Most Americans with mental health needs don't get treatment, report finds

SharkEatingBreakfast, 5 months ago

Mental health care is not profitable. That is why it is so bad and why the “higher powers” will not put into its growth and infrastructure.

wreckedcarzz, 5 months ago

This just in: water is wet

Apytele, 5 months ago (edited 5 months ago)

I’m an inpatient psych nurse. We do need more facilities and clinicians, but the muuuch bigger issue is affordable housing. I would say about 33% of our unit census at any one time, especially in the winter, often boils down to people staying for what I like to call “3H1C” treatment, or “three hots and a cot.” They’re homeless and come to the Emergency Room and say they’re suicidal (the good ones fake or exaggerate psychosis) so they won’t freeze to death or otherwise die of exposure. I don’t blame the doctors for not taking any chances, and I don’t blame the patients for lying. I also honestly just don’t want to live in a world or work in a system where I have to try and figure out if someone is lying about wanting to die.

Honestly I don’t even really want more homeless shelters; we need to make housing affordable again. We can’t be keeping people in shelters, especially not when they also have mental health concerns, and there’s still a pretty big overlap in those populations. Just because they’re not suicidal and don’t need to be cared for at my very invasive and expensive level of care, doesn’t mean they’re mentally healthy enough to not shank their bunkie because they have PTSD from some kind of institutional or homeless experience. Some of these people jump up out of bed in a full rage if you’re not reeeeaaaallly careful about how you do it, imagine them sleeping in bunk beds! The only way to keep people safely packed in like that is an immense amount of supervision. It’s honestly probably cheaper to just give them more personal space. Many of them will still need significant assistance to safely live independently due to the psychological effects of chronic institutionalization, but coming by once a week to teach them how to cook or do their own laundry is a much cheaper, less invasive, and more humanizing approach.

Edits: sorry I just keep adding shit and fine tuning I’m way too ADD.

rekabis, 5 months ago

Up here in my tiny corner of Canada, a 1bdrm shoebox typically costs 75% of a monthly full-time minimum wage just in rent. And that’s your gross, pre-tax wage, and not post-taxes net.

People are literally living without heat or even electricity just to put a roof over their heads. At least it’s easier in apartments, if you choose a middle unit you have warmth coming from five of six sides such that the pipes are unlikely to freeze, and the hot water is usually from central boilers.

Commensurately, vacancies have been hovering at 0.02% (2 available vacancies for every 10,000 rentals) for a good chunk of the last decade, and the homeless population (visible and working homeless) has swelled from 1.7% of the city’s population to almost 6% in less than two decades. Wal-Mart recently banned overnight stays in its parking lots for the first time since they opened shop in the 90s because they were having over a hundred vehicles there each night.

And this being Canada, we do not typically have mild winters. we usually have at least 2-3 weeks at -20℃ or lower some time January or February.

You can see how this ends up being a mental-health crisis generator on steroids.

GONADS125, 5 months ago (edited 5 months ago)

I couldn’t agree more with everything you’ve said.

I was an caseworker for the adult population with serious mental illness (SMI) and was on a specialized team working exclusively with individuals whose SMI was severe enough that they were unable to live independently. All of my clients lived in various residential care or assisted living facilities in my region. A big part of my job was teaching daily living abilities and working to reintegrate people into independent living in the community (or often a semi-indepent housing facilities with more freedom to take steps).

Covid was a substantial disrupter, cost of living is out of control, housing is completely unaffordable, and before covid + RSV + pneumonia kicked my ass out of my job, all of the housing programs in my region were totally backed up. A former team member told me recently that the housing programs all basically are at a standstill.

The population I worked with typically were not their own guardians. Most had court-appointed guardians (typically the county public administrator, because family usually was non-existent, inappropriate, or unwilling) due to repeated hospitalizations and arrests (often behavior from drugs, alcohol, or psychotic episodes). Some absolutely needed guardians due to level of function, others were capable of governing themselves, but trapped under a guardian.

The thing most of my clients had in common was being homeless at some point. That’s often what signified the start of their substance use and most severe period of SMI. It’s very common for people to develop substance use when living on the streets due to the widespread use in the homeless community. They are simply comforting to the group that typically is their only source of support.

Since deinstitutionalization, the Department of Corrections (DOC) has been the largest mental health provider, and the situation is a revolving door. By that, I mean people are arrested due to crisis, substance use, psychotic episodes, etc.; receive medications and become stable; are released on the streets without adequate support/stable housing; can’t/don’t refill their medications; often fall back into substance use because of prevalence among peer-support; have a relapse of symptoms, experience a crisis, or have psychotic episode or drug-induced psychosis; and finally they are arrested again. Rinse and repeat. That is how most of my clients ended up under guardianship.

We must have our basic needs of safety and shelter met if we are to be able to live stable within society. The homeless population’s basic human needs aren’t being met. They are a massive and growing marginalized society in the US. We must have affordable housing and rent or the problem will just continue cascade.

Edit: Worth noting I also have ADHD and I’m slightly medicated from vaping… Makes me rant…

Drusas, 5 months ago

Most Americans can't even get mental health care even if they can afford it and try to get it. Everywhere is always booked up and not taking new patients. Extra good luck to you if you're actually trying to find a therapist who meshes well with you and not just whatever random therapist will get you in within the next year.

And this is not a pandemic problem; it has been going on for many years.

SirSamuel, 5 months ago

Well of course I know him. He’s me

reddig33, 5 months ago

We don’t have socialized medicine in the United States. Don’t be surprised when a for-profit system treats people this way. If you don’t like it, push to change it.

the_q, 5 months ago

Push what?

MotoAsh, 5 months ago

Push for reforms that de-privatize the hospitals and get rid of insurance in favor of which ever single-payer plan. If people know they can see a psychologist or psychiatrist without spending loads of money and effort, they likely will. We can make schooling affordable while we’re at it get some more doctors brewing…

Semi-Hemi-Demigod, 5 months ago

Push how?

Warl0k3, 5 months ago

Senators off ledges, maybe?Forreal though, public protest, running for local elections, fucking voting

All do more than people give them credit for.

Cruxifux, 5 months ago

He means vote once every four years, make Facebook statuses about it, and maybe even send an email to your local representative. You know, the things that have been working so well for you guys so far.