Wednesday, February 2, 2011

Reflecting on Part 1: WBUR's series on Mental Health Treatment

First, this is really well done, in depth, radio journalism. You should listen to this here, if you haven't already. It tells the story of a young man who has a story similar to many that I have seen over the years, who has had some sort of mental health problem, has accessed our system (in a manner, to be clear, that most of the country cannot) and is entering adulthood confused about his diagnosis, his need for treatment and his prognosis going forward. He (and implicitly the reporter) imply that it really shouldn't be so hard. What is it about? A few themes, that you may have heard before.
1) Behavioral/psychiatric problems are hard to diagnose, in part because diagnosis is based on clinical impression. This family had many reports; with many diagnoses and many recommendations and it made them confused.
2) Stigma lives. A youth with mental health, who develops substance abuse problems suddenly has to find a whole new treatment system. Why? Read the comments that people have left on the website. The obsession with blame and fault is impressive.
3) Primary care wasn't helpful. This family really would have benefited from a primary care doc who stayed with them throughout the journey. Kind of sad that they had to keep looking.
4) Treatment works. Sort of. Sometimes. The young man in the story was not a big fan of the many medications that he has taken over the years, although, in the end, he conceded that they may have been helpful. A long term relationship with a consistent provider may have been helpful.

More tomorrow.


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