World Health Organization, "...there is no health without mental health."

(Direct link to Fact sheet N°220, September 2010, written for the W.H.O. is below.)

"Strategies and interventions

Mental health promotion involves actions to create living conditions and environments that support mental health and allow people to adopt and maintain healthy lifestyles. These include a range of actions to increase the chances of more people experiencing better mental health.

A climate that respects and protects basic civil, political, socio-economic and cultural rights is fundamental to mental health promotion. Without the security and freedom provided by these rights, it is very difficult to maintain a high level of mental health.

National mental health policies should not be solely concerned with mental disorders, but should also recognize and address the broader issues which promote mental health. This includes mainstreaming mental health promotion into policies and programmes in government and business sectors including education, labour, justice, transport, environment, housing, and welfare, as well as the health sector.

Promoting mental health depends largely on intersectoral strategies. Specific ways to promote mental health include:"  (Please click link for remainder of Fact Sheet.)

http://www.who.int/mediacentre/factsheets/fs220/en/

 

(original post 1.17.13, repost 2.20.13)

My Testimony: Sandy Hook Hearings on Mental Health Services.

Testimony: CT State Legislature
Sandy Hook Hearings on Mental Health Services 1.29.13
I’m a Mental Health Advocate & lifelong caregiver of a mentally ill loved one.  I represent caregivers, my loved one and my business Turtles & Lemonade.
Thank you for holding this hearing and listening to our voices.  I feel the voice of the caregiver is the most important one to have at the table when discussing access, the successes and failures of Mental Health Services.  We navigate the public, private and insurance system year-in-and-year-out.
I ask you to look at the bottom line issues & the true costs of offering parity in Mental Health Services, parity certainly isn’t easy to define.  The numbers speak for themselves: Connecticut lost between $31-17 billion dollars in income tax revenue from caregivers over the last 15 years.  Over this same time period insurance companies have steadily reduced coverage for Mental Health Services, have posted unprecedented profits and health insurance premiums have increased 131% in the last decade. The insurance company practice of having administrators not doctors recommend what is best for our loved ones is unacceptable.  This practice reduces their costs, while reducing Connecticut tax revenue and my personal income.
As a caregiver I’ve had to fight for covered hospitalizations, secure exceptions for services denied my loved one, research and find ways to access public services to add to the sparse services and therapy available for my insured loved one, pay copays and bus fares while building my loved one up who is unable to advocate and speak for herself while trying to work, take care of my family and volunteer.
We need a zip-line to services when someone with chronic mental illness reaches out.  Neither the private nor the public system can expect a person with chronic mental illness to properly fill out disability insurance paperwork, advocate and be tenacious enough to break through a cumbersome system in order to access covered or available services.
Information on services and support need to be advertised and publicized to caregivers more so than the chronically mentally ill.  As an informed consumer until I came out of the closet as a caregiver I too had little information on many of the valuable support services available for my loved one.
I urge you read the Connecticut Office of the Health Advocates January 5th, 2013 report & the Blue Ribbon Commission report of 2003.  These reports were very difficult for me to read as the obstacles and problems I live and navigate daily were clearly spelled out 10 yrs. ago and have cost Connecticut and my family quite a bit.
Please look at the true costs to properly insure Mental Health Services.  Examine the real costs to our State when care for our mentally ill loved ones is pushed onto non-professional caregivers. Providing proper mental healthcare coverage will decrease not increase insurance costs, reducing overall health care cost to all.  Providing proper coverage will reduce the need and associated costs of emergency hospitalizations whose costs are often passed onto the state through Medicaid reimbursement or to our hospital systems who can’t recoup these costs.
The bottom line to the State in lost income tax revenue is real. We need to look at not only the $31-17 billion dollar loss to our State but the cost to our Nation.  Nationwide the cost of lost wages, pension contributions and Social Security taxes over the same time period with respect to caregivers is 3 TRILLION dollars. (Per MetLife study.)
Thank you and your commission for holding this hearing.  I urge you to stay the course, reach out and help us move an inch in the right direction for our loved ones.
Legislators, caregivers, mental health professionals and insurance companies need to come together and fix this economic problem.

Mental Illness is just a character flaw. Get over it. Man-up!

