RE: Amid all the hysteria...

RE: Amid all the hysteria... (Full Version)

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angelikaJ -> RE: Amid all the hysteria... (1/15/2011 5:22:40 PM)
quote: ORIGINAL: popeye1250 quote: ORIGINAL: angelikaJ Actually, "case managers" work for non profit agencies, not for the state and are not particularly well paid. The benefits and pay are on par of that for most "human service agencies" which is to say not much. I only used the term once by the way, try counting again. I do appreciate your admitting your ignorance and asking the question. Well Miss Hostile, I did make a mistake, you really did only use the term once. Perhaps you could benefit from a "case worker." "And that's what makes me sad....." "You know what makes me sad,......*YOU DO!!!* Popeye, I was being accurate, not hostile. There was nothing hostile in my post; it was neutral. Ignorance is simply not knowing. Nothing more, nothing less... the remark was not meant to insult you. I did not realise that "admitting [ ] ignorance" was an insulting statement to you. Had I known it would have been perceived as such, I would have phrased it differently.

popeye1250 -> RE: Amid all the hysteria... (1/15/2011 10:56:48 PM)
Anjelika, are you and Stef roomates?

angelikaJ -> RE: Amid all the hysteria... (1/16/2011 5:16:52 AM)
quote: ORIGINAL: popeye1250 Anjelika, are you and Stef roomates? I am flattered that you have taken such an interest in me. Just so you don't get your hopes up when you make your next trip north, my Master doesn't share. [;)]

samboct -> RE: Amid all the hysteria... (1/16/2011 3:04:27 PM)
"I'm parting ways from you here, Popeye. These folks have already lost who they once were, you want to take their liberty from them as well? I want the bar of involuntary confinement and mandatory treatment set very high." Dr. Reagan, MD - that well known psychiatrist with a degree from a Cracker Jack box- set the bar so high that he decided that most of these people were just faking.....Can someone come up with an instance of a politician playing doctor and not making a mess of it? And I don't mean with a nurse, aide, mistress, whatever.... If you don't realize what liberty is because you're crazy- it's really not much of a choice. And the ethics are the same as for people suffering from senile dementia- should we be depriving them of their liberty too? Or is providing some dignity to deal with their illness and easing their distress and suffering more important? People deserve human dignity- I'd rather purchase that with my tax dollars than useless wars or the massive prison population. Sam

TheHeretic -> RE: Amid all the hysteria... (1/16/2011 3:28:57 PM)
Well thanks for being so quotable regarding government involving itself in health care issues, Sambo. A big Palin and Tea Party fan, huh? Or did you just not think that through?

pyroaquatic -> RE: Amid all the hysteria... (1/16/2011 3:32:15 PM)
Dear People, at this point in time I would like to state that the current topic of the mentally ill strikes a few resounding notes about my personal experiences. Not only have I worked at a facility that assisted mentally ill and disabled people but ironically-as time progressed-it turned out that I was one of those that I was taking care of. In my opinion the current system acts like a bandage on someone who can't help opening the wound. again and again and again. The reality of that situation is that in the process of taking care of these people the rehabilitation process is muted. The possibility of maintaining the self-discipline declines over time because self-reliance is not enforced. That and the fact that some of these individuals are incredibly over-medicated to the point where they are akin to walking pharmaceuticals.... if they could walk that is. When you do point that out (hey, this person can't even get up to go to the bathroom or eat) the medication is adjusted and they become a ticking time-bomb which can set off other people. Loughner was obviously sick enough for people to be afraid of him. Out of fear and sadly tolerance it seems that no one wanted him to face his own problems and consequently receive professional help. At another end there are those that ask and would embrace help but their cries are left unheard due to whatever reason-never enough time, not enough money, there are other more important things. The people who need help don't get it. Those that don't need professional mental help do and they get to turn around and abuse the system of case workers and care-takers for their own selfish desires instead of wanting to stand on their own. We tolerate media, politicians, the sick, the poor, the rich, and each other to the point where we are numb. Out of this numbness arises many of the problems we face today. Those that are prescribed the power want to keep the power for themselves. Who needs logic and reason when you have power and authority? Amid all of the hysteria we can see the hype and the grabs for power. The stereotypes (all mentally ill are dangerous, psychotics hallucinate all of the time and have no attachment to reality, poor people are that way because they are lazy and stupid, so on) we stand by are easy and dangerous in of themselves. It is also apparent that the government is quite limited and one unbalanced man with a gun can screw the whole thing over in an instant as well as the lives of others just living. The everyday people that make up the mass of this country have more real power than those that are perceived to have power. Im going to stop now though I would like to add it does not matter if you take the guns away. People are still going to find ways to kill and protect the things they hate and love.

