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If you talk to anyone who works in the mental health system, they will tell you they are sick and tired of those people who say we need more help for the mentally ill. It sounds good, but these people never pull out their wallets when it comes time to pay for needed services. What these health care professionals would like to shout is “show me the money.” The fact is, until the actions of Americans match their words, people with treatable mental illness will continue to go untreated.

There was no better example of this than a story that appeared on 60 Minutes. Virginia State Senator Creigh Deeds was stabbed by his son who was in the middle of a mental health crisis. Deeds had tried to find a hospital bed for his son the night before the stabbing because he knew he was a danger to himself or others. Despite the fact he was a state senator, there were no mental health beds available for his obviously disturbed son. His son ended up killing himself.

As often happens, people including politicians do not realize the severity of a problem until it happens to them or someone they love. To his credit, Deeds has become a tireless supporter of those who need mental health treatment.

Yet there are others who still have not seen the light. When John Elway was recently asked why he was a Republican he said, “Well, it goes to what my beliefs are,” Elway said. “I believe that we’re giving the opportunity to succeed or not succeed. I don’t believe in safety nets…”

Where was Gus Deeds opportunity to succeed? If there had been a safety net the night his father searched for a psychiatric ward, Gus may have had a chance to get well and realize his potential. Sadly, that was not the case.

In Maine there is an attempt to have EMS and other health care workers have access to Naltrexone, a medication that can help save the life of someone overdosing on opiates like Vicodin, Oxycontin, and Heroin. Amazingly, Republican Governor Paul LePage is against the program because he believes it will make drug addicts feel invincible. As his own public health officer says, there is no evidence that supports this conclusion. His belief is born out of ignorance.

Many people consider addiction a personal weakness or moral defect because they believe an addict can simply stop. However, like other diseases you can’t just stop much like you can’t stop having cancer, diabetes, or heart disease. These all have periods of remission which unfortunately are often followed by periods of relapse. The more we learn about the brain the more we know that addiction is a brain disease. People who don’t have it can’t understand because their brain works differently.

It’s so easy to prove on a simplistic level that an addict doesn’t have a weakness. Truly addicted people live horrible lives shrouded in fear, guilt, and loneliness. If they could just stop, wouldn’t they? How does the person who believes it’s a weakness or moral failure account for the addicts who with help get sober and become upright moral citizens? Is it possible that their morals became corrupted due to their disease and not because of some inner need to become immoral.

When a person is ill with a mental health issue or an addiction (which is a mental illness), they need help. They need a safety net. Republicans should be all for that since treatment is far cheaper than emergency room visits and incarcerations. However, mental health needs still go unmet. From 2009 to 2011 states reduced mental health funds by 1.6 billion dollars. Already, only half of the people needing mental health services receive them.

It’s time for America to act. Only through electing politicians who are concerned with the betterment of all people and not just the able bodied and wealthy will we be able to stand tall as a nation. A country is not judged on how well it treats it’s healthiest citizens, but on how it treats those citizens in need.

Originally posted to The Madrigal Maniac on Wed Feb 12, 2014 at 09:13 AM PST.

Also republished by Community Spotlight.

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Comment Preferences

  •  good diary, tx (11+ / 0-)

    "The corporate state’s repression, now on the brink of totalitarianism, would with the help of Christie, his corporate backers ... become a full-blown corporate fascism.' http://www.truthdig.com/report/item/the_trouble_with_chris_christie_20140112

    by SeaTurtle on Wed Feb 12, 2014 at 10:20:25 AM PST

  •  Affordable Care Act (11+ / 0-)

    Now, mental health services/substance abuse are covered under the new health care law ("Obamacare").  It is one of the ten basic services that must be covered in all policies on the health care exchange: Hospitalizations, preventative services (with no copays), labs, prescriptions, doctors, outpatient services, chronic disease management, maternity, pediatrics, rehabilitative services, and mental health/substance abuse.

    •  Sounds good. (12+ / 0-)

      But in NC I can tell you I spent most of an afternoon trying to find a hospital that would take my patient, off meds for pregnancy and in bad shape. She needed a medication safe for that stage of pregnancy and I did not feel I could supervise the restart as an OB/GYN dealing with an outpatient.