As our nation continues to debate Mental Health Services few are speaking in public about the perception that Mental illness is a character flaw.  Mental Illness' are serious chronic medical conditions, like diabetes and heart disease.  Is a diabetic a weak person that can't control their pancreas and its production of insulin? If you're born to a family that has a genetic disposition to create cholesterol resulting in heart disease are you too weak of mind to control your endocrine system?  To follow that logic a person who suffers from Mental Illness is too weak to control the chemicals and neurotransmitters in thier brain; the most unexplored organ in the body.  Why is there no parity of coverage and care?  What is parity of care when discussing Mental Health?

Mental illnesses are serious medical illnesses. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence. Mental illness falls along a continuum of severity. Even though mental illness is widespread in the population, the main burden of illness is concentrated in a much smaller proportion-about 6 percent, or 1 in 17 Americans-who live with a serious mental illness. The National Institute of Mental Health reports that One in four adults-approximately 57.7 million Americans-experience a mental health disorder in a given year.
http://www.nami.org/template.cfm?section=about_mental_illness

When you know better do better.

List of Murders by People on Psych Meds.

The following was on Facebook with no credit or source. See below for blog my post.)

“What Drug Date Where Additional

School Shooting Prozac WITHDRAWAL 2008-02-15 Illinois ** 6 Dead: 15 Wounded: Perpetrator Was in Withdrawal from Med & Acting Erratically 
School Shooting Prozac Antidepressant 2005-03-24 Minnesota **10 Dead: 7 Wounded: Dosage Increased One Week before Rampage 
School Shooting Paxil [Seroxat] Antidepressant 2001-03-10 Pennsylvania **14 Year Old GIRL Shoots & Wounds Classmate at Catholic School 
School Shooting Zoloft Antidepressant & ADHD Med 2011-07-11 Alabama **14 Year Old Kills Fellow Middle School Student 
School Shooting Zoloft Antidepressant 1995-10-12 South Carolina **15 Year Old Shoots Two Teachers, Killing One: Then Kills Himself 
School Shooting Med For Depression 2009-03-13 Germany **16 Dead Including Shooter: Antidepressant Use: Shooter in Treatment For Depression 
School Hostage Situation Med For Depression 2010-12-15 France **17 Year Old with Sword Holds 20 Children & Teacher Hostage 
School Shooting Plot Med For Depression WITHDRAWAL 2008-08-28 Texas **18 Year Old Plots a Columbine School Attack 
School Shooting Anafranil Antidepressant 1988-05-20 Illinois **29 Year Old WOMAN Kills One Child: Wounds Five: Kills Self 
School Shooting Luvox/Zoloft Antidepressants 1999-04-20 Colorado **COLUMBINE: 15 Dead: 24 Wounded 
School Stabbings Antidepressants 2001-06-09 Japan **Eight Dead: 15 Wounded: Assailant Had Taken 10 Times his Normal Dose of Depression Med 
School Shooting Prozac Antidepressant WITHDRAWAL 1998-05-21 Oregon **Four Dead: Twenty Injured 
School Stabbing Med For Depression 2011-10-25 Washington **Girl, 15, Stabs Two Girls in School Restroom: 1 Is In Critical Condition 
School Shooting Antidepressant 2006-09-30 Colorado **Man Assaults Girls: Kills One & Self 
School Machete Attack Med for Depression 2001-09-26 Pennsylvania **Man Attacks 11 Children & 3 Teachers at Elementary School 
School Shooting Related Luvox 1993-07-23 Florida **Man Commits Murder During Clinical Trial for Luvox: Same Drug as in COLUMBINE: Never Reported 
School Hostage Situation Cymbalta Antidepressant WITHDRAWAL 2009-11-09 New York **Man With Gun Inside School Holds Principal Hostage 
School Shooting Antidepressants 1992-09-20 Texas **Man, Angry Over Daughter's Report Card, Shoots 14 Rounds inside Elementary School 
