Mental Health Treatment. Is it value for money?

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Re: Mental Health Treatment. Is it value for money?

Post by pErvinalia » Fri Apr 27, 2018 2:09 pm

Regarding the practice of mental health treatment, in terms of pharmacology it's little better than trial and error. The action of most psychiatric drugs can only be explained in broad strokes. A lot of them they don't actually know the precise mechanism for how they work.
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Re: Mental Health Treatment. Is it value for money?

Post by Scot Dutchy » Fri Apr 27, 2018 2:28 pm

Dont tell me.
"Wat is het een gezellig boel hier".

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Re: Mental Health Treatment. Is it value for money?

Post by pErvinalia » Fri Apr 27, 2018 3:19 pm

Yeah, I'm getting tired of being a guinea pig.
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Re: Mental Health Treatment. Is it value for money?

Post by Scot Dutchy » Fri Apr 27, 2018 3:25 pm

When I was in the Tinnitus Group here everybody made the same complaint. One guy was so high the whole time he was always laughing and was so positive he quit his good paying job and started up for himself which proved a disaster. Another was totally suicidal and signed himself into hospital. Nothing helps tinnitus but they keep on trying.
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Re: Mental Health Treatment. Is it value for money?

Post by cronus » Fri Apr 27, 2018 4:42 pm

Most pysch meds are like Brexit. Total success if they make 51% of people improve on the symptom scale compared with 49% feeling worse. Lithium is a exception but that was discovered by accident, and no one knows why it works...precisely. I take Lithium. Without it I become unstable.
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Re: Mental Health Treatment. Is it value for money?

Post by Brian Peacock » Fri Apr 27, 2018 5:53 pm

mistermack wrote:
Fri Apr 27, 2018 12:37 pm
Brian Peacock wrote:
Fri Apr 27, 2018 12:22 pm
No, take that as a 'you can verify that for yourself on your own bandwidth'. ;)
I'll take it as a made up fact.
If you like. And I guess ignorance is the same as knowledge these days too.

Any drug, therapy or treatment available on the NHS first has to be approved by The European Medicines Agency (EMA) before the UK's National Institute for Health and Care Excellence (NICE) will make an assessment as to whether the treatment should be made available on the NHS. NICE does this according to number of factors - including efficacy, cost-effectiveness and overall benefit to patients. More info can be found on the NICE website. Unlike NHS drug therapies for mental health conditions, which have to adhere to NICE's regular NHS treatment guidelines, so-called 'talking cures' can often be accessed on an individual basis outside of the NHS (independent psychiatry and counselling service etc) - and people can always 'go private' if they wish. Drug therapies for mental health conditions offered by independent prescribing psychiatrists operating in the UK still have to meet the criteria set down by the EMA. Failure to adhere to the standards laid down by the EMA could lead to a prescribing psychiatrists loosing their registration to practice. The idea that mental health treatments are somehow exempt from these considerations or oversight processes is erroneous.

Now that this has been settled we can turn to the second point of my initial reply, which was: is there a substantial or significant difference between our social responsibilities towards the treatment of patients with mental health and medical diagnoses? I gave my view therein. What do you think?
.

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Clinton Huxley » 21 Jun 2012 » 14:10:36 GMT
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Re: Mental Health Treatment. Is it value for money?

Post by Rum » Fri Apr 27, 2018 6:16 pm

Going back to my long gone psychiatric social work stuff for this. There are no out and out cures for the major mental ill-health conditions such as schizophrenia, bi-polar disorder or clinical profound depression. There is greater understanding of some of the causes and despite what some people here (above) have said they are not about the 'awful world' we have created for ourselves. The common and most serious of them have a strong genetic linkage and overall the proportion of people who suffer from these are probably more or less as they always have been. Drugs have been developed to alleviate some of the symptoms and some of those have been improving over the decades.

Of course people talk a lot more about the issues. Unhappy people decide they are 'depressed' and seek cures - not to dismiss their concerns. It is also more acceptable and less stigmatising to be open about mental health stuff that a generation or two ago was pretty taboo.

As to value for money - the psychiatric sector in the UK is chronically underfunded. Way back in the late 70s and early 80s a swathe of huge psychiatric hospitals were closed in the name of 'care in the community'. It saved a huge amount of money but not as much of it as was needed found its way back to support those who needed it in my view. Heavy duty drugs were often prescribed too, to replace the walls of the old institutions.

