Mental Health Treatment. Is it value for money?

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

Post by mistermack » Wed May 16, 2018 1:05 pm

What I'm saying is that there should be a real hard look at what's effective, in the same way that it's done in general medicine.
If it doesn't work, what's the fucking point? And why put a hundred people through a process, if only one is helped? There is surely a point where you are doing more harm than good, by giving useless treatment and false expectations.

It's laughable that people on this thread both criticise the former regimes, of treatment that was far too drastic for no reward, and yet at the same time criticise the notion that a similar less drastic situation might be happening today.

As far my quoting the example goes, it would take a huge number of successful treatments to cancel out the fifteen years of psychiatric timewasting spent on that one case. You don't get the impression on this thread that that type of success is particularly common.

If they took a long hard look at what works, and what doesn't, then the money being wasted at present could be directed towards where it could actually do some good.
That's what happens in every other branch of healthcare, it's time to stop throwing money at problems out of guilt, and do some proper assessment of effectiveness.
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Re: Mental Health Treatment. Is it value for money?

Post by pErvinalia » Wed May 16, 2018 1:07 pm

mistermack wrote:
Wed May 16, 2018 1:05 pm
What I'm saying is that there should be a real hard look at what's effective, in the same way that it's done in general medicine.
How do you know that this isn't done?
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Wed May 16, 2018 1:25 pm

pErvinalia wrote:
Wed May 16, 2018 1:07 pm
mistermack wrote:
Wed May 16, 2018 1:05 pm
What I'm saying is that there should be a real hard look at what's effective, in the same way that it's done in general medicine.
How do you know that this isn't done?
Are you saying it should be done?
If it IS being done, does that mean I was right to advocate it?
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Re: Mental Health Treatment. Is it value for money?

Post by pErvinalia » Wed May 16, 2018 1:32 pm

Does asking questions when faced with a question help you get out of backing up your claims?
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Wed May 16, 2018 2:03 pm

pErvinalia wrote:
Wed May 16, 2018 1:32 pm
Does asking questions when faced with a question help you get out of backing up your claims?
I'm arguing that it should be done. That's the OP and all my posts so far. Hardly backing out of anything.
It's you who is suddenly scared to venture an opinion. :D
What's so scary about saying what you think? :biggrin:
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Re: Mental Health Treatment. Is it value for money?

Post by pErvinalia » Wed May 16, 2018 2:32 pm

mistermack wrote:
Wed May 16, 2018 2:03 pm
pErvinalia wrote:
Wed May 16, 2018 1:32 pm
Does asking questions when faced with a question help you get out of backing up your claims?
I'm arguing that it should be done.
Yes, that's not in dispute. The question is, do you think it isn't being done now, and if so, what's your evidence for this?
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Wed May 16, 2018 3:38 pm

pErvinalia wrote:
Wed May 16, 2018 2:32 pm
mistermack wrote:
Wed May 16, 2018 2:03 pm
pErvinalia wrote:
Wed May 16, 2018 1:32 pm
Does asking questions when faced with a question help you get out of backing up your claims?
I'm arguing that it should be done.
Yes, that's not in dispute. The question is, do you think it isn't being done now, and if so, what's your evidence for this?
Took you half an hour to decide what you think. Actually, that's impressive. For you. :hehe:

In this country, benefits against costs are assessed by NICE, and they make no mention of ever making that kind of assessment for psychiatric treatments.
To be fair, it would be trickier to perform than clinical tests, as there would be an awful lot of opinion evidence rather than data.

You can't prove a negative, and I'm sure that SOME kind of assessment of worth is made.
The problem is, it's done by the profession, and they are of course biased in favour of their own corner, and under pressure from patients to "do something".

https://en.wikipedia.org/wiki/National_ ... #Criticism
If you scroll down to cost effectiveness, it gives an idea of what goes on in the field of medical treatments.
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Re: Mental Health Treatment. Is it value for money?

Post by Sean Hayden » Wed May 16, 2018 3:48 pm

Just don't pay for anyone's treatment who isn't a burden on their family through no fault of their own. If you need a hand, I'm happy to apply this flawless logic to help decide who should get treatment.

