Phony diagnoses hide high rates of drugging at nursing homes • Hacker News Board

Re: Phony diagnoses hide high rates of drugging at nursing homes

#151

Post by hnuser123456 » Sun, Sep 12, 2021, 2:37 AM UTC

kbenson wrote: post #142

AussieWog93 wrote: post #113

Earlier quoted context omitted.

>Phony Diagnoses not just at nursing homes, also in mental facilities. Schools too. My mum spent two decades as a primary schol teacher, and it's an open secret in that industry that Ritalin and other behavioural drugs are, at least in some cases, administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it.

> it's an open secret in that industry that Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it. Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. I have a daughter, now an adult, which Ritalin and/or Adderall provided real benefit. The only thing in question was ho…

In my case, it "worked" by making me far more anxious of failure and the judgement of others. For 8 years. I had never previously had suicidal thoughts but I did less than a year after starting the "meds." Then I got in trouble for discussing suicide with another student. The whole situation is more hellishly dystopian than a grimdark fiction writer could imagine. It's no mystery why gen Z are often aggressive doomers. Maybe we could re-evaluate the school system instead of drugging kids to be more scared and spineless? Once I quit the meds and went to college (and did fine btw but maybe because my brain was already permanently altered), it took about a decade for me to realize most people are pretty cool and don't expect you to bend to every whimsical demand of any size, and you don't need to be terrified of everyone around you who could tell you to do anything at any time and you'll get in massive trouble if you don't.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#152

Post by aemreunal » Sun, Sep 12, 2021, 2:44 AM UTC

BingoAhoy wrote: post #32

Phony Diagnoses not just at nursing homes, also in mental facilities. Was really surprised (better word-traumatized) that one flippant casual mention of not valuing my life in a private text message was enough to to get me detained by police in a facility for a night. "Doctor" threatened me with drugging just because I refused to answer some of their questions and instead insisted on a lawyer. Funny how freedoms can…

Reminds me of Élan School [1] and how kids (under 18) can be abducted with the permission of their parents and put in confinement for dubious behavioral benefits, against their wishes – sometimes with the help of the judicial system.

The road to hell is paved with good intentions.

[1] https://en.wikipedia.org/wiki/%C3%89lan_School

Re: Phony diagnoses hide high rates of drugging at nursing homes

#153

Post by jac241 » Sun, Sep 12, 2021, 2:45 AM UTC

lotsofpulp wrote: post #96

matheusmoreira wrote: post #86

Earlier quoted context omitted.

Yeah, I've read some incredible stories. Locking the doors behind the patient. Using some tiny remark as cause for involuntary institutionalization. It made me think american psychiatry was like american prisons where they get paid per person and are therefore incentivized to stuff as many people in the building as possible.

All the while I can drive 15 min and find thousands of obviously mentally ill people in need of involuntary mental health treatment (the type perhaps not even available at this point in the US) wandering around and the police cannot do anything about it because their only avenue for detaining them is to wait until they catch them committing a crime. And even then they are shortly released onto their own recognizance…

The reason they aren't in a psychiatric hospital is because the only reasons we can involuntarily commit someone is if they are a risk to themselves or others, and like stated elsewhere in the thread is generally reassessed by a judicial process every 72 hours depending on the state. What I'm reading in your post is that you're in favor of involuntarily holding more people which I find interesting because many others in the thread are complaining that it's too easy to have someone committed. There are a lot of armchair psychiatrists in this thread who have never seen someone in psychosis or truly manic suggesting that it's a joke to have someone committed. I spent 3 weeks rotating in a psych emergency department and only saw 2 patients out of probably more than one hundred total patients admitted for being suicidal. Neither were involuntary. From what I've seen unless you have just attempted or have a concrete plan to attempt suicide again you're not going to be admitted. There are just too many people who are in not-on-the-same-planet level of psychosis or mania that are taking up beds to admit someone who is not really about to attempt suicide.

Not trying to pick on your post or anything just thought it is a good example to say that it's maybe not as easy as it may seem to decide who gets admitted/committed, and the dichotomy in this thread shows that point.

Regarding potential overuse of sedation (benzos) or antipsychotics in nursing homes, it's easier for a nurse to push a doctor to prescribe meds to "snow" a patient than to spend time in the room and try to reorient a sundowning delirious dementia patient.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#154

Post by AussieWog93 » Sun, Sep 12, 2021, 2:46 AM UTC

kbenson wrote: post #142

AussieWog93 wrote: post #113

Earlier quoted context omitted.

>Phony Diagnoses not just at nursing homes, also in mental facilities. Schools too. My mum spent two decades as a primary schol teacher, and it's an open secret in that industry that Ritalin and other behavioural drugs are, at least in some cases, administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it.

> it's an open secret in that industry that Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it. Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. I have a daughter, now an adult, which Ritalin and/or Adderall provided real benefit. The only thing in question was ho…

>Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up.

That's definitely correct. It can be a great help for some children, and some teachers (maybe even the majority) do make carefully considered decisions where the primary concern is for the welfare of the child receiving the drugs.

Other times, though, they just want some ratbag kid to STFU so they can get on with their job.

I distinctly remember overhearing a conversation where a teacher wanted to (in her words) "sedate" a problem child so that they don't disrupt the rest of the classroom.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#155

Post by kbenson » Sun, Sep 12, 2021, 2:46 AM UTC

hagibborim wrote: post #148

kbenson wrote: post #142

Earlier quoted context omitted.

> it's an open secret in that industry that Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it. Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. I have a daughter, now an adult, which Ritalin and/or Adderall provided real benefit. The only thing in question was ho…

The phrasing of the poster you're responding to does not discount the experience you're describing. I don't see how they could be more careful.

