Mental Issues and Health Care

[Zyphlin]

The Health Care debate in America is raging as strong now as ever, even in light of the recent passage of health care reform. However this post wants to focus on a particular subset of it, mental health issues.

First, what do you think the health care industries focus on these type of issues should be? Should mental health issues generally be looked at as a sign of weakness of a weak willed person? Or looked at more as a serious mental problem? If the latter, should the focus be more on medicating these individual or non-prescription means of healing?

Second, how should the health care industry...be it government ran or private...look at mental health issues? Is this something that should be covered in standard health care plans or is it different than traditional bodily illness and should fall under its own type of plan?

 

[reefedjib]

The Health Care debate in America is raging as strong now as ever, even in light of the recent passage of health care reform. However this post wants to focus on a particular subset of it, mental health issues.

First, what do you think the health care industries focus on these type of issues should be? Should mental health issues generally be looked at as a sign of weakness of a weak willed person? Or looked at more as a serious mental problem? If the latter, should the focus be more on medicating these individual or non-prescription means of healing?

Second, how should the health care industry...be it government ran or private...look at mental health issues? Is this something that should be covered in standard health care plans or is it different than traditional bodily illness and should fall under its own type of plan?

In answering the second question first, I think that health care should address the physical and mental well being of the individual. It should be viewed holistically. This implies that not only should mental health be included, but that preventative measures should be covered. In the case of mental health, preventative measures include life skills, CBT, and that other approach I keep forgetting the name to which is an alternative to CBT. These are all therapy based techniques, which leads to the first question...

A weak-willed person is one influence strongly by the opinion of others and under the influence of addicting substances. Those will mental health disease make also be weak willed, but it is not necessary. They are serious mental health problems. I think medication is useful, but many mental health medications are themselves debilitating. I think the focus should be 80/20 on therapy/medication. I will go further and say that the techniques and capabilities I mentioned in the first paragraph (life skills, CBT, ...) should be taught to every child in school. This would go along with financial management, a life skill. The open question in my mind is at what age should these things start being taught. Is 10 an old enough age to educate, yet young enough to address potential problems? We are responsible for ourselves.

Great question!

 

[Tucker Case]

First, I'm currently getting my masters degree in a mental health field, so I'm obviously going to have bias on the issue. But I think that my biases are somewhat offset by my knowledge on the topic, which I only occasionally share around here (I'm content letting CC be the resident expert on mental health issues because, quite frankly, he's way more experienced and knowledgeable than I am. But I'll give this one a whirl :mrgreen.

Let me address each point individually:

First, what do you think the health care industries focus on these type of issues should be?

This is a difficult question because mental health issues are very different from physical health issues.

These differences lead to mental health issues being treated as less important than physical health issues.

In fact, the only way that mental health issues get treated as equally important is when they are treated like physical health issues where drugs can be prescribed to "fix" the problem. I'll go more into detail on my problems with an over-reliance on the medical model of mental health later.

First, I think the healthcare industry needs to treat mental health issues as just as important to overall well-being as it treats physical health issues.

Right now, any general practitioner can prescribe medication for mental health issues as easily as they would prescribe antibiotics. There is no requirement for special training about mental health issues before they can prescribe these medications, nor are they inclined or expected to refer their patients to a mental health specialist in these situations.

When you think about it, this is absurd. A general practitioner doesn't prescribe chemotherapy for a cancer patient when they discover a lump that has not been really diagnosed. Instead of blindly treating their patients, they refer them to a cancer specialist so that they can get a proper diagnosis as well as the correct treatment for that diagnosis.

Instead, they prescribe medication as though mental health issues are similar to a bout of strep throat. Actually, that's not really true. They will actually perform tests on a throat culture before they just fill out a prescription for an antibiotic in order to find out if the best treatment for that infection.

So the first order of business is to treat mental health issues as though they are just as serious as physical health issues.

And they are. Just look at where suicide ranked among the leading causes of death per age group:

http://www.cdc.gov/injury/wisqars/pdf/Death_by_Age_2007-a.pdf

In 2007 Suicide was the 11th leading cause of death for all age groups. And there are many more suicide attempts than there are successful suicides. For people between 15-24, there are as many as 100-200 attempts for every successful suicide.

http://www.cdc.gov/violenceprevention/pdf/Suicide_DataSheet-a.pdf

The thing people forget is that mental health issues can be fatal. It's easy to forget that because the cause of death is never listed as "depression" on the coroner's report.

Should mental health issues generally be looked at as a sign of weakness of a weak willed person?

There is rarely any social stigmatization of people who have a physical health issues. Nobody looks at cancer patients as "weak" or claims that heart disease is a mythological illness.

