the dream is my reality
They keep me locked up in this cage
can't they see it's why my brain says Rage

Sanitarium, leave me be
Sanitarium, just leave me alone

Build my fear of what's out there
cannot breathe the open air
Whisper things into my brain
assuring me that I'm insane
They think our heads are in their hands
but violent use brings violent plans
Keep him tied, it makes him well
he's getting better, can't you tell?

No more can they keep us in
Listen, damn it, we will win
They see it right, they see it well
but they think this saves us from our Hell

Sanitarium, leave me be
Sanitarium, just leave me alone
Sanitarium, just leave me alone

Fear of living on
natives getting restless now
Mutiny in the air
got some death to do
Mirror stares back hard
Kill it's such a friendly word
seems the only way
for reaching out again.

Your secrets are the true reflection of who you really are...

[Andy9o8 3]

Cool.
So - what do you think about the topic of the thread?

[Andy9o8 3]

Very insightful post; thank you.

I don't think there'd be anything wrong with you submitting it to the editors of Psychology Today as either a proposed rebuttal article or letter to the editor (for publication).

[Coreece 190]

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Cool.
So - what do you think about the topic of the thread?

I thought I was clear!

Edit:
I have just retained the Law Rocket.

Hopefully airtwardo and Mike will be on the jury.

Your secrets are the true reflection of who you really are...

[kallend 2,184]

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2. I think the author overstates the power of insurance companies. There is quite a bit of paperwork involved and I would not want to defend the system as being in any way efficient but we do not run into problems with insurance companies denying hospitalizations. .

Sorry, but this is highly dependent on the company. I currently have Blue Cross/Blue Shield, who are indeed as you state. HOWEVER, a few years ago I had CIGNA, which was terrible. Every claim ended up in a dispute, or underpayment, or other error which took great persistence to resolve. By amazing chance, EVERY error was in CIGNA's favor. I was later told by someone in the medical field that CIGNA has a reputation throughout the healthcare industry for this behavior. I can imagine that anyone with mental illness who has to deal with CIGNA would have a very hard time.

...

The only sure way to survive a canopy collision is not to have one.

[Andy9o8 3]

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2. I think the author overstates the power of insurance companies. There is quite a bit of paperwork involved and I would not want to defend the system as being in any way efficient but we do not run into problems with insurance companies denying hospitalizations. .

Sorry, but this is highly dependent on the company. I currently have Blue Cross/Blue Shield, who are indeed as you state. HOWEVER, a few years ago I had CIGNA, which was terrible. Every claim ended up in a dispute, or underpayment, or other error which took great persistence to resolve. By amazing chance, EVERY error was in CIGNA's favor. I was later told by someone in the medical field that CIGNA has a reputation throughout the healthcare industry for this behavior. I can imagine that anyone with mental illness who has to deal with CIGNA would have a very hard time.

This is really directed to anyone out there: Has anybody had any experience with Aetna health insurance? Our broker is trying to get us to consider an Aetna plan.