1. Introduction: How can I improve the mental health care system?
We are often asked how we can improve the mental health care system. It is a difficult question to answer (we’ve written some of it here before, but never to this extent).
The short answer is that we don’t know how to improve it. The first step would be to recognize that one of the biggest problems facing the mental health care system today is not just the illness itself but our ability to diagnose and treat it correctly — which is often a very complex process.
From there, there are three areas we think are worth exploring: (1) improving diagnosis; (2) improving treatment; and (3) improving outcomes.
I suppose there are some other factors at play too: a lack of public reporting on mental health in general can be counterproductive, stigma may be one big factor, etc. But for now, let’s focus on diagnosis and treatment in particular.
2. The mental health care system is important.
I will start this post with a quote that I think sums up the crucial relationship between health and mental health well:
My life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in sideways, chocolate in one hand, a poorrelative in the other, and say “Welp, there’s no changing your mind, have a nice life!”
In many ways, this is the ideal way to live. You can’t control what’s going on around you. It’s not your fault. If it were your fault, you should be dead. Death isn’t something to be prepared for or worried about. The only way to deal with it is to learn how to enjoy it and make it into an art form.
The only thing preventing people from living this way is society itself. We are social animals, and we rely on each other. If we don’t depend on others for our lives, then we can’t live them; if we don’t live them, then they won’t depend on us either.
So how do you deal with what happens when all those people who depend on you die? How do you make sure that nobody gets hurt? What do you do when someone needs help but doesn’t want to talk about it? When they won’t tell you what’s wrong because they’re ashamed of their problems? When they won’t stand up for themselves because nobody makes them feel like they’re worth anything? When people lie about their problems so desperately that even if their loved ones refuse to believe them, will nobody believe them either?
These are just some of the more common things that people who are mentally ill do because of the stigma surrounding mental illness (the same thing happens here too). The reason I bring this up is that I think that stigma does more than just contribute towards making mental illness difficult for people to talk about; it also contributes towards making mental health care less effective (because people still need help). It also contributes towards creating an environment where demands from patients become more important than care from providers (because patients expect professionals to take care of them even before they ask). This creates an environment where professionals aren’t willing or able to provide adequate care despite the fact that there aren’t enough resources (and as such, leads many services back towards providing only limited forms of treatment instead of comprehensive treatments, which cost substantially less per patient per year and offer better outcomes).
3. Biological, social, and psychological factors in mental health.
We are a group of researchers who are working on a large project to understand how and why people’s mental health is affected by social and psychological factors. We want to understand the relationships between biological, social, and psychological factors in mental health.
The name of our project is “Deciphering Social and Psychological Factors in Mental Health” (DSPS).
We are probably going to stay on this topic for a long time.
We hope you will like it when we do something new again, so please come back again!
4. The mental health care system is underfunded.
If you live in the United States, you’ve probably heard that healthcare is expensive. But what does that mean? The opposite of affordable healthcare is unaffordable healthcare.
This is an important topic to cover because it highlights the very real and growing problem. While we may have good intentions, our country’s healthcare system isn’t doing us any favors.
A new study published in PLOS One demonstrates that the availability of mental health services for people with psychiatric disorders is often inadequate and, in some cases, nonexistent. The study found that more than one-third of mental and physical health services for a variety of psychiatric conditions were unavailable, far below the national average of 40 percent. And in some cases, there was no difference between availability and cost; people who are uninsured had access to less than one-third as many services as people with insurance coverage.
The authors write: “In other words, the majority of Americans—even those with insurance—are likely to be unable to access mental health services due to financial barriers or lack of resources.”
This is again not unique to the US—Canada’s Royal Commission on Mental Health (the country’s leading inquiry into mental health) found similar results: “[T]he availability of services for Canadians with severe and complex mental illnesses is substantially lower than recommended by international standards, including those recommended by national health organizations such as Health Canada and sections 1 and 2 of Bill C-42 [the Conservative government’s proposed law on assisted dying].”