School Shooting SSRI 2010-02-19 Finland **On Sept. 23, 2008 a Finnish Student Shot & Killed 9 Students Before Killing Himself 
School Shooting Threat Med for Depression* 2004-10-19 New Jersey **Over-Medicated Teen Brings Loaded Handguns to School 
School Shooting Antidepressant? 2007-04-18 Virginia **Possible SSRI Use: 33 Dead at Virginia Tech 
School Shooting Antidepressant? 2002-01-17 Virginia **Possible SSRI Withdrawal Mania: 3 Dead at Law School 
School Incident/Bizarre Zoloft* 2010-08-22 Australia **School Counselor Exhibits Bizarre Behavior: Became Manic On Zoloft 
School/Assault Antidepressant 2009-11-04 California **School Custodian Assaults Student & Principal: Had Manic Reaction From Depression Med 
School Shooting Prozac Antidepressant 1992-01-30 Michigan **School Teacher Shoots & Kills His Superintendent at School 
School Shooting Threats Celexa Antidepressant 2010-01-25 Virginia **Senior in High School Theatens to Kill 4 Classmates: Facebook Involved: Bail Denied 
School Violence/Murder Antidepressants* 1998-05-04 New York **Sheriff's Deputy Shoots his Wife in an Elementary School 
School Knifing/Murder Meds For Depression & ADHD 2010-04-28 Massachusetts **Sixteen Year Old Kills 15 Year Old in High School Bathroom in Sept. 2009 
School Stabbing Wellbutrin 2006-12-04 Indiana **Stabbing by 17 Year Old At High School: Charged with Attempted Murder 
School Threat Antidepressants 2007-04-23 Mississippi **Student Arrested for Making School Threat Over Internet 
School Suspension Lexapro Antidepressant 2007-07-28 Arkansas **Student Has 11 Incidents with Police During his 16 Months on Lexapro 
School Shooting Antidepressant WITHDRAWAL 2007-11-07 Finland **Student Kills 8: Wounds 10: Kills Self: High School in Finland 
School Shooting Paxil [Seroxat] Antidepressant 2004-02-09 New York **Student Shoots Teacher in Leg at School 
School Threat Prozac Antidepressant 2008-01-25 Washington **Student Takes Loaded Shotgun & 3 Rifles to School Parking Lot: Plans Suicide 
School Shooting Plot Med For Depression 1998-12-01 Wisconsin **Teen Accused of Plotting to Gun Down Students at School 
School/Assault Zoloft Antidepressant 2006-02-15 Tennessee **Teen Attacks Teacher at School 
School Shooting Threat Antidepressant 1999-04-16 Idaho **Teen Fires Gun in School 
School Hostage Situation Paxil & Effexor Antidepressants 2001-04-15 Washington **Teen Holds Classmates Hostage with a Gun 
School Hostage Situation Antidepressant WITHDRAWAL 2006-11-28 North Carolina **Teen Holds Teacher & Student Hostage with Gun 
School Knife Attack Med for Depression 2006-12-06 Indiana **Teen Knife Attacks Fellow Student 
School Massacre Plot Prozac Withdrawal 2011-02-23 Virginia **Teen Sentenced to 12 Years in Prison For Columbine Style Plot 
School Shooting Celexa & Effexor Antidepressants 2001-04-19 California **Teen Shoots at Classmates in School 
School Shooting Celexa Antidepressant 2006-08-30 North Carolina **Teen Shoots at Two Students: Kills his Father: Celexa Found Among his Personal Effects 
School Shooting Meds For Depression & ADHD 2011-03-18 South Carolina ** Teen Shoots School Official: Pipe Bombs Found in Backpack 
School Shooting Threat Antidepressant 2003-05-31 Michigan **Teen Threatens School Shooting: Charge is Terrorism 
School Stand-Off Zoloft Antidepressant 1998-04-13 Idaho **Teen [14 Years Old] in School Holds Police At Bay: Fires Shots 
School Shooting Antidepressant WITHDRAWAL 2007-10-12 Ohio **Teen [14 Years Old] School Shooter Possibly on Antidepressants or In Withdrawal 
School Threat Antidepressants 2008-03-20 Indiana **Teen [16 Years Old] Brings Gun to School: There Is a Lockdown 
SchoolSuicide/Lockdown Med For Depression 2008-02-20 Idaho”