But mental health issues are often categorized this way. While someone who does not have arthritis won't go up to someone who does and say, "Look what all the stuff I've been through and I don't have arthritis. You're just being weak", a person who is not depressed may go up to someone who is depressed and say "Look what I've been through and I don't have depression. You're just being weak."

There is a culturally-based resistance to mental health issues which stigmatizes it. it's been improving over the last 30 years or so, but it's still present.

To explain, the vast majority people have no problems with admitting that there are thousands of different types of physical health problems and that they are not always as severe as Cancer or heart disease.

But a lot of people want to discount that there are also thousands of different types of mental health problems, and just like physical health issues not all of them are as severe as Schizophrenia or Bipolar disorder.

But just like the less severe physical problems, they less severe mental health problems should be treated.

Or looked at more as a serious mental problem?

They should be looked at as a more serious health problem.

If the latter, should the focus be more on medicating these individual or non-prescription means of healing?

The focus should be on healing the mental health issue whenever possible, not merely masking the symptoms.

Medication deals with the symptoms and in many many cases, it is absolutely necessary, especially when the symptoms are so severe that they make life unmanageable for the person who is suffering from a mental health issue.

But including non-medication treatments into the mix has been shown to be more effective than medication alone. And there are some studies which indicate that non-medication therapies are more effective for some mental health issues.

Also non-medication therapies can also teach a person effective coping-strategies for managing their mental health issues better, which cannot be done with medication alone.

Not to mention that there are some mental health issues which do not have medicinal therapies. Take phobias as an example. Phobias are very effectively treated using cognitive behavioral therapies as well as some other non-medication therapies, but there exist no anti-phobia medications.

This is not a knock on the use of medication, though. I think that the health-care industry should have a multi-tiered approach to mental health issues utilizing the medical model, but not over-relying on that model.

That's how the industry should work towards healing people instead of simply treating the symptoms.

Second, how should the health care industry...be it government ran or private...look at mental health issues? Is this something that should be covered in standard health care plans or is it different than traditional bodily illness and should fall under its own type of plan?

They should see mental health issues as being just as important as physical health issues and falling under the overall category of health issues and thus they should be given the same degree of importance under any health insurance plan, regardless of it being private or public.

People who are seeking treatment for mental health issues should inform themselves of their options and learn about the various options available to them just as they would for physical health issues.

An issue that needs to be considered is the fact that insurance plans will often try to dictate what treatments will be used for the patient. I think such decisions should be left to the patient and their treatment provider. Patients should be informed of their options for care and they should also seek second opinions and learn as much as possible about their care-provider.

 

[Real Korimyr #9]

Speaking as someone suffering from mental illness, it is every bit as debilitating and, importantly, every bit as uncontrollable as any other illness.

Medication is typically indicated in the treatment of most mental disorders, but it is the combination of medication and psychotherapy that is most effective.

 

[samsmart]

The Health Care debate in America is raging as strong now as ever, even in light of the recent passage of health care reform. However this post wants to focus on a particular subset of it, mental health issues.

First, what do you think the health care industries focus on these type of issues should be? Should mental health issues generally be looked at as a sign of weakness of a weak willed person? Or looked at more as a serious mental problem? If the latter, should the focus be more on medicating these individual or non-prescription means of healing?

Second, how should the health care industry...be it government ran or private...look at mental health issues? Is this something that should be covered in standard health care plans or is it different than traditional bodily illness and should fall under its own type of plan?

To the first question, science has pretty much proven that the overwhelming number of mental health issues are biological in nature and not because of a weak will. A person cannot help what their biological make-up is. Therefore, all people suffering a mental illness should be able to get the help they need. This includes therapy and counseling as well as medications.

As for the second, I believe that mental illness should be covered by government health insurance. Mental illness spans all ages, all races, and both genders. Therefore, it doesn't seem fair to only allow those who can afford health insurance get treatment for it. Especially when having mental illnesses could possibly raise the price of health insurance for some.

Another reason why there should be government health insurance for mental illness is because, in the long run, I believe it's more cost effective. I believe by making it possible for anyone to get treatment for the mental illnesses they are afflicted with such a person can get the medication and counseling needed to become a productive member of society by being trained in how to get and keep a job, and therefore pay taxes, and how to follow laws. This is opposed to not giving them treatment or giving them inadequate treatment, in which they're more likely to wind up on the streets, be a potential hazard to the rest of society, and inadvertently break a law, and in so doing possibly cause harm to someone. It just makes sense for the government to be pro-active on this issue for the safety of both those who are mentally ill and for those who become affected by the mentally ill, which could be anyone.