Thursday, January 3, 2013

Health Care for the Mentally Ill

My opinion:
I've always thought that one of the largest problems with the contemporary health system is the limited access to treatment and care.  It's already incredible that 11 million people are not adequately served, but think of all the other issues at hand.  How do people who speak foreign languages find doctors with whom they can communicate?  How are the poor treated if they can't pay?  Even if the patients are not poor, what if their insurance doesn't provide enough coverage?  How do people in rural areas find doctors close to home?  These questions, as well as many others, must be answered in order to improve the health care situation across the country.  Feel free to comment.


Families facing barriers to mental care

NEW YORK -- Lori, a 39-year-old mother in New Jersey, would like to save for the usual things: college, retirement, vacations. But those goals are far down her wish list. For now, she and her husband are putting aside money for a home alarm system. They’re not worried about keeping burglars out. They need to keep their son in.

Mike, 7, began seeing a psychiatrist in 2009, after one pre-school kicked him out for being “difficult” and teachers at the public school he later attended were worried about his obsessive thoughts and extreme anxiety. He was eventually diagnosed with bipolar disorder.

As she keeps trying to get help for him, “I am learning firsthand how broken the system is when dealing with mental illness,” said Lori. (Surnames of patients and their families have been withheld to protect their privacy.)

“We fight with doctors, our insurance company, educators, each other; the list goes on and on... It isn’t even a system. It’s not like there’s a call center to help you figure out what to do and how to get help.”

Last week, the National Rifle Association blamed mass shootings such as that at Sandy Hook Elementary School in Newtown, Connecticut, on the lack of a “national database of the mentally ill,” who, it claimed, are especially prone to violence.

Dr. Paul Appelbaum, professor of psychiatry, medicine and law at Columbia University, disagrees, however. “Gun violence is overwhelmingly not about mental illness,” he said. “The best estimate is that about 95% of gun violence is committed by people who do not have a diagnosis of mental illness.”

But experts on mental illness agree with one implication of the NRA’s argument: families trying to get help for a loved one with mental illness confront a confusing, dysfunctional system that lacks the capacity to help everyone who needs it -- and that shunts many of the mentally ill into the criminal justice system instead of the healthcare system.

“Public mental health services have eroded everywhere, and in some places don’t exist at all,” said Richard Bonnie, professor of law and medicine at the University of Virginia. “Improving access to mental health services would reduce the distress and social costs of serious mental illness, including violent behavior.”

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