Mental Health Treatment. Is it value for money?

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Mental Health Treatment. Is it value for money?

Post by mistermack » Fri Apr 27, 2018 10:40 am

The question I'm posing is about how effective treatment is for the various mental ailments.
I'm well aware of how life-destroying mental problems can be. And how life-changing successful treatment can be.

But is a lot of money, time and effort also spent on treatments that DON'T work? Or that don't work MUCH? And should those treatments meet the same scrutiny for value for money that other medical treatments have to pass?

Or should mental treatments be exempt from that kind of assessment?
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Re: Mental Health Treatment. Is it value for money?

Post by Svartalf » Fri Apr 27, 2018 10:47 am

given that my mental health treatment costs me very little (paid by my taxes) it's value, my current treatment keeps me mostly functional, which I would not be without it.

now, 2 decades ago, when I was following therapy in hopes of preventing a relapse of nervous breakdown, that was money I spent for no good.
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Fri Apr 27, 2018 11:13 am

I wonder what would happen, if you just gave the patients the money, instead of the treatment?
(in the UK I mean)

Would the outcomes be better that way?

(obviously, it wouldn't work in practice, because people like me would suddenly start getting expensive mental problems) :tup:
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Re: Mental Health Treatment. Is it value for money?

Post by cronus » Fri Apr 27, 2018 11:15 am

No good to ask with countries that suffer a national mental health malaise. With individuals, a tragedy with a death toll like cancer but none of the sympathy, a nations government got to step in to make up for its callous uncaring populace. That costs. And I'd suggest half goes to patients to make up for inevitable unemployment. Hitler did something else. But it wasn't good for anyone in the end.
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Re: Mental Health Treatment. Is it value for money?

Post by cronus » Fri Apr 27, 2018 11:25 am

cronus wrote:
Fri Apr 27, 2018 11:15 am
No good to ask with countries that suffer a national mental health malaise. With individuals, a tragedy with a death toll like cancer but none of the sympathy, a nations government got to step in to make up for its callous uncaring populace. That costs. And I'd suggest half goes to patients to make up for inevitable unemployment. Hitler did something else. But it wasn't good for anyone in the end.
In the same way the mind is not the brain or liver....mental health is not a pure medical issue but intersects with the very centre of what humans and human culture is about. If you want to find a sustainable alternative to modern life, the endless experiments of the insane in modes of life - might be a great place look. In that regard, as blue skies experimentation into lifestyle differences the 'barmy' could be more than value for money, but the saviour of civilization as well?
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Fri Apr 27, 2018 11:52 am

The fields of addiction and eating disorders come to mind, as treatments that need looking at in terms of success ratios.

On TV last night was a documentary about Harold Shipman, the UK's worst ever serial killer.
He was seen by a psychiatrist years before he was caught, about the drug addiction problem that he had developed.
His quote on screen was that he was surprised that the General Medical Council allowed him to continue practising, when in his experience, addicts like Shipman almost never recovered.
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Re: Mental Health Treatment. Is it value for money?

Post by cronus » Fri Apr 27, 2018 11:58 am

mistermack wrote:
Fri Apr 27, 2018 11:52 am
The fields of addiction and eating disorders come to mind, as treatments that need looking at in terms of success ratios.

On TV last night was a documentary about Harold Shipman, the UK's worst ever serial killer.
He was seen by a psychiatrist years before he was caught, about the drug addiction problem that he had developed.
His quote on screen was that he was surprised that the General Medical Council allowed him to continue practising, when in his experience, addicts like Shipman almost never recovered.
Drug addiction isn't a mental health issue, it's a access to drugs one. When he could no longer get his 'bumping old ladies off' fix he was effectively cured. Nothing to do with mental health. Access or not access to old ladies was the thing with Harold.
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Re: Mental Health Treatment. Is it value for money?

Post by Brian Peacock » Fri Apr 27, 2018 12:00 pm


mistermack wrote:The question I'm posing is about how effective treatment is for the various mental ailments.
I'm well aware of how life-destroying mental problems can be. And how life-changing successful treatment can be.

But is a lot of money, time and effort also spent on treatments that DON'T work? Or that don't work MUCH? And should those treatments meet the same scrutiny for value for money that other medical treatments have to pass?

Or should mental treatments be exempt from that kind of assessment?
If you didn't try the treatment how would you know if it worked or not?

Actually, in the UK exactly this kind of assesment is made about pretty much every treatment for every disorder and condition. Discisions about the efficacy vs cost of treatments and diagnostic procedures are made at the national, regional and local level all the time - sometimes on a statutory basis and sometimes on a case by case basis. Patients also have some limited rights to ask for these kinds of assesments to be made in circumstances where novel, unlicensed or unorthodox treatments may prove useful.

Now, the question is should treatments in the mental health arena "meet the same scrutiny for value for money" that treatments in medical arena have to?

To answer that question we have to know two specific things. Are mental health treatments cirrently subject to the same kind of efficacy vs cost scrutiney as medical treatments, and is there a substantial or significant difference between our social responsibilities towards the treatment of mental health and medical conditions?

To the first we can categorically say that mental health treatments are subject to the same kind of efficacy vs cost scrutiney as medical treatments.

Addressing the second is a little more tricky because it entails a moral judgement, but for my part I'd say that there is no substantial or significant difference between our social responsibilities towards the treatment of mental health and medical conditions. Suffering is suffering no matter what the cause, and reducing suffering, where it is possible to do so, is an obligation that falls upon us all equally.
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Fri Apr 27, 2018 12:02 pm

cronus wrote:
Fri Apr 27, 2018 11:58 am
Drug addiction isn't a mental health issue,
Disagree

Habitual use of substances etc. cause a mental craving and dependence, as well as physical issues.
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Fri Apr 27, 2018 12:04 pm

Brian Peacock wrote:
Fri Apr 27, 2018 12:00 pm
To the first we can categorically say that mental health treatments are subject to the same kind of efficacy vs cost scrutiney as medical treatments.
Link ?
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Re: Mental Health Treatment. Is it value for money?

Post by Brian Peacock » Fri Apr 27, 2018 12:12 pm

I'm on the phone at the mo, but you can look up the statutory role of the National institute for health and care excellence (NICE) in assessing the efficacy and costs of all treatment offered on the NHS.
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Fri Apr 27, 2018 12:14 pm

I'll take that as a no.
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Re: Mental Health Treatment. Is it value for money?

Post by Brian Peacock » Fri Apr 27, 2018 12:22 pm

No, take that as a 'you can verify that for yourself on your own bandwidth'. ;)
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » 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.
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Re: Mental Health Treatment. Is it value for money?

Post by pErvinalia » Fri Apr 27, 2018 2:05 pm

mistermack wrote:
cronus wrote:
Fri Apr 27, 2018 11:58 am
Drug addiction isn't a mental health issue,
Disagree

Habitual use of substances etc. cause a mental craving and dependence, as well as physical issues.
There can be a physiological dependence, but psychologically drugs are largely a coping mechanism to an adverse environment. Remove the adverse environment and the psychological "addiction" goes.
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