END QUOTE

Pharmaceuticals have played a huge role in increasing the quality of life for many who suffer from mental illness. This blog post will address the argument being bantered about this week and implied above: The argument that Mental Illness is the problem, not guns.  I'm a supporter of the Second Amendment so the argument of Mental Health Reform vs. Gun Ownership has no correlation to me.  It's an attempt to put Mental Health on the hot seat to divert attention from conversations on guns.  They are both on the hot seat now because they were two of many pieces to the Newtown puzzle. I'm happy the conversations are happening but saddened for the reason...

I'm sure the point of the Facebook post above was one thing while to me it's something altogether different. My take-away is the fact that Pharmaceutical Companies and their Lobbyists have played a huge role in dismantling Mental Health Services in the US.  They've convinced Insurance Companies that it's cheaper to pay for a three-day hospital stay and have patients leave with an RX but with no support services.  When in fact it isn't (see blog post on the W.H.O.).  The Insurance Industry joined the Pharmaceutical Lobby to dismantle Mental Health Service funding and Insurance Companies responsibilities to policyholders.

Was the premise of the dismantling approach to try a RX if there was no clear-cut diagnosis?  Try every drug there is, keep trying, hopefully something will work.  This approach shows no regard for the effects of the strong meds on the mind, often growing teen minds and all the hormones that come into play. What are these 'trials' doing to the brain?  How long will it take for the RX to level out in the body and work?  What are the side effects (see Hospital Checklist tab above)?  Do the caregivers have the training and ability to watch their loved ones 24/7 until the proper med is found and works? Do they just keep trying until something works or the person snaps if it doesn’t? 

If an industry or two push Doctors to prescribe meds and free up Hospital beds they should have some responsibility, right?  Cause & Effect.  Yet, the resulting snap isn’t their problem nor their responsibility, its societies.

The US Pharmaceutical Industry alone made $300-$400 billion dollars in 2010 and they make nothing from support services.  Their largest customer is the Insurance Industry. US consumers also pay the most for each medicine we purchase, with or without insurance.  Why?  We pay for the R&D too.

I'd like to see these two industries help us help our loved ones by taking a portion of their profits to fund local support services.  There's no downside to giving back to their customers, is there?

Quite a different takeaway.

Get involved.   Ask your elected officials to look at the real issues and problems (see Advocate/Lobby tab above).

Mental Illness, Defined by Wiki

(Entire post from WIKI:  http://en.wikipedia.org/wiki/Mental_disorder)

Disorders

There are many different categories of mental disorder, and many different facets of human behavior and personality that can become disordered.[7][8][9][10][11]

Anxiety or fear that interferes with normal functioning may be classified as an anxiety disorder.[12] Commonly recognized categories include specific phobiasgeneralized anxiety disordersocial anxiety disorderpanic disorderagoraphobiaobsessive-compulsive disorder and post-traumatic stress disorder.

Other affective (emotion/mood) processes can also become disordered. Mood disorder involving unusually intense and sustained sadness, melancholia, or despair is known as major depression (also known as unipolar or clinical depression). Milder but still prolonged depression can be diagnosed as dysthymiaBipolar disorder (also known as manic depression) involves abnormally "high" or pressured mood states, known as mania or hypomania, alternating with normal or depressed mood. The extent to which unipolar and bipolar mood phenomena represent distinct categories of disorder, or mix and merge along a dimension or spectrum of mood, is subject to some scientific debate.[13]

Patterns of belief, language use and perception of reality can become disordered (e.g., delusionsthought disorderhallucinations). Psychotic disorders in this domain include schizophrenia, and delusional disorderSchizoaffective disorder is a category used for individuals showing aspects of both schizophrenia and affective disorders. Schizotypy is a category used for individuals showing some of the characteristics associated with schizophrenia but without meeting cutoff criteria.

Personality—the fundamental characteristics of a person that influence thoughts and behaviors across situations and time—may be considered disordered if judged to be abnormally rigid and maladaptive. Although treated separately by some, the commonly used categorical schemes include them as mental disorders, albeit on a separate "axis II" in the case of the DSM-IV. A number of different personality disorders are listed, including those sometimes classed as "eccentric", such as paranoidschizoid and schizotypal personality disorders; types that have described as "dramatic" or "emotional", such asantisocialborderlinehistrionic or narcissistic personality disorders; and those sometimes classed as fear-related, such as anxious-avoidantdependent, or obsessive-compulsive personality disorders. The personality disorders in general are defined as emerging in childhood, or at least by adolescence or early adulthood. The ICD also has a category for enduring personality change after a catastrophic experience or psychiatric illness. If an inability to sufficiently adjust to life circumstances begins within three months of a particular event or situation, and ends within six months after the stressor stops or is eliminated, it may instead be classed as an adjustment disorder. There is an emerging consensus that so-called "personality disorders", like personality traits in general, actually incorporate a mixture of acute dysfunctional behaviors that may resolve in short periods, and maladaptive temperamental traits that are more enduring.[14] Furthermore, there are also non-categorical schemes that rate all individuals via a profile of different dimensions of personality without a symptom-based cutoff from normal personality variation, for example through schemes based on dimensional models.[15]

Eating disorders involve disproportionate concern in matters of food and weight.[12] Categories of disorder in this area include anorexia nervosabulimia nervosaexercise bulimia or binge eating disorder.

Sleep disorders such as insomnia involve disruption to normal sleep patterns, or a feeling of tiredness despite sleep appearing normal.