samboct -> RE: Amid all the hysteria... (1/16/2011 4:50:59 PM)
"Well thanks for being so quotable regarding government involving itself in health care issues, Sambo. A big Palin and Tea Party fan, huh? Or did you just not think that through? " Huh? Sarah Palin and human dignity seem to be mutually exclusive.... And in case you haven't noticed- most of the advances in human lifespan ARE directly related to government- especially building codes and sanitation codes along with enforcement as well as vaccines developed largely by the Army. Or did you forget about all the good capitalists providing substandard food and housing prior to Federal acts such as the FDA? Seems to me that people bash government and conveniently forget what things were like before the regulations were enacted-kinda like the recent financial meltdown. Sam

angelikaJ -> RE: Amid all the hysteria... (1/16/2011 5:38:22 PM)
quote: ORIGINAL: samboct Angelika- interesting point that smaller facilities may be more effective than larger ones. Hey- it's something to do with some of the empty buildings we've got lying around. And in terms of improvement in meds- yeah, there's been some, but well trained people in talk therapy are diminishing. Often the most effective therapy is a combination of the two.... Sam Sam, It isn't that there aren't people who don't do talk therapy anymore although you are right about there being less psychoanalysts. It is that more therapists are using other methods as well: Cognitive Behavioral Therapy for example or Dialectical Behavioral Therapy (which is often taught in groups). Talk therapy has limited use in helping someone to deal with their delusions. edit: quote trim

willbeurdaddy -> RE: Amid all the hysteria... (1/16/2011 5:46:11 PM)
quote: ORIGINAL: Lucylastic sticking up for "blood libel" nice one willbur oh what a surprise, One insightful, one spiteful not surprised at all.. Nor am I surprised that youre making things up about what I post, again.

samboct -> RE: Amid all the hysteria... (1/16/2011 6:10:15 PM)
Hi Angelika Gotta disagree with you here. Most psychiatrists no longer have training in talk therapy- they're just shoving pills down peoples throats. Since talk therapy is a casualty of the insurance industry, it's not surprising that more people aren't doing it. Since psychiatry became the province of pill pushing only and it pays poorly, it's also not surprising that it's pretty low down in terms of desired specialties. Well trained people can do better with psychotics, but there are too few of them around. And to reiterate- really the combination of talk therapy and meds often works best for psychotics. Sam

angelikaJ -> RE: Amid all the hysteria... (1/16/2011 6:22:40 PM)
quote: ORIGINAL: samboct Hi Angelika Gotta disagree with you here. Most psychiatrists no longer have training in talk therapy- they're just shoving pills down peoples throats. Since talk therapy is a casualty of the insurance industry, it's not surprising that more people aren't doing it. Since psychiatry became the province of pill pushing only and it pays poorly, it's also not surprising that it's pretty low down in terms of desired specialties. Well trained people can do better with psychotics, but there are too few of them around. And to reiterate- really the combination of talk therapy and meds often works best for psychotics. Sam Sam, Do you have an issue with people who are not psychiatrists providing therapy? The good agencies that provide services to the mentally ill incorporate a variety of mental health supports, at least here in Massachusetts. Edit to add: I have always believed a combination of therapies (medication plus ...) to be the best route: I am a great believer in talk therapy, but I know many people with bipolar disorder who had much better results from cognitive behavioral therapy than talk therapy ever provided them.

samboct -> RE: Amid all the hysteria... (1/16/2011 7:32:57 PM)
Hi Angelika I do have an issue with GPs pushing pills- especially to kids. There was a kid in NC I posted about a while back who went psychotic while taking the meds that the GP pushed down his throat- who's now in jail for 20 plus years for whacking his grandparents. Notice how a bunch of ads these days warn that such and such wonder drug shouldn't be given to kids?-I think that's why. I do think that the separation of meds and talk therapy is occasionally a bad idea. I've heard about way too many patients who see one doc for meds and another for talk therapy and the docs aren't communicating about patient progress and so the treatment fails. For some folks who are stable on their meds though, seeing a psychiatrist to make sure there are no adverse reactions and getting talk therapy from a psychologist or a social worker can be effective- but in a tough case, it's sub optimal treatment. Note- some of the docs I'm talking to are seeing only treatment failures- it's clear that not all therapies and all therapists are created equal. However, can a well trained psychologist do well with talk therapy? Absolutely. But given the potential side effects of some of these meds, I tend to grumble about anybody other than an MD prescribing them- and a well trained MD, not a GP who can't recognize a bad reaction to a psych med if it bit him on the ass. In terms of what therapy works best....There are lots of different types of mental illnesses- there isn't a one size fits all solution. Sam