      Having insurance is sadly not enough to buy good mental health services in many areas.

      •  Not yet. (6+ / 0-)
        Having insurance is sadly not enough to buy good mental health services in many areas.
        Obamacare's coverage just began.  It will take some years to build up facilities.  I realize this doesn't help your patient.

        "My country, right or wrong; if right, to be kept right; and if wrong, to be set right." -- Sen Carl Schurz 1872

        by Calamity Jean on Thu Feb 13, 2014 at 12:11:49 AM PST

        [ Parent ]

        •  Agreed. Not yet ... (5+ / 0-)

          I had my first experience with mental health care and the ACA just this week. I haven't had mental health benefits prior to 2014: insurance but zero mental health benefits.

          I knew I needed help and worked to find the most generous ACA policy in my area, a silver plan which stated on both the healthcare.gov site and the Anthem site that I would be limited to 20 annual visits.

          On Monday during the 90 minute intake process I discovered that my mental health benefits are actually unlimited, subject only to diagnosis and an approved treatment plan. NO co-pay once I meet my reasonable deductible.

          I know that I will be more productive with treatment, more money for me, more tax dollars for the government. It's going to be a win-win-win all the way!

          "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

          by annan on Thu Feb 13, 2014 at 06:08:44 AM PST

          [ Parent ]

    •  The problem is (5+ / 0-)

      that outpatient services are limited in number and are more aimed at people who are working and at medication rather than talking therapy - even for depression.

      The services aren't there.

      Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

      by ramara on Wed Feb 12, 2014 at 02:30:26 PM PST

      [ Parent ]

      •  It will come ... (3+ / 0-)
        Recommended by:
        ramara, artebella, bigjacbigjacbigjac

        if my recent experience is a harbinger of the future, it will come. I began the outpatient process on Monday under a new ACA plan.

        The treatment plan includes cognitive behavioral therapy, talk therapy, med management and coordination with my primary care physician all under the umbrella of a multi-county mental health association staffed by a full range of professionals.

        The organization, called Aspire, even has sheltered work opportunities including a nearby farm with a CSA. The ACA will be a boon to this organization and the clients they serve. It will come.

        "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

        by annan on Thu Feb 13, 2014 at 06:18:10 AM PST

        [ Parent ]

        •  This is really good news. (1+ / 0-)
          Recommended by:
          annan

          Best wishes.

          Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

          by ramara on Thu Feb 13, 2014 at 11:31:44 AM PST

          [ Parent ]

  •  We have (15+ / 0-)

    and extensive mental health system. They're called prisons.

    /snark

    "The object of persecution is persecution. The object of torture is torture. The object of power is power. Now do you begin to understand me?" ~Orwell, "1984"

    by Lily O Lady on Wed Feb 12, 2014 at 12:49:03 PM PST

  •  costs and mental health (7+ / 0-)

    The cost of mental health treatment is incredibly inflated.  You don't need psychiatrists to prescribe the pills, and the other services -mainly psychotherapy- Are priced according to a medical model.  In fact, psychotherapy has much more in common with teaching or the clergy.  So the fees ought to be in keeping with teacher or minister salaries.
             Out in my rural area, I charge 20 -30 dollars a session.  I do that whether the person has insurance or not. Insurance companies want me to charge more.  I figure that is part of what is making people sick.

    •  You are underpaid at 20-30 $ (3+ / 0-)
      Recommended by:
      ramara, annan, DavidMS

      I was paying 75$ for my former spouse back in 1987. Didn't do any good for her. She died in '94.

    •  I agree that some situations are as simple (0+ / 0-)

      as active listening and coaching. Having a compassionate listener will solve many of life's thorny problems.

      However, in the mental health field lives are literally at stake. The mind/body/brain connection is complex and therapeutic mental health interventions are equally delicate.

      Advanced degrees and overhead in mental health are as expensive as any other medical profession. They warrant the professional income they command.

      If you have an advanced degree and are charging $20-$30 per session you are selling yourself short. Have you considered a sliding scale?

