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Reinventing the E.R. for America’s mental-health crisis

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Re: Reinventing the E.R. for America’s mental-health crisis

#41

Post by harimau777 »

bill_joy_fanboy wrote: post #36
zer8k wrote: post #18

Earlier quoted context omitted.

Is there a rise in mental illness or more people simply being diagnosed now? We're more aware of mental illnesses, leading to more diagnoses, leading to what appears to be a spike in mental illness. I haven't dug deeply into this but I wonder if studies on this have attempted to separate the two. Psychology is notorious for it's crisis of reproducibility. I take everything related to mental illness with two heaping s…

One way to cut the nonsense is to look at things that can't be fudged. Suicide is an example. You can't "overdiagnose" suicide unless you outright lie that it happened. The rate for suicide was something like 10/100K in 2001 and is hovering at 14/100K now. This is a significant increase. If more people are killing themselves, it's almost certain that there are far more people are also miserable or struggling than the…

I think you are probably correct that suicide is a decent proxy measurement. It is possible that it could be skewed by changes in how likely people are to honestly report suicide; as opposed to calling it an accident.

Re: Reinventing the E.R. for America’s mental-health crisis

#42

Post by harimau777 »

willcipriano wrote: post #2

Alternative title: "Bringing back the asylums without admitting we were wrong about closing them"

Can you explain what policy you are advocating for? Asylums pretty egregious abuses of people's human rights; and that's to say nothing of instances where they were used to lock up mentally well but socially "undesirable" people. I'm guessing that you must have intended to advocate for something else?

Re: Reinventing the E.R. for America’s mental-health crisis

#43

Post by lostNFound »

jdietrich wrote: post #31

The facilities described in this article seem to be broadly similar to a "psychiatric intensive care unit", a care concept that has been developed in the UK and Australia in recent decades. If you've ever been in an emergency department, you'll know that it's far from ideal if you're experiencing an acute mental health crisis. EDs are often noisy, chaotic, and aren't equipped to provide the continuity of care and sup…

Just a tiny nitpick to avoid confusion, but a PICU is already a thing and it means Pediatric ICU, not psychiatric.

Re: Reinventing the E.R. for America’s mental-health crisis

#44

Post by 1234554321a »

outlace wrote: post #16

Something is seriously wrong with our culture the past 10-15 years to have contributed to such a dramatic rise in mental illness.

20 years ago a mental illness, now they changed the name and it’s not an illness anymore so everything is ok.

Re: Reinventing the E.R. for America’s mental-health crisis

#45

Post by OldGuyInTheClub »

I think we've gone over the cliff on this and a lot of other issues like education and health care in general. If it isn't profitable for private equity it won't get done. If it is something that private equity gets into, the results are predictable.

It reeks of Dickens, "Are there no workhouses? Are there no prisons?"

Re: Reinventing the E.R. for America’s mental-health crisis

#46

Post by EgregiousCube »

hezralig wrote: post #40
duped wrote: post #38

Earlier quoted context omitted.

> Suicide is an example. You can't "overdiagnose" suicide unless you outright lie that it happened. People have been outright lying about suicides for a long time.

Do you mean in regards to under-reporting to save face?

"Died cleaning his gun" etc, yeah.

Re: Reinventing the E.R. for America’s mental-health crisis

#47

Post by obblekk »

There’s gotta be some reason for the mental health crisis, along with all the other crises out there.

It doesn’t make sense for every level of American to be meaningfully wealthier and higher income than 20 years ago and yet also be suffering (in multiple ways!) more as well. We even (mostly) fixed health insurance by massively redistributing income! The rest of the world seems to be tracking the same trends but 10 years behind.

It used to be that increasing people’s income improved all cause mortality. Have we crossed some threshold where that’s reversed?

Re: Reinventing the E.R. for America’s mental-health crisis

#48

Post by dec0dedab0de »

obblekk wrote: post #47

There’s gotta be some reason for the mental health crisis, along with all the other crises out there. It doesn’t make sense for every level of American to be meaningfully wealthier and higher income than 20 years ago and yet also be suffering (in multiple ways!) more as well. We even (mostly) fixed health insurance by massively redistributing income! The rest of the world seems to be tracking the same trends but 10 y…

It doesn’t make sense for every level of American to be meaningfully wealthier and higher income than 20 years ago and yet also be suffering (in multiple ways!) more as well.

I would argue that we are not meanigfully wealthier in community, sense of purpose, love, and many other intangible things.

Re: Reinventing the E.R. for America’s mental-health crisis

#49

Post by julianeon »

obblekk wrote: post #47

There’s gotta be some reason for the mental health crisis, along with all the other crises out there. It doesn’t make sense for every level of American to be meaningfully wealthier and higher income than 20 years ago and yet also be suffering (in multiple ways!) more as well. We even (mostly) fixed health insurance by massively redistributing income! The rest of the world seems to be tracking the same trends but 10 y…

I don't know if mental health has necessarily changed for the worse, as much as we stopped locking people up in the attic (Victorian solution), or tossing them in the 'loony bin'.

Here's a novelty song from the 60's about those days.

https://www.youtube.com/watch?v=eQNI1KfGXBA

And here's a movie from a decade later, based on a famous book.

https://www.youtube.com/watch?v=OXrcDonY-B8

We don't deal with people that way anymore, but of course the problem remains.

Re: Reinventing the E.R. for America’s mental-health crisis

#50

Post by EgregiousCube »

obblekk wrote: post #47

There’s gotta be some reason for the mental health crisis, along with all the other crises out there. It doesn’t make sense for every level of American to be meaningfully wealthier and higher income than 20 years ago and yet also be suffering (in multiple ways!) more as well. We even (mostly) fixed health insurance by massively redistributing income! The rest of the world seems to be tracking the same trends but 10 y…

I think it has a lot to do with the birth rate. Here's a study from the prior century on the topic - there are a lot of correlated "people doing well" metrics, but when they controlled for fertility only it had the strongest negative correlation with suicide. https://pubmed.ncbi.nlm.nih.gov/1737819/
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