Sexual and gender identity disorders may be diagnosed, including dyspareuniagender identity disorder and ego-dystonic homosexuality. Various kinds of paraphilia are considered mental disorders (sexual arousal to objects, situations, or individuals that are considered abnormal or harmful to the person or others).

People who are abnormally unable to resist certain urges or impulses that could be harmful to themselves or others, may be classed as having an impulse control disorder, including various kinds of tic disorders such as Tourette's syndrome, and disorders such as kleptomania (stealing) or pyromania (fire-setting). Various behavioral addictions, such as gambling addiction, may be classed as a disorder. Obsessive-compulsive disorder can sometimes involve an inability to resist certain acts but is classed separately as being primarily an anxiety disorder.

The use of drugs (legal or illegal, including alcohol), when it persists despite significant problems related to its use, may be defined as a mental disorder. The DSM incorporates such conditions under the umbrella category of substance use disorders, which includes substance dependence and substance abuse. The DSM does not currently use the common term drug addiction, and the ICD simply refers to "harmful use". Disordered substance use may be due to a pattern of compulsive and repetitive use of the drug that results in tolerance to its effects and withdrawal symptoms when use is reduced or stopped.

People who suffer severe disturbances of their self-identity, memory and general awareness of themselves and their surroundings may be classed as having a dissociative identity disorder, such asdepersonalization disorder or Dissociative Identity Disorder itself (which has also been called multiple personality disorder, or "split personality"). Other memory or cognitive disorders include amnesia or various kinds of old age dementia.

A range of developmental disorders that initially occur in childhood may be diagnosed, for example autism spectrum disorders, oppositional defiant disorder and conduct disorder, and attention deficit hyperactivity disorder (ADHD), which may continue into adulthood.

Conduct disorder, if continuing into adulthood, may be diagnosed as antisocial personality disorder (dissocial personality disorder in the ICD). Popularist labels such as psychopath (or sociopath) do not appear in the DSM or ICD but are linked by some to these diagnoses.

Somatoform disorders may be diagnosed when there are problems that appear to originate in the body that are thought to be manifestations of a mental disorder. This includes somatization disorder andconversion disorder. There are also disorders of how a person perceives their body, such as body dysmorphic disorderNeurasthenia is an old diagnosis involving somatic complaints as well as fatigue and low spirits/depression, which is officially recognized by the ICD-10 but no longer by the DSM-IV.[16]

Factitious disorders, such as Munchausen syndrome, are diagnosed where symptoms are thought to be experienced (deliberately produced) and/or reported (feigned) for personal gain.

There are attempts to introduce a category of relational disorder, where the diagnosis is of a relationship rather than on any one individual in that relationship. The relationship may be between children and their parents, between couples, or others. There already exists, under the category of psychosis, a diagnosis of shared psychotic disorder where two or more individuals share a particular delusion because of their close relationship with each other.

There are a number of uncommon psychiatric syndromes, which are often named after the person who first described them, such as Capgras syndromeDe Clerambault syndromeOthello syndrome,Ganser syndromeCotard delusion, and Ekbom syndrome, and additional disorders such as the Couvade syndrome and Geschwind syndrome.[17]

Various new types of mental disorder diagnosis are occasionally proposed. Among those controversially considered by the official committees of the diagnostic manuals include self-defeating personality disordersadistic personality disorderpassive-aggressive personality disorder and premenstrual dysphoric disorder.

END

"Managed care has not caused a shift in the pattern of care but an overall reduction of care." *

*1999 Psychiatry Online, American Journal of Psychiatry, full article found here:  http://ajp.psychiatryonline.org/article.aspx?articleid+173643

This certainly has proved true over the last 14 years.  The reduction in care by insurance companies and the availability of cost effective private services has dwindled to an unacceptable low.  The financial burden is passed along to caregiving family members who have little or no say over their loved ones care. Most care in the Northeast is private pay;  Therapy, DBT, CBT, etc...

I urge you to read the World Health Organizations report on the burdens and costs of Mental Health Issues that was published in 2001:  http://who.int/whr/2001/chapter2/en/index3.html

Studies show that providing proper insured care for our mentally ill loved ones lowers health care costs for all.  It doesn't raise them.  It also lowers the costs to society by not placing the burden of continued crisis hospitalization costs on the very hospitals that care for our uninsured loved ones.  Effective Social Services are in place but funding has been drastically cut.   