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Re: Mental Health Treatment. Is it value for money?

Post by JimC » Fri Apr 27, 2018 10:59 pm

cronus wrote:
Fri Apr 27, 2018 4:42 pm
Most pysch meds are like Brexit. Total success if they make 51% of people improve on the symptom scale compared with 49% feeling worse. Lithium is a exception but that was discovered by accident, and no one knows why it works...precisely. I take Lithium. Without it I become unstable.
It's people like you who make it difficult for companies like Tesla to make enough Lithium Ion batteries! :lay:
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Sat Apr 28, 2018 12:05 am

While a lot of the drugs used in mental health are well known and subject to approval, the actual TREATMENT is a different kettle of fish. Treatment involves diagnosis as well as prescription, and a lot of the diagnosis in the health world is so fuzzy, it's little more than hit and hope.
Hence the comments on here about people being used as guinea pigs. It's not the drugs, it's the diagnosis that's being experimented with.
Basically, the doctor decides to give this or that a try. (for perfectly respectable motives)

That's where mental health is so different from the often precise diagnosis of medical problems.

So your treatment can be as approved as you like, and pass a battery of tests. But if it's not the right thing for what's bothering you, it can cause more harm than good. Or just be a waste of time, effort, money and emotion.
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Re: Mental Health Treatment. Is it value for money?

Post by Hermit » Sat Apr 28, 2018 12:49 am

cronus wrote:
Fri Apr 27, 2018 4:42 pm
I take Lithium. Without it I become unstable.
If you consider yourself stable right now your definition of the word is one I have yet to encounter.

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Re: Mental Health Treatment. Is it value for money?

Post by Sean Hayden » Sat Apr 28, 2018 12:55 am

Is crumple really that weird to you guys? I must be under his spell. :lol:

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Re: Mental Health Treatment. Is it value for money?

Post by Hermit » Sat Apr 28, 2018 1:12 am

Sean Hayden wrote:
Sat Apr 28, 2018 12:55 am
Is crumple really that weird to you guys? I must be under his spell. :lol:
Did I write "weird"? Sorry about that. I meant to write "unstable" - instability of the ordinary variety, much like yours, but a little more thoroughgoing.

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Re: Mental Health Treatment. Is it value for money?

Post by Brian Peacock » Sat Apr 28, 2018 1:29 am

.

"It isn't necessary to imagine the world ending in fire or ice.
There are two other possibilities: one is paperwork, and the other is nostalgia."

Frank Zappa

"This is how humanity ends; bickering over the irrelevant."
Clinton Huxley » 21 Jun 2012 » 14:10:36 GMT
.

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Re: Mental Health Treatment. Is it value for money?

Post by Sean Hayden » Sat Apr 28, 2018 1:50 am

:{D

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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Tue May 15, 2018 8:33 pm

I watched a repeat edition of "Nightmare neighbour next door" the other day.
A family were so harassed and intimidated by the man next door, they moved out to the guy's father's house. The neighbour tracked them down and started harassing them there. The police had been involved at various stages but did nothing until then.
One of the cops thought to look up the guy's past. His name was Harry Street, but previously, under the name Barry Williams, he had harassed a previous neighbour, and snapped one day, and went on a shooting spree, killing five people and wounding others.
He was diagnosed as paranoid schizophrenic, and detained indefinitely.
After fifteen years, he was deemed "safe" to release, given a new name, got married, and eventually started an identical build up of harassing his nearest neighbour. Nobody knew of his history, not even the local police.
He was arrested, and they found a stash of illegal guns and bombs in his house.

If you count up the money spent on his psychiatric treatment over fifteen years, and put it against the measured success, it was on top of everything else, a vast waste of money. For zero result. Or worse, it could easily have ended in another massacre.

How much money is spent in similar fashion on people who can't really be cured?
A lot of the spending on mental health is really "guilt" money. It's not spent with any prospect of making much difference. It's just because those in charge are on a guilt trip that they somehow should be "doing more".
Doing more of fuck all in an awful lot of cases.

The driving force for a lot of the spending is people who say "if only they had intervened sooner, a tragedy could have been averted". When in reality, it would probably be a tragedy delayed, at best.
It's that magic gift of perfect hindsight that busybody politicians always brandish.

https://en.wikipedia.org/wiki/Barry_Wil ... ee_killer)
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