Involuntary Psychiatry Extends its Reach: Illinois

Great Debates
81

Parents don’t mind us asking questions. They want reassurance or validation that their concerns are justified. As a general rule parents worry about their kids and are happy to know that we care about them too.

I am a bit nervous about what the State will be asking me to do. I do not especially like the reliance on standardized instruments. They too often force clinicians to focus on the the piece of paper and the score and less on the patient in front of them. Governmental initiatives often focus on documentation and leave less time for the face to face, and that face to face time already has enough pressures on it. I prefer open ended questioning. Standardized instruments are perhaps more scientifically valid, but do not develop a relationship or trust.

Let us take postpartum depression. I’ve actually written a piece in our continuing education mainstay (Pediatrics in Review) on the role of the pediatrician in screening for postpartum mental illness. I feel strongly that we are in the best position to identify it, to demystify it, and to make appropriate referrals. In my mind all it takes is an awareness of when it tends to show up, and at those times asking some openended questions about how the Mom is doing, is she sleeping, eating, taking care of herself? My tactic was to convince practioneers that it takes little effort and that it effects the well being of their patients, the childrren. The more official approach is, however, to use that Edinburgh scale. This is a questionaire that the Mom fills out and is scored with particular values resulting in a referral. More time scoring a paper, less time talking to parents. But quality assurance requires documentation.

Another point. Postpartum depression at least has an easy action for us to take. There are several good national organizations (Depression After Delivery, Postpartum Support International, etc) to refer to, plus good adult psychiatrists and even just encouraging that she talk with her ob. Autism and early developmental disabilities also now can be easily referred to Child and Family Connections, a state organized and supported early intervention program. Having something to do with what you find encourages you to look for it. The resources for social and emotional problems are much less developed. Yes, there is potential harm of getting kids to someone who will overpathologize what is really just part of the wide spectrum of normal, or charge lots of dollars for little effective help. Good mental health care is very time consuming. And that time is poorly compensated. There is pressure on many in mental health to do it faster or starve. Thus diagnoses get rushed, potential quick fixes are jumped to. Lots of my time ends up with me doing nothing, but, hopefully, doing it well.

If this ends up with more high quality supports being available to patients and their families in a noncoercive way, if it ends up with a focus on educating practioneers on what to look for and how to help and only mandating standardized screening instruments if they are going to pay us for the time it takes to administer and score them, then I might be happy that it has occurred. But I am a little nervous about implementation of a well intended start.

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Parents don’t mind us asking questions. They want reassurance or validation that their concerns are justified. As a general rule parents worry about their kids and are happy to know that we care about them too.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------You certaintly show that you do not understand psychology, or that you care, because you and many others refuse to address the real causes for mental illness.

Mental illness is nothing more than a confused state of mind for the many and when this very government, business and schools, allow for discriminatory practices in the many ways, all of societies thinking becomes clouded and do as I say and not as I do, creates insecurity and ignorance, which breeds contempt and outright hatred, when we are all taught as youngsters, what is right and what is wrong and then we are forced to live the opposite in so many ways.

Yea right, you care, that’s why you keep advocating, that this nation keep putting a band aid and drugs on the problem, instead of addressing and correcting the problems at their source.

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Yay! Finally an expert with definitive answers has come to rescue us families struggling with mental illness in our kids.

BoyScout11, can you please explain in detail how to correct it at the source? What is the source?

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To accomplish the needs of the many, our leaders would have to start the ball headed in the right direction and everything else would snowball in the same direction. The problem is, this nations so called leaders, live in the red light district, behind high iron walls, with others that use these so called leaders, for their own gain.

This entire nation is nothing more than a puppet and our so called leaders sold this entire nation, just so they could prosper. Our so called leaders gave this nation to the Jewish nation for nothing more than supporting votes. Along the way, the American leadership has used and abused these Jewish leaders. The Jewish people as a whole, teach their children in the ways of psychology, pholosophy and most of all, business, from the time the children can talk and comprehend. I was raised in much the same manner, but from a Catholic prespective and I have not been Catholic for many years. I was not taught business either, but I do understand the inner workings of the mind in business, but not the numbers. I was raised by just my mother and she raised a total of 5 children by herself.

