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View Diary: Stop Blaming Newtown Tragedy On Mental Illness (301 comments)

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  •  Screening in vulnerable populations (2+ / 0-)
    Recommended by:
    Oldestsonofasailor, Brit

    is one answer which NAMI has proposed.

    Destigmatizing mental illness all around is another.

    Providing resources for society to have on hand if someone they know is psychotic which doesn't involve the prison system or the police.

    Of course psychosis is resistant to treatment. Compliance is one issue. Side effects another. Diagnosis another. And then just a lack of response. I have seen this firsthand. It's less likely to be treatable if a casual approach is taken to treating it.

    I don't have a strong opinion of the UK's mental health (and other medical) services much more than I do the US's. I find both lacking, each in different ways.

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    by mahakali overdrive on Wed Dec 19, 2012 at 11:35:09 AM PST

    [ Parent ]

    •  But what do you do (0+ / 0-)

      with the results of the screen?

      And yes, compliance is one issue, side effects another, and diagnosis another.  But even someone takes their medication, and finds the side effects tolerable, and the diagnosis is such that the treatment does in fact reduce the symptoms, many patients continue to experience symptoms, including those that are reduced by the medication, and others that simply are not touched by it.

      In other words, we do not have good treatments yet for serious mental illness, even when what we do have is taken and tolerated.  That's only partly the fault of mental health services - it's also simply a reflection of the state of psychiatric neuroscience.

      I hope we are making progress, but there's a long way to go.

       

      •  The earlier the treatment, the less likely (1+ / 0-)
        Recommended by:
        Febble

        complications ensue.

        excerpt

        Research into the early course of schizophrenia has identified a prepsychotic prodromal stage (mean duration: 4.8 years) and a psychotic prephase (mean duration: 1.3 years). Comparisons of individually matched samples have demonstrated prodromal symptoms common to schizophrenia and moderate to severe depression. It is not until positive symptoms emerge that psychosis and mood disorders become distinguishable from each other. In both disorders the prodromal stage early produces functional impairment and related social consequences. Hence, early intervention is of great public health relevance. This intervention is targeted at manifest symptoms and not at the underlying, still unknown disease process. Cognitive-behavioural therapy at the prepsychotic prodromal stage seems to favourably influence the short-term illness course. In the psychotic prephase, a combination with low-dose antipsychotics seems to have some efficacy. The aim of early recognition by the instruments discussed in this paper is to permit the identification of the largest possible proportion of at-risk persons as early as possible and their referral to appropriate treatment.

        cont...

        NAMI, the National Alliance for the Mentally Ill (a patient advocacy group), advocates early screening for mental health issues as well:

        They feel it could help destigmatize mental illness and lead to better outcomes for patients and society.

        excerpt

        Liz Downey is the Executive Director of the National Alliance on Mental Health, or NAMI, a grassroots effort by families to offer services. She says the stigma associated with the disease is the biggest hurdle to overcome.

        "That's why we don't have the money, it's the stigma. Until you are personally affected by it, you're not going to see a big change," says Downey.

        ...She proposes children receive mental assessments every year at school just as they get physicals.

        "We don't want schools diagnosing, but we want to make sure we're covering all the bases," says Downey.

        -cut-

        "We don't have it today because of the funding," says Downey.

        Returning to schizophrenia (which is only one of several disorders which can cause problems with psychosis, of course; others could be organic as well)...

        excerpt

        It was reported by Yale University today that there is more evidence that "Detecting and treating schizophrenia rapidly, following the onset of a first psychotic episode, improves the patients' response to treatment, according to a study by a Yale researcher.

        -cut-

        "It looks like the longer the period of time before treatment, the worse off the patients are not only when they come into treatment, but how they respond to treatment," McGlashan said.

        -cut-

        "All factors being equal, early detection efforts will bring people into treatment at lower symptom levels," McGlashan said. "Patients who began treatment earlier tended to be younger, less symptomatic, and more responsive to treatment."

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        by mahakali overdrive on Wed Dec 19, 2012 at 02:31:53 PM PST

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        •  Yes indeed (1+ / 0-)
          Recommended by:
          mahakali overdrive

          but none of that means we have it licked, unfortunately, even if early detection screens were optimal.

          Effect sizes for interventions, even early, remain depressingly small, apart from control of positive symptoms (hallucinations and delusions) by antipsychotic medication, which can be substantial, but even so is rarely complete.

          But I agree that early detection is important.

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