On December 8, 1990 the State of Connecticut closed two facilities with the promise that the money would go to local level mental health support services and to the New Department of Behavioral Health.  In fact, even during the economic boom of the 1990's these services continued to see cuts.  As insurance companies profits rose, Mental Health Services were cut.  Since the recession we've seen more and more of our loved ones in shelters, on the streets, unemployed and left without insurance and services.  This is unacceptable.

Remember 1:4 Americans are diagnosed each year with a Mental Illness and 1:4 Americans are caregivers of someone with a Mental Illness.  

We need to be at the table. Our voices need to be heard.

Stigma.

Stigma.  Our mentally ill loved ones deal with it every single day of their lives.  It's discrimination, a fear based form of shame by those who don't understand.

The only shame one should carry is how we each treat those less fortunate than us.  The mentally ill certainly didn't chose to have an illness of the brain.  They have enough to worry about, stigma isn't something that we need to add to their burden.

I've looked into my loved ones eyes and felt the pain that the 'words' and actions of others caused.  It's difficult for our loved ones to be around people judging them all the time.  

Open one person's eyes to the plight of mental illness and you begin to change the world.

Caregiver Isolation.

As a caregiver, who do you talk to about what you're going through and living?

Who could understand? 

A favorite example of mine that I use to illustrate this loneliness follows:   

'If someone broke their foot in August and then broke it again in December you'd feel bad, offer to drive the kids around, cook...anything.  Yet, if someone has a depressive episode in August and another in December they become invisible.  No one knows what to say and they're afraid of the unknown. So they avoid them or the topic, yet are quick to use the term 'crazy' to describe them.'  

Sadly that is stigma, you learn to isolate.  

Fact: 1:4 Americans are caregivers of someone with a mental illness and 1:4 Americans are diagnosed each year with a mental illness.  Movies like 'The Shining' did tremendous damage to our loved ones and prevented so many from reaching out for help. That genre of movie really isolates all suffers of mental illness and scared the public. The percentage of people with acute psychosis, like the Shining character is so small,  less than 1% of the population, it's statistically insignificant.

Stigma is real and it is propagated by the media and my Hollywood to the detriment of the very people around us who need our compassion the most.

My measure of my life is this:  How I treat those who can't help themselves.  

In fact that is my measure for all.

After Newtown. No Quick Fix.

Since Newtown the conversations and need for a quick fix are everywhere.  I remain grateful that the conversations are happening.  I've spoken to State Legislators, written my Federal Elected Officials, Vice President Biden, spoken to Doctors, Psychologists, caregivers, neighbors, and public safety officers. Understandably we all want to make sense of this horrifc tragedy and never let it happen again. Yet the issues are very complex.

It's natural to want a quick fix. The hard truth is that it took decades to get here and it will take decades to fix the mental health system. There is too much blame to spread, it permeates every layer of society and the political system. The decisions to cut extremely effective and empowering services ocurred slowly over several decades. No one that I've spoken to took away the major funding for these effective support systems, the low hanging fruit so to speak, but their predecessors did.  I fear that after one month of true dialog we'll turn to quick fixes of the symptoms, a feel good process' because the issue is ugly and very complex.  

There is no quick fix, the burden is on the caregivers and they too are stigmatized.  There's an article about a quick 10 minute screening that Medical Doctors can do to screen for mental illness (link in references).  I'm not confident that that is an answer.  A Psychiatrist from PsychCentral best described my concerns of this screening process, it's labeling and implications  (see link in references). This screening tool could be wonderful if there were accessable and affordable services available and the patient accepts the Medical Dr's opinion.  As someone who watched several family member either never accept their diagnosis or conditionally accept them decades later and then only privately.  At which point they're often unable to follow protocols given to them by professionals.  

Why do patients wait so long to accept help?  Accept their diagnosis?  Stigma.  I fear the approaches being bandied around to these very complex issues will only compound societies stigma and prevent people from getting help for themselves and thier loved ones.  We as caregivers and consumers of boht covered and unvcovered Mental Health Services for our loved ones know what is effective and needed.  The answers are there for anyone who will listen.

Money would be best spent being put into restoring effective programming and services to support those whohave accepted their diagnosis' and to support also caregivers so they can work and have a respite are the ONLY responsible answer.  Anything else is window dressing.

It may not be what society and politician want to hear but it is the truth.  Society can no longer look the other way and through this issue and politicians refusing to fund these programs yet funding pork places a responsibility on them. Let's look at the real issues and to listen to the caregivers and organizations like NAMI. Nothing is new in Mental health care needs, actually there is...no funding.

The measure of man is how they treat the lesser amoung the.