      "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

      by annan on Thu Feb 13, 2014 at 06:34:46 AM PST

      [ Parent ]

    •  It sounds like you do counseling (0+ / 0-)

      of the "worried well" which is important but not the same as coping and helping someone with a serious disabling mental illness.

      I had experience with someone like you sound like. She discounted my history and what I know about myself. She changed my meds without tapering the old — but I didn't catch on to the danger. Then she assured me about the drug she prescribed but  I finally realized she either lied or didn't know what she was doing.

      There was more but I won't go on about it but I should have reported some of her unethical behavior.

      I don't mean to imply you are like that but I hope you know when to refer someone who needs more than what a teacher or the clergy can do.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Sat Feb 15, 2014 at 12:20:05 AM PST

      [ Parent ]

      •  Thanks for sharing. (0+ / 0-)

        I'm actually an LISW-S, A Licensed Independent Social Worker with a Supervision designation. My specialization is in mental health and addiction. I have worked with some of the most ill clients there are. Especially on the addiction side where I worked with inner city clients who were addicted to crack, heroin, you name it.

        Moreover, I have a dual diagnosis, meaning I have a mental health diagnosis and am a person in recovery from addiction. There is a large correlation between the two.

        I'm sorry to hear about your experience but you do raise several important points. A good patient history is vital to a correct diagnosis which is what will dictate treatment. In addition, a clinician should always pay close attention to what their client is telling them. How else would you know if you're intervention is helping or hurting?

        It sounds to me as if you were not being treated by a well trained clinician. If it was a social worker, by all means contact the board. As a social worker I don't want poor clinicians in our profession anymore than the public does.

        I hope you are now getting the help you need and hope you are doing well. Take care.

        The truth is that there is nothing noble in being superior to somebody else. The only real nobility is in being superior to your former self. -Whitney Young

        by Madrigal Maniac on Sat Feb 15, 2014 at 03:05:37 AM PST

        [ Parent ]

  •  Thank you for this diary. (10+ / 0-)

    There is not enough exposure of mental health issues in this country. I've suffered with depression for 50 years; 30 of them since diagnosis. It is literally exhausting working through the mental health laboryinth. And that's just to keep my head above water. There are so many rules and regulations to keep track of, and some of them change yearly, that even some of the providers have a difficult time.

    The lack of intreatment options kills people, literally. Recently there have been some tragic examples of this. Quite often all that's needed is a medication change that has to be monitored for a few days. Keeping people with mental health issues on an even keel is a delicate balance. A patient may need some medications that don't go together very well; or could produce serious side-effects. If problems are caught early, the ramifications can be limited.

    The last time I needed a medication change is a good example. There were no "open beds" when I needed one.I was dangerous, mostly to myself, but the possibility of that changing was serious. There was an open bed for someone "legally" comitted; so after a discussion we went that route. I was told it would be on my "record", but I didn't care. I needed and wanted help. It's kind of sad that the situation has gotten to that point.    

    •  Thanks for sharing Alice. (5+ / 0-)

      If we saw someone with a broken leg we would go out of our way to help them. But when it is an 'invisible' injury, it often seems no one cares until it is too late.

      Also, so many people are isolated in our 'me first' society. And all it takes sometimes is a friendly word and a shoulder to find comfort on.

      May you stay well and safe from our hostile world.

  •  As the mother (10+ / 0-)

    of a mentally ill son who is also addicted, and also as a woman who has suffered major depressions and also been a therapist, I remember that story of the state legislator and his son and feeling it in my gut.

    My son currently has a place to live, but there have been periods when he's been homeless. We have been cutting beds for the mentally ill for more than 20 years, and replacing them with beds in jails and prisons. When my son was in his mid-teens, it was impossible to find a place that would take him overnight; apparently all the shelter beds for teens in this city were in the juvenile justice system. Indeed, the juvey detention center was set up like a residential treatment center because so many of the kids there were mentally ill.

    We know what good community mental health looks like. You need case managers who are well-paid professionals, who will do needed outreach even with homeless patients. We need beds at various levels of security, where a patient in any sort of crisis can stay for even one night even if it's only to get back on meds.