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

Post by pErvinalia » Wed May 16, 2018 4:00 pm

mistermack wrote:
Wed May 16, 2018 3:38 pm
pErvinalia wrote:
Wed May 16, 2018 2:32 pm
mistermack wrote:
Wed May 16, 2018 2:03 pm
pErvinalia wrote:
Wed May 16, 2018 1:32 pm
Does asking questions when faced with a question help you get out of backing up your claims?
I'm arguing that it should be done.
Yes, that's not in dispute. The question is, do you think it isn't being done now, and if so, what's your evidence for this?
Took you half an hour to decide what you think. Actually, that's impressive. For you. :hehe:
I haven't made any assertions, so what I think or don't think isn't relevant to your claim.
In this country, benefits against costs are assessed by NICE, and they make no mention of ever making that kind of assessment for psychiatric treatments.
Shifting the goalposts? You said what's effective, not what's cost effective. Here's what you said:
If it doesn't work, what's the fucking point? And why put a hundred people through a process, if only one is helped? There is surely a point where you are doing more harm than good, by giving useless treatment and false expectations.
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Re: Mental Health Treatment. Is it value for money?

Post by Rum » Wed May 16, 2018 4:30 pm

I'm not sure if it has been mentioned as yet but there are occasions when hospitalisation in a psychiatric unit is not about 'cure' or effectiveness, but about protection - 'asylum' in effect. Some though not all acutely psychotic people are a danger to themselves and very occasionally to others and even heavy duty drugs do little to reduce the potential harm they may do.

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

Post by JimC » Wed May 16, 2018 9:17 pm

I think that many people get the impression that treatments for mental health issues involve a fair bit of trial and error, more so than other areas of medicine, so it looks like "floundering around". Drug treatments do seem to be on the basis of "let's try this, come back in a while and we'll try something else if it hasn't helped". What is unclear is the extent to which this is simply inevitable, because the science of brain physiology and its connection to the mind is still lacking, or whether it is an institutional fault that could be improved by more attention to research results. The pervasive influence of "Big Pharma" doesn't help, either.

However, mm seems to be indulging in extreme hyperbole, with his "And why put a hundred people through a process, if only one is helped?"

There are plenty of cases where real improvements to people's lives are occurring; the question remains how can the industry do better?
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Wed May 16, 2018 10:16 pm

I'm not questioning the effectiveness of some of it.
But from what I've read over the years, the general trend seems to be of rubbishing the treatment that was all the rage twenty or thirty years ago.
It always seems to be a case of "if only we knew then what we know now".

Drug treatments that were widely sworn by in the past are now seen as a massive mistake.
Pills that were given out as cure-alls are now only recommended in exceptional circumstances.

It seems a shame that we can't break that cycle, and get a true assessment a damn sight earlier.

It seems to be the current fashion that mental health treatment should be given the same importance as physical treatment. In that case, it should have to undergo the same critical assessment in terms of results.
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Re: Mental Health Treatment. Is it value for money?

Post by JimC » Wed May 16, 2018 10:24 pm

mistermack wrote:

It seems to be the current fashion that mental health treatment should be given the same importance as physical treatment. In that case, it should have to undergo the same critical assessment in terms of results.
This goes to what rEv was saying about your evidence for such a claim (that mental health treatments do not have as much "critical assessment in terms of results" compared to physical treatments)

I mean, there may be some truth in what you say, but you are only putting this position in terms of a general impression you have...
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Re: Mental Health Treatment. Is it value for money?

Post by Brian Peacock » Wed May 16, 2018 10:46 pm

pErvinalia wrote:
Wed May 16, 2018 1:07 pm
mistermack wrote:
Wed May 16, 2018 1:05 pm
What I'm saying is that there should be a real hard look at what's effective, in the same way that it's done in general medicine.
How do you know that this isn't done?
Haven't you been paying attention? Because he saw a TV show, that's how. ;)
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Re: Mental Health Treatment. Is it value for money?

Post by mistermack » Wed May 16, 2018 11:15 pm

JimC wrote:
Wed May 16, 2018 10:24 pm
mistermack wrote:

It seems to be the current fashion that mental health treatment should be given the same importance as physical treatment. In that case, it should have to undergo the same critical assessment in terms of results.
This goes to what rEv was saying about your evidence for such a claim (that mental health treatments do not have as much "critical assessment in terms of results" compared to physical treatments)

I mean, there may be some truth in what you say, but you are only putting this position in terms of a general impression you have...
I did link to the NICE page. They are the body that assesses effectiveness and value for medical treatments. There's no mention of the same process being applied to mental treatment.
I can't prove a negative but I can point to an absence of any mention of an equivalent process for mental treatment.
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