Should mental illness be prioritized more when it relates to health care funding?

LifeOfAMedicStudent

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I have severe mental illness. Most patients I care for have severe mental illness.

Mental health is HIGHLY neglected and misunderstood in our legislation and healthcare as compared to physical ailments.

People complain about health care in this country, but funding is far more limited with mental health.

Many insurances do not cover residential mental health treatment. I am having to undergo residential treatment for anxiety. My family is fighting my insurance company to cover it.

I can only imagine what it is like for those on public insurance.

I see mental health as a huge priority, and in some cases, more important than physical health. Because those with severe mental illness can cause harm to others if not addressed. I see it as a public safety issue too.

But even in EMS, I feel we do not stress mental illness enough. Why don't we offer or even mandate crisis intervention training or have a special supplemental course dedicated to dealing with mental illness? I have yet to see anything like that in Tennessee especially.
 

GMCmedic

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Why don't we offer or even mandate crisis intervention training or have a special supplemental course dedicated to dealing with mental illness? I have yet to see anything like that in Tennessee especially.

You mean besides the CIT (crisis intervention team) program that originated in Tennessee.


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mgr22

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I have severe mental illness. Most patients I care for have severe mental illness.

Mental health is HIGHLY neglected and misunderstood in our legislation and healthcare as compared to physical ailments.

People complain about health care in this country, but funding is far more limited with mental health.

Many insurances do not cover residential mental health treatment. I am having to undergo residential treatment for anxiety. My family is fighting my insurance company to cover it.

I can only imagine what it is like for those on public insurance.

I see mental health as a huge priority, and in some cases, more important than physical health. Because those with severe mental illness can cause harm to others if not addressed. I see it as a public safety issue too.

But even in EMS, I feel we do not stress mental illness enough. Why don't we offer or even mandate crisis intervention training or have a special supplemental course dedicated to dealing with mental illness? I have yet to see anything like that in Tennessee especially.

Ok, I'll bite:

Most patients you care for have severe mental illness? What do you do, exactly?

You say you have severe mental illness, and are concerned about the harm those with severe mental illness can cause others? How have you resolved that paradox in your own practice?
 
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LifeOfAMedicStudent

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Ok, I'll bite:

Most patients you care for have severe mental illness? What do you do, exactly?

You say you have severe mental illness, and are concerned about the harm those with severe mental illness can cause others? How have you resolved that paradox in your own practice?

There are different types of mental illnesses and can present differently depending on the person.

Mine is severe obsessive thinking that causes anxiety and depression.

Other people can have psychotic episodes and mania.

I have been in psychosis one time. That was in my adolescence. My eyes would literally role back in my head too because I would be so isolated from reality and would be so lost in thought.

I have been hospitalized numerous times. Had to have the police show up.

But most of the issues were during adolescence. Although, when I was 20, I was hospitalized 3 times in one year!
 

mgr22

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I have been hospitalized numerous times. Had to have the police show up.

But most of the issues were during adolescence. Although, when I was 20, I was hospitalized 3 times in one year!

So now you're 22, with a history of psychosis, and in-patient treatment as recently as two years ago, and the medic in me wonders what steps you and your caregivers have taken to ensure you won't cause "harm to others."
 
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LifeOfAMedicStudent

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So now you're 22, with a history of psychosis, and in-patient treatment as recently as two years ago, and the medic in me wonders what steps you and your caregivers have taken to ensure you won't cause "harm to others."

What makes you assume I am 22?
 

NysEms2117

ex-Parole officer/EMT
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What makes you assume I am 22?
your age- on the forum you voluntarily signed up for.

I'll bite as well, I work parole which deals with convicted felons. The term felon means you have gone to state prison(with the big dogs, murderers, rapists, traffickers ect.) for over 1 year. Would it be safe to assume that I deal with a lot of people with mental illness? If I as a parole officer can get 50+ parolees(yes people with a felony on their record) mental health treatment, at an affordable price for THEM. People who are days out of prison, I'm not sure what your asking. Surely you with a full time job, and most likely insurance of some kind can find a solution, no? Not to mention you have a 1 up on them because your not convicted of a felony.
 

VentMonkey

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NysEms2117

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DesertMedic66

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In EMS awe usually can not make a huge impact in these patients. On my psych calls I am only with this patient anywhere from 10 minutes to a maximum of 1 hour. All of that time is usually spent doing the medical care portion of my job. Psych issues can be very complex and I highly doubt taking a semester course in college would prepare us anymore.