    But you're right; nobody is willing to pay, so we have huge turnover in staff, rules about staff not driving patients in their cars, and so on.

    Thanks for writing this.

    Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

    by ramara on Wed Feb 12, 2014 at 02:25:54 PM PST

  •  While I agree with much in this diary, (2+ / 0-)
    Recommended by:
    susanala, annan

    including the fact that under mental health services and research are horribly under funded, I have never been a fan of the "disease model" of  psychological disorders.

    While there are certainly physiological aspects to every psychological disorder, this model tends to convey the idea that genetics and/or biology is destiny. I find my patients respond better to the idea that may have a genetic vulnerability that increases their risk for illness by interacting with stressors in their life but their actions are up to them.

    It's the Central Limit Theorem, Stupid!

    by smartdemmg on Wed Feb 12, 2014 at 03:11:24 PM PST

    •  It's not an either/or (6+ / 0-)

      We have no idea about what causes mental illness from a physiological perspective. Even changes in brain chemistry could be either the cause or effect.

      The same goes for nature/nurture - I'm convinced it's both. We exist in our bodies, but also in our environments.

      Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

      by ramara on Wed Feb 12, 2014 at 05:24:22 PM PST

      [ Parent ]

    •  I agree. (1+ / 0-)
      Recommended by:
      samddobermann

      My clients feel more motivated when I tell them they have a genetic predisposition and not a destiny for certain maladies. Most of my work has been with addicts and certainly genetics play a role as a risk factor, but it does not mean one is destined to a life of addiction.

      Regarding the disease model, at some point I think it all becomes semantics. As we learn more about the brain, I believe the kind of interventions we use will change. You can call it a medical model or whatever, as long as it works.

      One of the things we have learned by studying the brain is that addicts are born with a higher tolerance to alcohol from the beginning. Again, this is important when planning a course of treatment and for educating those who may be at risk.

      Obviously you are right when you talk about underfunding research and treatment. Considering the number of people suffering from mental health issues, you would think it would be a top priority.

      The last time I checked, the best practice for addicts was using the "new" disease model combined with 12-step group participation.

      The truth is that there is nothing noble in being superior to somebody else. The only real nobility is in being superior to your former self. -Whitney Young

      by Madrigal Maniac on Sat Feb 15, 2014 at 03:22:08 AM PST

      [ Parent ]

    •  smart then you can play (0+ / 0-)

      blame the victim. people with serious disabling mental illnesses cannot always control their behavior. Often their behavior seems appropriate and logical to them although at other times they can realize how injurious it is.

      Mental illnesses are brain disorders. Saying so does not imply anything about the causes. There are very few things where genes or biology is destiny; no one knowledgeable thinks mental illnesses are.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Sat Feb 15, 2014 at 03:37:25 AM PST

      [ Parent ]

      •  I'm not "blaming" anyone. (0+ / 0-)

        For clarity I guess I should point out that I am both a clinical neuroscientist  (I do the research on brain structure and function that informs the development of clinical interventions, as well as sit on study sections that review other researcher's grants for federal funding, and serve on an editorial board for a journal that publishes clinical neuroscience research) and am a clinician myself with a private practice.

        I don't blame anyone for developing a psychological disorder. I do however, inform my clients/patients that what they choose to do behaviorally is a choice they make everyday. That choice is more difficult for someone with a genetic vulnerability for a particular illness than someone who does not have that vulnerability but it is no less a choice.

        So yes, I know mesolimbic DA function certainly influences addictive behavior and stress exacerbates this activity but the decision to act on reward cues is up to the individual.

        It's the Central Limit Theorem, Stupid!

        by smartdemmg on Mon Feb 17, 2014 at 11:03:48 AM PST

        [ Parent ]

  •  expanding the conversation (8+ / 0-)

    our medical system and the delivery of health care in america is woefully out of kilter.  in america we treat the body, the mind, and teeth as though they were disassociated parts.  many people, those with employer based plans or individuals who can afford overvalued insurance, have little understanding of what it is like to be without care.  untreated illness of any kind results in  avoidable loss-death, criminal homicide, violence, and elevated risk of illness and morbidity.  we all pay more than we should for the travesty we call medical service.  the most viable and rational plan is to have universal health care. there can be no rational argument against it-none!  

