Mental Health is a Miserable Failure in the United States
Sunday, 07.01.2007, 02:26pm (GMT)
The recent tragedy at Virginia Tech illuminates the colossal failure of
government and public policy to all our citizens who have mental
disabilities and are ignored, denied. blurred, blamed and are
invisible. The Federal Government should lead in establishing an
environment of reality and acceptance of treatment without the ignorant
stigma of shame. Mental problems are just as legitimate as a cut
needing stitches or a heart attack. Yet people who seek help for a
psychological problem are still looked upon as flawed and blamed for
not being able to handle their own problems.
We need public education to encourage individuals to go for help when
they recognize feeling out–of-control or in a situation where they need
counseling, support and advice. Some problems are chemical imbalances
and often medications can reduce symptoms or stabilize the individual,
if the person takes the medication. They don't always take them because
the medications have such uncomfortable side effects that the patient
believes that the disease is easier to cope with than the drugs.
Other problems are situational and don't need to be medicated but
brought to the surface, worked out and resolved. The best way to do
this is through "talk therapy." There are many modalities that
effectively work to educate and empower people to stop repeated
patterns of destructive and self-deprecating behaviors. Childhood
trauma caused from molestation is one example. There is no drug to
resolve the damage done and continuing negative effects on adult
relationships like trust issues, guilt, shame and sexual confusion and
dysfunction. These issues need to be resolved by other means.
Medicating such a wound just exacerbates the dilemma and doesn't resolve or heal the wound. Neither does behavior modification.
Grief is similar issue. Typically it isn't pathological, yet it hurts
like hell for a long time. Medication isn't recommended. Talking about
the pain and expressing the hurt is a healthier way to deal with grief.
Knowing what to expect, the hot spots and the time frame is empowering.
Just knowing that the immediate pain will heal itself is part of the
healing process.
Historically, we as a nation have attached a stigma of shame on the
individual suffering from a mental problem and on the family. I know
because in 1956 my father was diagnosed with bipolar disorder and
rather than go to a hospital and inflict shame on his family and
himself he killed himself at 45 years old.
In the 1960's we began systematically to empty out all our mental
hospital. Often they were less than ideal, but rather than reform them
we dumped the patients onto the street. Many homeless people have
serious mental problems as do most inmates crowding our jails. Today
when a person is identified with serious mental problems there is no
place to put him or her, few long-term beds and certainly not an
adequate amount are available for the mentally ill. Half way houses
substitute as a safe place to be housed, but they are rarely safe. Most
of the population in prison need counseling and therapy to turn their
lives around to reduce to high recidivism rate.
Then in the 1990's the Health Maintaince Organizations (HMO's) appeared
on the reimbursement stage and embraced short-term therapy with an
emphasis on behavioral modification and limited psychotherapy to six or
on occasion twelve sessions. Sessions necessary to complete effective
therapy must be approved by the HMO responsible for service delivery.
This was the death knoll to effective therapy for the severely mentally
ill.
Behavior modification is basically a band-aid type of therapy believing
if you change your thoughts you heal any pain or problems from old
wounds. Just sweep it under the carpet and it will fade away. short
term therapy works for minor problems but ignores and fails the needs
of the severely mentally ill who need long term therapy. The most
seriously disturbed patients may take months just to establish trust in
their therapist before they even reveal what happened to them.
States don't have enough money to adequately fund Community Mental
Health Programs. Many people fall between the cracks even when
identified and mandated to get out patient therapy. Mental health
practioners are overloaded, overwhelmed and underpaid. It is a job with
high burn out and high turn over. In community mental health agencies
patients may be shuffeled from one therapist to another and must start
all over with someone new adding to their problems.
Private insurance limits the number of visits they will pay for through
reimbursement and co-payments. They closely monitor the number of
visits, that are regulated by HMO staff. A mental health professional
literally has to beg for additional visits when deemed necessary.
Additionally the HMO tells the practitioner what they will pay and it
is rarely his or her regular fees, always less.
Mental health must become a higher priority in this country to prevent
innocent people from becoming victims. All of society is responsible
for this tragedy. We must demand more education, better treatment and
prevention strategies to avoid similar incidents in the future.
This is a broken system and needs to be fixed. Now!
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