It isn’t just how much money we are spending on mental illness; it is how much money we would like to spend on mental illness — specifically suicide prevention (a huge problem in both countries). When considering suicide prevention, a Canadian study showed that a child who suffers from depression will attempt suicide about one year after their symptoms are first recognized; another Canadian study reported similar findings for girls ages 15–19 years old: “[A] child who has been diagnosed with depression at 15–18 years old will attempt suicide at age 33–41 years old if they have not received treatment during this time period.” In children who are currently receiving treatment for depression at age 18 years old, it took six months before children attempted suicide when compared with their peers who were not receiving treatment… [and] three months after treatment began, 5% (0%) of children attempted suicide, compared to 7% (0%) of children whose parents did.
5. The mental health care system is understaffed
Mental and physical health are not the same. If a person is mentally healthy, they will not become physically ill (or vice versa). While a lack of mental health may not manifest as physical health, it can manifest as a host of other problems, such as depression or low self-esteem. In this post, I’ll address the way the healthcare system is structured to help fix this problem.
A variety of ways have been proposed to address the problem of spending too much money on people who would benefit from more money spent on things like medication and therapy. One approach has been to look for ways to cut costs lower than necessary in order to save money in the long run. Another has been to look at medical treatment methods that will actually help people rather than just make them feel better while they wait for later treatment or treatments (which can be expensive).
I think the best approach is neither top-down nor bottom-up, though it is important to acknowledge both approaches exist. There are many reasons why mental and physical health care require different treatment methods, but one thing all agree upon is that there are more people who need more money invested in their future than there is money available for them right now.
6. The mental health care system is inaccessible
One of the major problems with mental health care is that it’s not just about helping people feel better—it’s also about trying to make them change their behavior. For example, many people with depression are too embarrassed to seek help and too afraid of being judged by others. As a result, they may be reluctant to admit their illness and talk about it with the people who are supposed to be able to help them.
Mental health is sometimes called “the invisible disease” because people don’t want to talk about it, and yet, without treatment, it can have a cumulative negative impact on a person’s physical and mental health. It can also lead to other forms of social isolation, such as being unable or unwilling to connect with family members or friends, or feeling like nothing in life matters as a result of severe depression.
If you think you might be depressed or have already been diagnosed with depression (if you think your symptoms are not severe), here are some things you can do right now:
• Learn everything you can about depression:Symptoms and causes Helping yourself Feelings and emotions Depression Treatment When is someone else trying to treat me? What should I expect? What if I’m not getting treated? How long will it take? How much does treatment cost? Whom should I ask for help?
Remember that this isn’t just something you need for yourself; your doctor could be helping someone else too. Download these resources for depression (or any other mental health issue): ••• If You Need Help Now – 8-page pdf document (free); ••• Talking About Depression – 6-page pdf document (free); ••• Mental Health Professional Training Course (TPRT) – 23-hour course ($27 value); ••• The National Alliance on Mental Illness Guidebook – 20 looseleaf pages ($23 value).Here are some tips on being open with your doctor: www.nami.org/information/resources/resources_for_supportive_care/list_of_articles_on_listening_to_yourself/.
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7. Conclusion: How can I improve the mental health care system?
According to a UN report, mental health problems are the leading cause of ill-health worldwide.
The question is how to improve and maintain mental health, which is a problem because most people suffer from it without even realizing it. The Mental Health System in Canada offers us an opportunity to do so.
In this post, I’ll discuss how we should approach the problem of mental health, what we can learn from other countries or from our own culture, and why we should look at improving the mental health system as a public good.
It will be useful for you to have read through my previous posts on this topic (which you can find here [1] and here [2]). If you haven’t already done so, see “Mental Health Too Important To Ignore” from the last post. Most of what I say is applicable to any country: if you are attempting to implement something in your country, even if it appears to be a good idea at first glance, what works in one country may not work in another;
If you are interested in applying some of these ideas, please get in touch with me via email [3].
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