If you want more psych stuff to be added to the EMT and/or paramedic class that means you will probably have to cut out other information from the class. What subject would you like to completely cut out or condense? If you want a program to expand then IMO there are much better topics/subjects to deal with that may actually assist us in providing better patient care.
 

NysEms2117

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Monitoring....
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Tigger

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In EMS awe usually can not make a huge impact in these patients. On my psych calls I am only with this patient anywhere from 10 minutes to a maximum of 1 hour. All of that time is usually spent doing the medical care portion of my job. Psych issues can be very complex and I highly doubt taking a semester course in college would prepare us anymore.
All of our paramedics go through such a program, and it does help us significantly. Being able to talk people down and get them to make the decision that's right for them instead of doing it for them does a whole lot of good. It also lets us work with patients that are not cut and dry suicidal patients that need a quick ride to the ED. Not everyone in crisis is easy to deal with or even needs an ED and working with the patients to get them to care is not something I learned in paramedic school.
 

DesertMedic66

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All of our paramedics go through such a program, and it does help us significantly. Being able to talk people down and get them to make the decision that's right for them instead of doing it for them does a whole lot of good. It also lets us work with patients that are not cut and dry suicidal patients that need a quick ride to the ED. Not everyone in crisis is easy to deal with or even needs an ED and working with the patients to get them to care is not something I learned in paramedic school.
Is this just a general maybe day long class that just does a very broad coverage of how to deal with psych patients? I agree that not everyone in a crisis needs an ED however for my area every patient that is having any kind of crisis gets cleared at the ED before moving on in the process, with the exception being if the county mental health team is already on scene in which case the patients will go directly to a psych facility. I just have a hard time believing this would be a benefit when the much needed time could be spent on many subjects that are much more relevant for the paramedic level.
There are way to many mental illness to even begin to cover at the paramedic level and each requires their own way to handle it: PSTD, Bi-polar, depressed, anxiety, OCD, schizophrenia, multiple personalities, ADHD, psychosis, eating disorders, dissociative disorder, gender dysphoria, Aspergers, etc.
 

Tigger

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Is this just a general maybe day long class that just does a very broad coverage of how to deal with psych patients? I agree that not everyone in a crisis needs an ED however for my area every patient that is having any kind of crisis gets cleared at the ED before moving on in the process, with the exception being if the county mental health team is already on scene in which case the patients will go directly to a psych facility. I just have a hard time believing this would be a benefit when the much needed time could be spent on many subjects that are much more relevant for the paramedic level.
There are way to many mental illness to even begin to cover at the paramedic level and each requires their own way to handle it: PSTD, Bi-polar, depressed, anxiety, OCD, schizophrenia, multiple personalities, ADHD, psychosis, eating disorders, dissociative disorder, gender dysphoria, Aspergers, etc.
It's a part time program that's about a semester long. I don't think it would be feasible to add to current paramedic education as of yet as many (most) systems are still stuck in the dark ages with having to take pysch patients to the ED, which is just not helpful in most cases.
 

RocketMedic

Californian, Lost in Texas
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I honestly don't think so. Call it obsolete, old-school or callous, but I just don't see anxiety and similar problems as public health threats, I see them as maladaptive trends and excuses for unacceptable performance and behavior. I personally think that anxiety used as an excuse is a sign of unfitness.

In my opinion, people with dangerous mental health conditions should be forced to accept and provided with medical treatment for their problems, but everyone needs to be responsible for their actions.
 

E tank

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I'm not proud to admit it, but prior to doing a clinical rotation in a locked psych unit in San Francisco, I really never believed that the patients that the cops had 5150'd were doing anything but yanking my chain. The hallucinations, the violent behavior, the suicidal thinking. I never bought any of it because I was absolutely clueless. I wasn't drawing the distinction between being high and drunk and mental illness, in part because they were sometimes the same patients.

Looking back on that time, I'm incredulous that I could think that way, but I just was not trained in that aspect of care. And I can say, as a parent of someone that has struggled in this way over the years, how absolutely and eternally grateful I will always be to the emergency folks that showed up to help that understood and showed incredible compassion and humanity. It's more than I ever did.

It's as much for the family as it is for the patient.
 
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