angelikaJ -> RE: Amid all the hysteria... (1/16/2011 8:04:27 PM)
Sam, The subject here seemed to be severe mental illness that includes delusions. Competent MDs would refer those issues to a psychiatrist. There are warnings regarding kids and medications. They are well documented. I am not sure where the blame should be: Should the FDA step in and say no way, no how should anyone but a child psychiatrist ever prescribe to someone under 18? Should it be the AMA? There are holes in communication for sure but some of those holes are legal. Without consent communication between practioners is not legal due to HIPPA. Matching practioners from any modality: the right person to the patient, not every one is a good fit. I think sometimes GPs write the RX because the person they are writing it for is depressed and would never agree to see a psychiatrist. For adults, and SSRIs: the side effects are very well documented. I am not too uncomfortable with a family practioner writing out a prescription, even though I am in agreement that A) therapy might work better or B) medication plus therapy is simply a better option. There are some people who will simply not go that route. The other question is how do we catch these people before they fall in the cracks to prevent tragedies such as this and VA Tech from happening.

samboct -> RE: Amid all the hysteria... (1/16/2011 8:32:28 PM)
Hi Angelika I tend to use the Hippocratic oath as an answer here- First- do no harm. I translate this to a GP prescribing a child a med he can't recognize the side effects to as doing harm. Same for any psychiatrist who is prescribing meds while the patient is undergoing talk therapy without being in touch with the person doing the talk therapy. Same for a GP writing a scrip for depression- again, if they don't know the side effects and the patient commits suicide- they bear a lot of the responsibility. If the human doesn't want reasonable treatment- then the correct response for the GP is "Well, I can't treat you." GPs generally don't have a problem referring a patient to a specialist- why should psychiatry be any different? In terms of dealing with people like Loughner- if the cops are getting called in, it's time to get a decent psych evaluation. At a minimum, if the guy is delusional, he should be barred from purchasing guns, same as a felon. The problem is that decent psych evaluations and the facilities to monitor people just don't exist anymore- at least, not to treat the 400,000 or so psychotics in this country. We've got prisons instead. I guess prisons are cheaper than hospital beds- but most hospitals can't deal with psychotics either. Note- I'm not sure I'd equate McVeigh with Loughner. Loughner is crazy- I'm not sure McVeigh was. Killing a lot of people doesn't mean that you're crazy- sociopaths aren't crazy either-they just enjoy killing. But as I understand it- Loughner's hearing voices and is delusional. Sam

popeye1250 -> RE: Amid all the hysteria... (1/16/2011 8:40:45 PM)
quote: ORIGINAL: samboct "I'm parting ways from you here, Popeye. These folks have already lost who they once were, you want to take their liberty from them as well? I want the bar of involuntary confinement and mandatory treatment set very high." Dr. Reagan, MD - that well known psychiatrist with a degree from a Cracker Jack box- set the bar so high that he decided that most of these people were just faking.....Can someone come up with an instance of a politician playing doctor and not making a mess of it? And I don't mean with a nurse, aide, mistress, whatever.... If you don't realize what liberty is because you're crazy- it's really not much of a choice. And the ethics are the same as for people suffering from senile dementia- should we be depriving them of their liberty too? Or is providing some dignity to deal with their illness and easing their distress and suffering more important? People deserve human dignity- I'd rather purchase that with my tax dollars than useless wars or the massive prison population. Sam Sam, perhaps I didn't explain myself good enough, I don't want them involuntarily confined, just facilities where they have their own rooms, three meals a day, medical and dental care, people there to look over them and keep them safe. Of course they'd be free to come and go!

samboct -> RE: Amid all the hysteria... (1/17/2011 6:24:37 AM)
Hi Popeye I think the same moral principles apply to psychotics and senile dementia. If someone is suffering from senile dementia, do we try and prevent them from wandering around? The concept of liberty only makes sense if you have the capacity to understand it. If you're delusional and can't comprehend the world- then the discussion of liberty is pretty irrelevant in my book. What becomes tougher to deal with are the cases like Loughner who are delusional, but can function well enough to hold down a job. Do I think guys like Loughner should be confined for their own good? No- but they need to be in therapy if not. These guys don't understand the concept of right or wrong which is where all the civil libertarian arguments break down since that's a requirement for a functioning society. Loughner probably didn't know he was doing something wrong- he probably thinks he's a hero. The concept of freedom of choice only makes sense if you understand what your choices mean. Furthermore- there's a similar argument that can be made about people with infectious diseases such as AIDs. It's a curtailment of their civil liberties to deny them the right to go out and have sex with whoever they want. Yet we used to have good methods of following certain illnesses such as gonorrhea and syphilis- if you had the disease, your doc began notifying your partners or you were faced with jail. Its also why certain vaccinations are required. Medical necessity often trumps civil liberties. Sam

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