    •  Here, here. (4+ / 0-)
      Recommended by:
      ramara, ladybug53, annan, irocdk

      The mind and body are connected, as are the teeth and the eyes.

      Until usa gets single pay health care for all we will be a 4th rate country as far as health care is concerned. Unless you can pay for cutting edge treatment or pay for it yourself.

      Basic health care is a right, not something you have to purchase. We owe it to our humanity, and our sense of dignity and respect for each other.

    •  In the US we would have the same (0+ / 0-)

      problems with care with a single payer system that we do now. Medicare is a single payer system and has the same problems; high costs, unnecessary treatments and a lot of mistaken treatments because of sloppy or inadequate diagnosis and just plain sloppy care.

      Very few countries have single payer. We will have a universal health care system when the ACA takes over and more get folded into the system so that every one who wants insurance has some and thus access.

      Only 95% of Seniors are "on" Medicare. If the same proportion held with younger than 65 there could be ~ 15 million without coverage.

      There IS a rational argument against single payer plan if that payer is the federal or state governments. Can't you think of it/them?

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Sat Feb 15, 2014 at 01:13:06 AM PST

      [ Parent ]

  •  Republicans don't understand such things.... (5+ / 0-)

    ...until it happens to them - and only when it happens to them.

    They're so obsessed with justice, that they've become oblivious to mercy.  They're the kind of people who would rather convict an innocent person, than ever see a guilty person go free.

    All that is necessary for the triumph of the Right is that progressives do nothing.

    by Mystic Michael on Wed Feb 12, 2014 at 04:15:51 PM PST

  •  Great diary--hope to read more (6+ / 0-)

    Let's hope that the new "parity" requirements in the ACA will help open up beds in existing hospitals. But there still exists very little funding for beds at the pre-crisis stage.

  •  They give it lip service when it comes to guns (2+ / 0-)
    Recommended by:
    ramara, ladybug53

    But otherwise, you are on your own.



    Women create the entire labor force.
    ---------------------------------------------
    Sympathy is the strongest instinct in human nature. - Charles Darwin

    by splashy on Wed Feb 12, 2014 at 06:05:45 PM PST

  •  I think a lot of people commenting (2+ / 0-)
    Recommended by:
    DavidMS, bigjacbigjacbigjac

    have figured out the problem. The ACA will be a great program for our nation and the fact that it covers mental health and addiction is paramount. However, that does not solve the problem of lack of resources. In fact, now that more are going to be insured I worry this will create a greater need for services which are already at the breaking point.

    The truth is that there is nothing noble in being superior to somebody else. The only real nobility is in being superior to your former self. -Whitney Young

    by Madrigal Maniac on Thu Feb 13, 2014 at 06:45:46 AM PST

    •  Group homes for anyone not violent. (0+ / 0-)

      For those dangerous,
      obviously,
      there is a challenge,
      shortage of beds
      in secure mental hospitals.

      (Did I say that about right?)

      From what I've heard,
      this shortage has been with us
      for decades.

      I'm mentally ill myself,
      but my illness
      lets me analyze everything.

      There will be a famine,
      as indicated in my sig line,
      around the year 2050.

      I hope I'm wrong.

      If I'm right,
      the mental health care situation
      will not be much better
      for maybe 100 years.

      After ninety percent of Americans are dead,
      the survivors
      will work something out.

      Famine in America by 2050: the post-peak oil American apocalypse.

      by bigjacbigjacbigjac on Thu Feb 13, 2014 at 04:55:03 PM PST

      [ Parent ]

    •  The ACA has funds for training more (0+ / 0-)

      professionals for primary care but it needs to be expanded to help get more clinical social workers and psychiatric nurses as well as more psychiatrists.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Sat Feb 15, 2014 at 03:42:57 AM PST

      [ Parent ]

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