When this nations leaders were selling out to the Jewish people, people like Henry Ford saw the threat and started their own movement, but because the Jewish peoiple had been thru so much as a people, no one would dare say anything against them, except Henry Ford and they harassed him thru other people and behind the scenes. The Jewish people were forced to work behind the scenes by the American, so called leaders and they have actually done much better behind the scenes, until a person looks at how the media is controlled by the Jewish people in this country. If the Jewish people did not control our media, why did Jimmy Carters speech and that importance, get NO PLAY in our national media? Wouldn’t you think that an ex president saying our middle East policy is being controlled by Israel and the fact that our soldiers are fighting and dying, would be cause enough to say something in the media? If you watch, there is never an attack against the Jewish people in this country, but we sure attack our own leaders. Because of that, the Jewish people have learned to use that to their advantage, even though we give every family in Israel 14,000 dollars and they can still work and save and live quite well, while our own people here at home, suffer in the many ways.

By the way, besides the native Indian, I have heard, but cannot prove, that the Jewish people that come here, get some of the largest gifts of money to start their own businesses. Someone just recently showed how now, the Asian Indians are getting favored status and when they come to this country, they can get million dollar loans for prime commercial real estate, soon after they are on welfare.

Where all this is leading, is that this country is being given away for votes and the hard working people of this country are paying for it all, as goods and services, are the only things taxable. Since it takes hard work to produce goods, we go back again, to sweat labor, as the only thing really taxable. Hard working Americans are at the breaking point not only monitarily, but the hard working don’t have near enough time for their children, but those on welfare do and so do our leaders and most rich people.

Do you know where most of this nonsense came from? In my opinion, it came from our own two party system, which all by itself, has divided an entire nation down the middle and when you divide a people, you also conquer them. All this leads to DO AS I SAY AND NOT AS I DO, which creates the dichotomies for an entire nations children, OURS. The red light district in this nation, controlls and they will not give up that control. WE THE PEOPLE must take back our nation, or we are doomed to become a third world country, dominated by the dregs of the red light district.

All this permeates, not only our government, but our businesses and schools. America is lost and Bush has surely sold out to the Jewish interests and now we see Kerry had a grandparent that was Jewish and he recently met with the Jewish leaders, to assure them, he will protect all their interests, even at the costs to this nation, if he can just get elected. This country gives away money to many other nations and then exports our jobs to other nations, because it’s cheaper. I would laugh my heart out, if it was not so tragic.
Foreigners come to this country and we give them loans to open businesses and dominate Americans. Are we having fun yet. Our so called leaders give away our hard earned money for votes. Our nation is now deeply in debt, while Americans fight the war in the Middle East, that the Jewish nation, setting policy, kills our sons and daughters, makes the whole world mad at us and Israel sends no troops at all.

Mental illness. LOL LOL LOL.

85

Although the analogies offered in contrast to your morphine analogy eventually break down, as all analogies must, there are SSRIs that are a far cry from morphine and morphine addiction.

I have been taking 40 mg. of prozac daily for fifteen years. Whatever side effects that I may have are symptoms that I was already experiencing from depression itself so it is hard to know what is or was caused by chronic depression and what is a side effect of the medication and what is the result of aging and hormonal changes.

If prozac is actually “addictive,” I wouldn’t know it, although I have been told not to stop taking it suddenly. I will probably be taking it or another SSRI for the rest of my life unless something even better is available.

Yes, they “fuck” with my brain. Thank God! They have restored some semblance of my basic personality instead of the weeping, hopeless, vacant and shaking shadow that I had become.

I don’t consider the side effects “heavy baggage,” especially in comparison to the almost certain death by suicide that would have been the result of not finding relief in SSRIs. And as for “fucking with my brain,” I’ll take medication over the grave anytime.

