RapierFugue
Posts: 4740
Joined: 3/16/2006 From: London, England Status: offline
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quote:
ORIGINAL: barelynangel I have a question i see so many people when it seems like a vast amount of people on the boards claim some type of mental issue and they take drugs for their mental issues and the advocating of same on here is like watching commercials on TV for same. I don't have any mental issues that i know of, so i am coming from a position of ignorance, but could someone explain to me why drugs seem to be many times the treatment of choice versus intense therapy? I don't have mental issues myself, but have worked with mental health teams previously, and it boils down to a number of factors (this from a UK perspective); 1. Cost; Put simply, "intense therapy" as you put it, is nightmarishly expensive. Drugs are (relatively) cheap. 2. Risk & timing; If someone is assessed as being "at risk" (ie may possibly self-harm), but not to the extent that suicide is imminent, then it presents a dilemma; if someone is assessed as potentially and imminently suicidal they can be sectioned (removed to a mental institution against their will, subject to the signature of 2 doctors, as per the Mental Health Act, most usually Section 4 (emergency basis, 3 day maximum), but very occasionally Section 2 (28 day assessment), or Section 3 (6 month treatment approval - rare), but for those likely to self-harm or otherwise deteriorate, but unlikely to suicide, it may well take too long for "intense therapy" to elicit a response, whereas proper medication can show results in a matter of days - it gives the assessment team a breathing space in which to calm or otherwise improve the patient's situation while other alternatives are explored (like therapy). 3. Degree: most people with mental health issues present little danger to others, and can be effectively treated with medication. This removes or reduces the need for costly and time-consuming therapy, and impacts their lives, and the lives of their carers and family/friends much less, meaning that, in many cases, they can continue their lives, keeping their jobs and homes, rather than being hauled off and having their lives derailed. Put simply, only a small proportion of mental health patients are an imminent danger to themselves or others. The majority of drugs used are relatively very safe, with only handful (lithium being the most famous) requiring intense supervision (due to its uptake being different for everyone who takes it), so regular blood tests are needed in the initial period to determine to what degree the person's body is metabolising the drug. For most medications this is unnecessary, with only GP visits and some mental health team assessment being required over time. 4. Capacity; if you were to implement an "intense therapy" solution for every initial mental assessment you would need huge numbers of therapists and clinicians, and it's questionable whether the results would be any better. Again, for the majority of patients, medication provides an effective solution. 5. Approach; for mild-to-medium cases, medication is usually used alongside conventional therapy, where appropriate, so there's a 2-pronged approach. In recent years the conventional model of n patients to 1 psychologist/therapist has been shown to be inefficient, so multi-skill teams, consisting of psychologists, mental health nurses, administrators and sometimes social workers, is often used to provide a more complete solution, meaning that more patients can be treated more quickly. Also, most people with issues need only some help for a period of time, while they re-establish their mental balance - many of them don't actually need therapy, but instead a short-to-medium term course of medication sees them back on their feet. 6. Efficacy; "intense therapy" has a patchy track record with regard to long term solution for mild-to-medium severity cases. Put simply, you need good teams, well funded, with plenty of capacity/personnel, and that's not always possible to provide, either due to cost, recruitment, or location issues. There are a few other factors, but I have to get down the shops in a minute, so that'll have to do for now
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