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View Diary: Breaking: Hostage crisis over in Alabama (188 comments)

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  •  Ignoring treatment of mental illness is too simple (1+ / 0-)
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    old possum

    for this problem.
    We do have problems with access to treatment,no dispute there.

    But this guy seemed to have major paranoia and odds are very good he did not think he needed treatment, would refuse any offered treatment, would not go to scheduled appointments and even if we had more outreach workers he would not let them on his property.
    We'd be talking forced treatment.
    Sometimes it is not societal neglect, it is resistance of the sick and that resistance is actually a symptom of their illness.

    If it is an Axis I diagnosis like schizophrenia medication and services can be very helpful but still takes cooperation. When there is a decompensation starting there is a very short time when they know something is going wrong and when they are so far into an exacerbation that they think their delusions are just real.
    To a lesser degree paranoid personality disorder can also be helped through treatment

    But in any case they have to be receptive to intervention and paranoia creates a huge barrier to that. If you get them into a therapeutic relationship at all trust is hard to form and easy to break.
    At what point do we force treatment and how aggressively?

    I likely didn't say that well but even if we had a super available mental health treatment system there would be many barriers that would not exist in physical health care.

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