AHunter3, you know that I respect you and your efforts and that I have come to agree with you on much over the last couple of years. But don’t forget that not all “behavioral health” issues are the same. I believe that you and others have been done a great injustice by the system. Please understand that there are those of us who have benefited from the practice of psychiatry and from the development of medications.

If I want to alleviate my thirst, why must I drink dishwater when fresh water is available? Giving me thorazine for depression doesn’t make sense. Giving me prozac does.

DSeid, your patients are fortunate that you see them as a whole person and not just body parts. A physician with a similar approach to healing is the one who saw the signs of depression in me and called in a specialist. Even though I had had problems with the illness off and on for 29 years at that time, I still couldn’t recognize it when it was happening again. I just thought that the world had gone to hell – not that my perception of my world had shifted.

Are there any teachers at SDMB who have been asked to screen for ADHD and ADD? I was never asked to in the 20 years that I taught, but I was in high school. In Tennessee I think that would be considered practicing medicine without a license. I am interested in knowing if my situation was exceptional.

If they had “essentially supressed” it, you wouldn’t know about it. But the debate is still out there. The consensus was that younger patients should be very carefully monitored when they are on SSRIs. (That doesn’t say a lot since everyone on SSRIs should be monitored (with their permission, of course.) The problem is that establishing a link is a little like finding a link between juveniles who take insulin for diabetes and the incidence of blood sugar instability. (I’m probably over-simplifying.)

Sometimes the root problem is the seratonin imbalance that makes it difficult to deal with stressful situations such as job pressure, the death of a spouse, etc. in appropriate ways. When your “attitude adjuster” is the part of you that is busted, then what do you do?

Certainly you have the right to your opinion, but if you were aware of the hours that psychiatrists keep, I don’t see how you would call it “easy work” or “easy money.”

Given your own experiences with the system, I can understand why you might think that. From my own experiences, I would assume they are trying to find solutions to such problems as teenage suicide and the school terrorism.

86

The learning process in here has been a two-way street, Zoe.

While I think the jury is still out on the overall subject of SSRI drugs, which aren’t quite as benign as they’ve been (until very very recently) painted, it is also true that a great many people have said they’ve experienced nothing but good from them, that they’ve saved their lives.

In the name of informed consent, I’d like anyone who is in a position to consider psychiatric services to hear that side of the story as well. If it don’t stress it as much as you think I should, I’m sorry – I’m going to acknowledge that I am still biased by my own experience, and I’ll also admit that I tend to think – perhaps erroneously – that more people have heard that side of the story and that therefore there’s less direct need for me to tout it.

Still, I earnestly hope that if you read through any of my more modern-era postings on the subject, you’d always find at least a disclaimer’s worth in which I note that psych drugs have been found to be wonderfully beneficial to some people.

Do I think SSRI meds are to depression as insulin is to diabetes? Do I think depression is an SSRI-deficiency disease? No. It may come closer to that than schizophrenia is a thorazine-deficiency disease, but I’d still call foul if anyone tried to make that analogy.

Addictive? Yes, for most people. As you note, that may not be an issue if they work for you and you have no reason to think you’d ever want to quit taking them.

Problematic side-effects? Yes, for some people. More of them than the drug manufacturers initially let on about, which has caused them to be in hot water right now in some venues, for suppressing that information. Not for everyone though.

And yes, there are many many people who say without these drugs they would either not be alive at all or they would not be functional in any real sense. If that were true for me I’d be taking them too.

I totally support your right to take them, and the right of your doctor to prescribe them, as long as the context is one of voluntary informed consent.

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Zoe I agree with AHunter3 that it’s about informed voluntary consent. I’ve really struggled in the last few weeks with the info that Lilly have just been forced to release about risperidone/risperdal. I’m not sure I would have chosen to use that medication with a prepubescent boy if I had known about the lactation side effect or the diabetes.

WRT the legislation, I’m of two minds. If it leads to good services and support for families then it could be a good thing. Personally I’m not sure that I would have wanted my kids screened in this way if it were solely about using standardised testing.

