Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

newyorker.com

Post reply on HN
Print view View original

71–80 of 113 posts

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

#71

Post by mvncleaninst »

zer8k wrote: post #67
mvncleaninst wrote: post #64

Earlier quoted context omitted.

The people who need help most can be legally compelled by a court to receive it Saying that someone with anxiety "needs help most" is unconvincing given the presence of psychotic homeless who aren't receiving treatment because of limited capacity or lack of financial incentive I really don't understand your comment: why does a violent, untreated psychotic "need help less" than a neurotic who rejects the help for lega…

My point was the breach of doctor-patient confidentiality. Which destroys the foundation of trust therapy requires. Being "legally compelled" to get help does not mean that help will be received. Forced compliance has never worked. There's plenty of history to back up that statement. I don't understand if you're trying to show how much you know about mental health or something but it appears you missed the greater po…

I'm not disagreeing with your point about confidentiality, it's good for people to have that kind of outlet where they can speak without consequences. The liquidation of that confidentiality is very very bad because it destroys an important outlet for emotional support

The disagreement we have seems to be based on what the actual goal is of mental health intervention. It sounds like (correct me if I'm wrong) that you're saying the purpose is emotional growth. A neurotic is in more of a position to benefit from therapy than a psychotic. But I'm not considering things in terms of that, more so in terms of public safety

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

#72

Post by plemer »

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…

Wealthier, yes. But meaningfully wealthier?

Money buys power and the political economy is zero sum, so: concentration of wealth -> concentration of power -> most people lose power -> most people's lives get worse.

And wealth has become much more concentrated. Consider that in the US: * billionaires increased their wealth by ~$5T during the pandemic [1]

* the top 1% own ~30% of wealth and the top .1% own ~13% of wealth [2]

* unlimited election spending by corporations and labor unions has been legal since 2010 [3]

* in FY2018, the top ten Fortune 100 companies receiving the most federal funding achieved an ostensible ROI on lobbying of 100,000% [4]

The trend is only picking up speed.

[1] https://www.oxfam.org/en/press-releases/ten-richest-men-doub... [2] https://www.statista.com/statistics/203961/wealth-distributi... [3] https://en.wikipedia.org/wiki/Citizens_United_v._FEC [4] https://www.forbes.com/sites/adamandrzejewski/2019/05/14/how...

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

#73

Post by AndrewKemendo »

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.

9/11 and the Global War on Terror pretty much killed anything like optimism and kicked off the rise in authoritarianism worldwide.

Throw in the 2008 recession and collapse in generational mobility worldwide.

Add to that global media/internet access and increasing alienation with the increase in inequality worldwide.

Finally top it off with a fat pandemic and you have at least two generations (X and Millennials) totally get their future put on hold while everyone older cashes out.

Everyone younger is looking at all this in horror and are just waiting us out while innovating humor in the most refreshingly gallows way.

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

#74

Post by ProllyInfamous »

keithalewis wrote: post #26
ProllyInfamous wrote: post #23

Earlier quoted context omitted.

The juice ain't worth the squeeze. Social media has disconnected us all. DNGAF. Amen.

If you don't have anything to add to a discussion on social media then don't post.

I'm just sharing personal perspective.

As a recovered uppers abuser (sober over 14 years) I am grateful to care more than most peopls are willing to in such an unjust society.

"It is no measure of health to be well-adjusted to a profoundly sick society."

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

#75

Post by liamwire »

NoZebra120vClip wrote: post #61
lostNFound wrote: post #43

Earlier quoted context omitted.

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

Would ΨICU be mistaken for a fraternity?

I really appreciate the cleverness of this.

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

#76

Post by balderdash »

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 comes down to less connectedness and community, fewer personnel connections, less religion/spirituality, less moral grounding, tech/media landscape that drives feelings of division/fear/inadequacy, generally less sense of purpose and belonging and self worth.

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

#77

Post by Groxx »

EgregiousCube wrote: post #46
hezralig wrote: post #40

Earlier quoted context omitted.

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

"Died cleaning his gun" etc, yeah.

You absolutely see this in insular communities - lots of attempts to hide abuses or family politics that led to a suicide, by hiding it behind accidental death of some kind.

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

#78

Post by bill_joy_fanboy »

dredmorbius wrote: post #66
NoZebra120vClip wrote: post #62

Earlier quoted context omitted.

If suicide is directly correlated to mental illness, then what of euthanasia and assisted suicide? Anyone who applies to end their own life would be incompetent to make that choice, due to mental illness.

Those modalities should be discernable when looking at data by age (assisted death tends to occur at older ages) and, with a slightly greater data burden, comorbidities. When looking at data, an otherwise healthy 20 year old, and an 80-something with multiple chronic and/or terminal Dx's, would stand out. The challenge in looking at population-level data is that the Dx may well not be available, though other indicia…

Like you said, I think looking at younger ages is sufficient.

In 1999, teen (15-19) suicide was at around 8/100k, and it's now around 11/100k. It's lower in absolute numbers than in the general population, but there's still a disturbing uptick.

https://www.charliehealth.com/research/the-us-teen-suicide-r...

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

#79

Post by diogenescynic »

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.

It's the potency and accessibility of drugs, now you can get fentanyl or meth that are dozens of times more pure and cheaper and available all over with virtually zero consequences. If you want to use drugs, there are no cops or doctors who are going to intervene and your family can't just force you into rehab. This new reality is simply sum of the cumulative bad decisions we've made--get rid of mental institutions, make health care unaffordable, tie insurance to employment so mentally ill and drug addicts have a harder time getting access to treatment, the breakup of the nuclear family, more females working and less time to raise their kids, decriminalize drugs, decriminalize sleeping outside in public places, decriminalize theft... this is the end result.

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

#80

Post by diogenescynic »

zer8k wrote: post #18
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.

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…

When I was a kid growing up in the '90s, there was only one visibly homeless person and he was just a schizophrenic guy who pushed a tv around in a shopping cart. Now, there are tent cities and visibly mentally ill using drugs openly in most cities on the west coast. Something has definitely changed.
Post reply on HN