Friday, November 07, 2014

Is community mental health care really worse in USA?

Allen Frances asks "How do we create a compassionate, cost effective mental health system?" and Psychiatric Times collects some answers in a blog post. There seems to be general agreement that the US mental health system needs fixing. Francis explains that, "Sixty years ago, community psychiatry was the big new idea". He thinks, "The dream worked well in many countries, but turned into a bitter nightmare in the US".

I'm not so sure that community care is the problem. Nor that the situation is much worse in the USA. Providing personalised mental health care worldwide is not easy and is not necessarily any better in the community than it was in the asylums.


Anonymous said...

I agree that there is no black and white answer to the problem of mental health care not being compassionate enough or "cost effective". However I am convinced that pharmaceutical drugs have got a lot to do with it, the profiteering of drug companies and the collusion of medical "professionals" who are making money and/or prestige from being connected to big pharma incestuously.

As a psychiatric survivor, someone who has "recovered" 3 times from "mental illness" and psychiatric treatment, I see some things better now than the 1970's and some things much worse. Polypharmacy of neuroleptics is a definite downside in my opinion. It was easier for me to break free from psychiatric services in the 1970's and 1980's than it was in 2002/3. The drugs tied me in, took away my agency and it required great resilience to taper them and get off, going against local psychiatry's lifelong prognosis of "severe and enduring mental illness" in 2004. I didn't believe it.

Anonymous said...

Duncan it is easily worse in the US speaking to US survivors and professionals, only requires a single medical opinion to detain there. Much easier to fall into and harder to get out of. Some states have 'mandated community treatment' where income/housing is made contingent on drug compliance, of course it's worse there.

Peter Jones said...

“Quick: what’s the top-selling drug in the United States?” the Daily Beast asked. “Prozac? Viagra? Maybe something for heart disease?”

The answer is actually Abilify (aripiprazole), a powerful antipsychotic used to treat schizophrenia and bipolar disorder, among other major psychiatric conditions.

Americans spent over $7.5 billion on the drug between October 2013 and September 2014, with nearly 8.8 million prescriptions filled per month in that same time period, Medscape Medical News reported. The sales of aripiprazole were more than all other major antidepressants combined.

Source :