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Very much so! And choosing the right psychiatrist is also crucial All it takes is one really bad psychiatrist to destroy a delicate human being.

AHunter3, I know you have read my story before. What do you know about Power-of-Attorney for health care? Would that be a way of helping to protect yourself? I don’t know that much about it, but at least you could pick someone you trust, couldn’t you?

89

Mom and or dad take Johnny to church. Johnny learns about God and love and doing the right thing. At home, Johnny is given these same rules to follow. Johnny comes to believe this is the right thing to do and be, but when Johnny goes to school, many of the other children ridicule him for his looks, or lack thereof and lack of the best in clothing, along with say, red hair and freckles. Johnny is also an altar boy. Johnny goes to the playground and the same things happen there. Johnny goes to work and the same kinds of things happen there, WHAT DOES JOHNNY LEARN and where did all those other children come by the traits they use against Johnny? Who taught those other parents the things their kids use on Johnny? How are Johnnies thought processes affected and how should Johnny respond to other children? Should Johnny make fun of children even more challenged, or should Johnny stand in the line of fire and defend the other children worse off than himself and how will that affect Johnny, for trying to live by his religious beliefs? Can Johnny get along in school and learn, with such dichotomies? Will Johnnies grades suffer? Will Johnny come to hate the learning process and want to drop from school as quickly as possible? Would you?

Johnny also goes to say, a Catholic school and in this school, the children that go there have money and status in the community and their parents are big contributors to the school and Johnny starts out in school, wanting to raise his hand for every question and gives many correct answers, while most of the other children do not. Then, the nuns start to ignore Johnnies hand all the time and Johnny starts to lose interest and he comes to feel the teachers don’t care, but not just because of that. All along the way, Johnny is made fun of by the kids and as time goes by, Johnny finally has enough and pushes one of the rich kids out of his face, but does not hurt him. That child tells a nun and then the child is sent to the principle and he is whacked on the palms of the hand.

Johnnie also stands up to these bullies that are making fun of other children that are very timid, or do not look so good and the ones doing the bullying are not being punished by the nuns, but they punish Johnny instead. What does Johnny learn? Johnny goes to the priests, but the priests tell Johnny they cannot get involved in the school. Johnny cannot tell his mother or dad, because they are working two and 3 jobs. How does Johnny come to view the world and where does sanity lie for Johnny?

Where does sanity lie for the children taught to ridicule others for money, clothes and looks, if they get into an accident, that disfigures them, or they lose all their money and clothes and all of a sudden, they are the ones being ridiculed? What of the rich before the depression and when it hit and they became poverty stricken, did many of them not take their own lives, just because they had no money? Mental illness? It is everywhere. Johnnies is just one part, of one story, dealing with religion and childhood and the effects of discrimination and bullying.

How does this effect Johnny going into the business world, when school and that learning process beat him up, and cared not for the truth? What kind of job can Johnny get and how will all those children that learned thru their parents to bully other children and control them, treat Johnny in the business world, because just as sure as they had the money as children, most of them will be doing the same things in the business world, while they control and beat their workers, for more control and money, in not just the ways they learned as children, but many new ways they will add to what their parents them.

All this creates a type of class warefare, that further divides this nation, which in turn, takes from those that live by what they are taught as right and wrong, Gods laws and children that consider other childrens feelings and needs. Our country now espouses the need to find the cheepest workers and will outsource, or insource those foreign people, so investor driven bullies can rule and destroy an entire nation, for the sake of money and control, no matter how many lives are destroyed. A child or business that believes in Gods laws, would sek to pay their employees as much as they can, while those who don’t care, won’t. In that senario, government and big business, thru tax breaks and many other things, discriminate against co’s. that would try to treat their people properly and make it almost impossible for these co’s, to survive. There are many more senarios than just these couple.

Mental illness? How about the children that are not strong enough in childhood to stand up and fight these nasty people?

Shall tell you of a hundred more?