> does not discount the experience you're describing

It's not about saying it's not possible, it's about setting expectations, and scaring people away from a medication which may be helpful.

>> Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it.

That clearly states the reason it's administered is not primarily for the child's benefit. While it doesn't discount that the child may benefit, it clearly sets the expectation that it's not the child's well being that's being considered. The natural extension of accepting that is to wonder if there's any actual benefit to the child or if that part is just in service to "the secret".

Implying that the reason a specific medicine is prescribed is not actually for the benefit of the patient might have real repercussions if it scares away someone that it could have haloed. At a minimum, I think a statement like that should be backed up in some manner.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#156

Post by AussieWog93 » Sun, Sep 12, 2021, 2:47 AM UTC

hagibborim wrote: post #148

kbenson wrote: post #142

Earlier quoted context omitted.

> it's an open secret in that industry that Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it. Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. I have a daughter, now an adult, which Ritalin and/or Adderall provided real benefit. The only thing in question was ho…

The phrasing of the poster you're responding to does not discount the experience you're describing. I don't see how they could be more careful.

I could have explicitly acknowledged that sometimes the child's welfare is the primary concern. I could have used weaker language, too. I've updated my comment a bit to more accurately reflect my understanding.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#157

Post by wonnage » Sun, Sep 12, 2021, 2:50 AM UTC

kevinmchugh wrote: post #123

coryrc wrote: post #94

Earlier quoted context omitted.

Same time we hardly pay that per year for k-12. Shows how messed up our priorities are.

School aged kids and teenagers also require a lot less individual care and attention

Nursing homes have some similarity to schools, the staff is mostly occupied by a few problem patients while the rest quietly shuffle along

Re: Phony diagnoses hide high rates of drugging at nursing homes

#158

Post by philwelch » Sun, Sep 12, 2021, 2:53 AM UTC

david-gpu wrote: post #49

koolba wrote: post #29

Earlier quoted context omitted.

> I'm terrified of growing old in this country. Have kids, raise them right, and you’ll be fine. It’s worked out pretty well for a couple thousand years.

Kids do not choose to be born. We can't expect them to serve us when we get old. They owe us nothing. We forced them into this world.

This argument bothers me because it seems to devalue human life on a very fundamental level. If your children resent you for “forcing them into this world”—if they would have preferred to have never been born in the first place—that’s not a healthy or normal reaction, but rather, near-suicidal depression. Sure, some people are suicidally depressive, but that’s a very dark attitude to project onto one’s hypothetical children as a default assumption.

If your kids aren’t suicidally depressive but also don’t love you enough to take care of you in your old age, there’s probably something else they resent you for other than being born in the first place. Which isn’t necessarily your fault—some people are just irrationally resentful. But that is probably the bigger risk to worry about. It’s just that, compared to trusting nursing homes not to become abusive, it’s still a better bet.

It’s also not necessarily about obligation, at least not in the negative sense of the term. I took care of my father during the last year of his life, not out of obligation but out of love. (One might define love as the act of willingly accepting the obligation to care for another, but a willingly accepted obligation is not really the same kind of obligation.)

In any case, the goal is to go into old age having people in your life who are capable of taking care of you and who will choose to do so out of love. Having kids and maintaining a strong relationship with them gives you a good chance of reaching that goal. Institutions, on the other hand, will never love you and will instead just fuck you up with psychoactive drugs for their own convenience.

Re: Phony diagnoses hide high rates of drugging at nursing homes

#159

Post by _nalply » Sun, Sep 12, 2021, 2:54 AM UTC

comrh wrote: post #69

quetzlbazaar wrote: post #53

Earlier quoted context omitted.

Suicide is offensive to society and many individuals on a deep level, especially of people who do not have a "good reason" (such as a terminal illness). While it may have progressed beyond being a criminal act, it is still taboo enough for alternative and equally good avenues to exist for society to deal with it, in this case, police and physicians empowered by law with the "duty of care" concept. This is of course b…

It's one of the two things every therapist will tell you that can force them to break the confidentiality. That it can take away your freedom, get you institutionalized, remove your ability to make your own medical decisions. It's important to take ideations seriously but as someone who struggled with that at points in my life I never felt completely safe about discuss it.

What's the other thing besides mentioning suicide?

Re: Phony diagnoses hide high rates of drugging at nursing homes

#160

Post by kbenson » Sun, Sep 12, 2021, 2:56 AM UTC

AussieWog93 wrote: post #154

kbenson wrote: post #142

Earlier quoted context omitted.

> it's an open secret in that industry that Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it. Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. I have a daughter, now an adult, which Ritalin and/or Adderall provided real benefit. The only thing in question was ho…

>Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. That's definitely correct. It can be a great help for some children, and some teachers (maybe even the majority) do make carefully considered decisions where the primary concern is for the welfare of the child receiving the drugs. Other times, though, they just want some ratbag kid to STFU so they can get on with their job…

> some teachers (maybe even the majority) do make carefully considered decisions

In the United States, teachers do not prescribe medications. They may make a recommendation that parents seek the guidance of a doctor, and a qualified medical professional (usually a psychiatrist) will diagnose the child, and the parent may choose to pursue medicating or not. In our case, we had regular checkup appointments with a psychiatrist where our daughter and us were present at the same time, and a later point in the session where the parents were asked to leave so the psychiatrist could speak with her privately.

> I distinctly remember overhearing a conversation where a teacher wanted to (in her words) "sedate" a problem child so that they don't disrupt the rest of the classroom.

Unless the laws have changed since then in Australia, Ritalin is a controlled substance, according to this, and it's not even guaranteed a general practitioner can prescribe it, and a psychiatrist is preferred.[1] Maybe you misheard, or maybe the teacher misunderstood what their capabilities were?

1: https://www.health.nsw.gov.au/pharmaceutical/patients/Pages/...