Mental health cilnics will frequently offer a variety of services. Individuals going to mental health clinics can see a variety of individuals. Individuals can see therapists, med nurses, psychiatrists, social workers, peer support specialists, attend groups headed by group therapists etc. Fine. Some individuals appreciate and benefit from the broad range of services provided by mental health clinics.
On the other hand many individuals with mental illness are very wary of the mental health system. This is perhaps unfortunate but it is a fact. Say an individual only wants to pick up some prescriptions. He or she knows that he or she is ill but wants minimal contacts with the mental health system. Only getting prescriptions at mental health clinics is almost impossible despite the fact that medications are the cornerstone of treatment.
Mental health clinic adminstrators see clients as income streams. The more services used the more billable hours. Demanding that clients use all the services available can get in the way of individuals with major mental illnesses getting prescriptions for medications which are the cornerstone of the treatment.
Mental health clinic admistrators are pro maximizing billed hours. Lots of services are offered. Mental health clinic administrators are always telling funding authorities that the programs really do work and that individuals can go back to work with the services offered though a broad range of services are required, however, psychiatrists are not required.
Given someone has a psychotic disorder then the pyschotherapist will want to delve into that psychosis. Given the zeitgeist individuals with psychoses are expected to admit to entertaining very dark scenarios and if they don’t they are fit for work. If they talk extensively about various dark scenarios the treatment team can re-arrange the brain chemistry in all sorts of unpleasant ways. To avoid really terrible re-arrangements of brain chemistry individuals must use all the services of the mental health clinic and must see the benefit of the services with indviduals then fit to work. The threat of re-arrangemets of brain chemistry are always the sword of Damocles that hangs over the heads of individuals with psychotic disorders at mental health clinics.
What is the best kind of treatment for psychotic disorders? Not too much treatment and not too little treatment which is almost impossible to get at mental health clinics. Most individuals with schizohprenia even with the best treatment are disabled and unable to work which is not to say that treatment cannot be of terrific assistance. .
Parents could band together approach mental health clinics tell the clinics that their sons or daughters are disabled but that they do not want their children overdosed. Maybe then mental health clinics could become warms places for individuals with psychotic disorders, rather than pressure cookers, to the benefit of all.
An individual with a psychotic disorder goes to a mental health clinic. He is safe for himself and others but he is seriously ill. He is on low dosages of an antipsychotic. He thinks off to the side that National Security Forces are tracking his every movement. The psychiatrist does an hour interview and then sends him to a psychotherapist who asks him what is going on and after some reluctance he talks about how the National Security Forces are watching every move he makes. The psychotherapist listens sympathetically. The psychotherapist sends him to a med nurse who demands that he increase the dosage of the antipsychotic or maybe add a second antipsychotic. The patient does so and the patient is now a zombie.The patient goes back to the psychotherapist. She says new medications take awhile to work. The psychotherapist recommends some group therapy sessions where maybe inspirational books are read. The psychotherapist asks about the National Security Forces. The patient does not have the energy to think about the National Security Forces or anything else.
The patient decides to never again talk about the National Security Forces. He goes to every group suggested as the clinic can adjust his meds again at any time after what he has said about the National Security Forces. He attends groups, says positive things about the inspirational books and the med nures allows him to decrease his dosages. He is on dosages he was on when he first entered the clinic. The National Security Forces are again on his case but he is safe for himself and others. He is still disabled by a severe mental illness. The team who has been treating him have a meeting and decide that the patient is doing much better now. The psychotherapist tells the patient that he is ready to go back to work. The mental health clinic tells funding authorities thanks to all the services provided by the mental health clinic, where a range of services are required, that another patient is ready for work.
So at the mental health clinic if a patient is safe for himself and others but still severely mentally ill he is either dangerously ill or completely well. And if he is dangerously ill the proferred solution is to accept zombiehood. And of course the patient can not explain what is going on to family. Family thinks that the mental health team just wants to listen sympathetically, in a warm, professsionally caring environment to their ill relative. While listening pleasantly what the mental health team is also doing is generating billable hours and reporting either successes to funding authorities or why the mental health clinics need more funds.
Very frequently individuals on mental health teams are well-intentioned, however, they are on jobs. One might think if the record shows that an individual has had a long history of schizophrenia that efforts to get some one back in the job market would cease, that patients just picking prescriptions for medications and not running up costs would count as a victory but not so. Mental health clinics can be pressure cookers for patients.
First of all and most importantly the seriously mentally ill require medications where dosages are the lowest effective dosages which could leave the mentally ill still neurodifferent even very neurodifferent. On effective dosages the seriously mentally ill must be safe for themselves and others.
Second and next in importance the seriously mentally ill require housing.
Last in importance is that a warm, safe place where the seriously mentally ill could talk about the difficulties they are facing with professionals would be very nice. The goal of these talks would be support rather than treatment.
Unfortunately, mental health clinics totally fail to deliver what the seriously mentally ill need. Heads of clinics tell funding authorities that ‘our services can get individuals back to work in short time’. If there are difficulties in treatment and there are always difficulties in treatment of the seriously mentally, after all the seriously mentally ill are seriously mentally ill, higher dosages and polypharmacy are the answer and all of kinds psychological services are proffered that are totally besides the point. Funding authorities get billed for lots of hours and patients get to be zombies and are still disabled. Patients all too frequently decide not to visit mental health clinics. Patients can end up homeless and off medications. As mental health clinics are now set up mental health clinics deliver very mediocre mental health services at very high cost.
Unfortunately, the words of Mick Jagger and Keith Richards have no application in the treatment of the seriously mentally ill at mental health clinics.
No, you can’t always get what you want
You can’t always get what you want
You can’t always get what you want
But if you try sometime you find
You get what you need