This is very interesting. This is a blog of a PhD student and there's
commentary from a psychiatrist in America about how they're pushed by
financial reasons into a out size fits all approach of medication.
There's more in the New York Times article.
http://www.nytimes.com/2011/03/06/health/policy/06doctors.html?_r=2&pagewanted=all
<http://www.nytimes.com/2011/03/06/health/policy/06doctors.html?_r=2&pagewanted=all>
It's not so different in the UK but for different reasons, at least up
until a few years ago (and is still the case for people with severe
mental illness).
Let's take a first episode psychiatric crisis. Almost without exception
- be it for psychosis, mania or depression - doctors resort to
medication and often hospitalisation. The purpose of hospitalisation is
meant to be observation and treatment (in the initial stage using a
Section 2 of the Mental Health Act) and then treatment (using Section 3
which can force treatment). In practice it is a period of incarceration
while the healthcare team wait for the drugs to kick in. I've heard this
happen so many times and I've experienced it myself.
Doctors in the UK still value the chemical approach like a teenager at
their first rave. Though behavioural modification has had success in
treating people it is often not offered. Instead chemicals are used to
achieve the desired effect of making the unwanted behaviour or
emotions/experience of consciousness which causes the behaviour to
disappear. Suppression of these behaviours using chemicals is cheap and
easy. It also fits into what doctors are used to doing. They don't treat
cancer by talking. They give pills and use other physical treatments.
These drugs are little different from what a teenager might get.
Admitted illegal drugs usually work a lot faster. Research in the last
few years into illegal drugs as psychiatric medication is adding to the
research into enthogeons which has been suppressed in the past by the
mental health movement. There is also a lot of hope for psychological
therapies though.
The
not-really-a-mental-illness-but-for-the-purposes-of-this-rant-will-be-termed-a-mental-illness
borderline personality disorder, a disorder characterised by a
significant risk of death by suicide, was considered untreatable however
new techniques have offered hope for clinicians and patients who want
their behaviour changes. Dialectical Behavioural Therapy seems to have
significant backing for the idea that it works. It is an expensive
option though. 2 therapist and a year of therapy. Instead they hand out
antipsychotics or other medications. They're cheaper and they deal with
the behavioural problem. (People with BPD don't really experience
psychosis as far as I am aware however the use of a strong behavioural
change chemical has been shown to work because that's really what
antipsychotics are).
Easy and cheap. Unethical and harmful. This is current mental
healthcare's tendency.
Progress will happen but it needs this mentality to change.
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