91–100 of 113 posts
Something is seriously wrong with our culture the past 10-15 years to have contributed to such a dramatic rise in mental illness.
I can't talk about culture but in Australia, this definitely correlates with the spread of methamphetamine. Meth-induced psychosis is a very real thing.
The first place they take you after triage at the ER is harsh, uncomfortable and at times dangerous for both staff and patients.
All your stuff is taken away, you get a hospital shirt and pants, then taken to a room with few comforts. Usually, a doctor will do the minimum of triage (again) as you enter the unit, or sometime after.
This is mostly to ascertain if you are likely to be a danger to yourselff and/or others. Which decides who much freedom you will have.
Spending time in your room that does not have anything in the form of distraction / games / or anything else is boring. Walking around the unit, or the common room can be dangerous if one or more patients are admitted who are not safe to be around other people.
These get moved or locked in usually pretty fast if possible.
Some also have physical health emergencies. One guy who was brought in had a rotting foot that required emergency treatment.
What I saw of it was a worthy of a horror movie, and the stench was considerable.
And yes you get people who sling fleeces, vomit violently,
Staying in your room is a reasonably good idea.
Then you have people who are actively suicidal or self harming. That will get you a dedicated nurse who stares at you / observes you at all times (at a safe distance with an alarm button) (if staffing allows).
Usually the next workday, (which is Monday if you are admitted on Friday) a doctor will come to perform a more thorough assessment and figure out a temporary list og diagnoses and a decision on where to move you. This might involve a second doctor / psychologist if its a complicated case
Then you get put on a list of what / where to move you when that unit has space available. (if they already do, you are moved as soon as possible) otherwise, you get to wait for a while.
So its harsh, uncomfortable, a bit dangerous, and sub optimal but I have learned why it is like this and I dont see a way to alter it that is ideal for everyone.
The nurses at the intake are hardcore. They have seen it all many times and it takes a lot to impress them, thrown them off. People having a psychotic break, streams all forms of nonsense, threats, paranoid delusions and they are not impressed. They are also usually fairly nice if they agree you are not dangerous to be around.
ER is not a place for treatment of mental illness, nor can it be. It takes people in and do their best to keep the person safe (Usually from killing themselves, sometimes for the staff to be safe) and a temporary diagnosis.
You are then either considered well enough to leave and get back to the real world, or sent to a long term care unit, which is a hell of a lot nicer that will start treatment, full diagnosis and so on.
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,…
which dispense drugs,
> make health care unaffordable
so patients can't afford drugs,
> getting access to treatment
which starts and ends with drugs.
I would like to see more focus on teaching people skills to navigate different aspects of self and others - dating, friendships, career, relaxing, finding something to be happy about. And also providing opportunities to actually practice those skills, modern society has become intrinsically stressful and isolating.
Obviously I am not talking about someone who suffered a complete break from reality and is sitting catatonic for days without interacting with anyone. But I bet a lot of patients admitted to ICU are not in this category, as evidenced by common sense measures described in the article working.
I have a feeling that future generations of doctors will look at today's mental health care in the same way as we now look at bloodletting. Belgian town of Geel has demonstrated that many mentally ill can lead content, functional life with a different attitude from society. Current mental health care emphasizes drugs with uncertain mechanisms of effectiveness and severe side effects, and Freudian style therapy that p…
The article has an insert section stating "Get Support If you are having thoughts of suicide, call or text 988" It's worth noting that this number has been associated with police interventions and a rise in psychiatric detentions: https://www.madinamerica.com/2023/05/psychiatric-detentions-...
Might it also be associated with fewer deaths?
Earlier quoted context omitted.
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...
It would be interesting to know how many people committing suicides were on SSRIs or antipsychotics, etc. at the time. These drugs are known to induce suicidal ideations (and ideations of violence, aggression, and homicide) and have carried black-box warnings. Sometimes, the cure is worse than the disease. Oh sorry, not a cure.
I have a feeling that future generations of doctors will look at today's mental health care in the same way as we now look at bloodletting. Belgian town of Geel has demonstrated that many mentally ill can lead content, functional life with a different attitude from society. Current mental health care emphasizes drugs with uncertain mechanisms of effectiveness and severe side effects, and Freudian style therapy that p…
Technically I think Freudian analysis is very uncommon in a clinical setting in 2023. Most often it’s some variant of CBT, and for some conditions DBT, that have more outcome oriented approaches and frankly can be more systemically applied by less skilled clinicians.
Earlier quoted context omitted.
Technically I think Freudian analysis is very uncommon in a clinical setting in 2023. Most often it’s some variant of CBT, and for some conditions DBT, that have more outcome oriented approaches and frankly can be more systemically applied by less skilled clinicians.
And also work long term, unlike psychoanalysis.
Earlier quoted context omitted.
It would be interesting to know how many people committing suicides were on SSRIs or antipsychotics, etc. at the time. These drugs are known to induce suicidal ideations (and ideations of violence, aggression, and homicide) and have carried black-box warnings. Sometimes, the cure is worse than the disease. Oh sorry, not a cure.
At the same time it would be interesting to know how many had these ideas before SSRI. If you've been feeling suicidal for a long time, and SSRIs haven't improved your condition, you might feel hopeless enough to commit the act - without SSRIs being any kind of cause.
But it would be extremely unknowable whether or not they had experienced suicidal ideations, and how long they had had them. Because the most you will get is a note in the medical chart, based on a verbal claim by an unreliable narrator.