By David Joel Miller
Who should treat mental illness, where and how should it be treated?
The mental health field is changing. A host of events and forces have intersected to influence our feelings on the proper response of society to this thing we are calling mental illness. Lots of things are happening or about to happen in this mental health field.
Here in America the very ground underneath mental health treatment is moving.
In 1900, here in America, less than 10% of doctors had ever been to college. Until 1914 drugs were legal and you could openly buy them anywhere. As late as 1950 there were no meds to treat mental illness and those who were given a diagnosis could be tucked away first in barns and attics and latter in sanitariums.
The talk therapies are just past their hundredth birthday and many people have still never been to see a therapist. Three months ago more Americans were without health care than there were those who had coverage. The few who did have heath insurance here in America did not have coverage for mental illness or substance abuse. Treatment of those disorders while improving is still not on an even footing with most physical illnesses.
Less than a year ago the American Psychiatric Association released the new DSM-5 which redefined, reclassified and altered our understanding of what is and is not a mental, emotional or behavioral disorder. The new version of the International classification of diseases is due out soon which will change the field of treating mental health problems also.
This alteration in the landscape of the treatment of mental disorders is not solely confined to the United States of America. Blog readers and commenters from all over the world are asking similar questions and telling similar stories of their efforts to recover from an emotional or mental problem. They are also telling tales of less than helpful services.
The very mention of mental illness can evoke some pretty strong emotions. Some cultures, religions and even professions still are denying the existence of such a thing as a Mental Illness.
People leave comments and they send me emails. The comments of every reader of counselorssoapbox.com are valued. Some of them I answer briefly as soon as I can. Others require longer blog posts to give them the space they call for. A few are so angry or personal I have hesitated to approve them.
Some of you have left comments or sent me emails about how we are doing things here in America and how that might differ from the way things are done in other places. I have been having an interesting ongoing conversation with Ellen in the U. K. about how they do things there. I will fill you all in on that discussion as soon as possible.
Let me offer this invitation to all of you out there to share your experiences and how the mental health delivery system works in your part of our planet. I will share my clearly limited perspective from here in Fresno, California, one of the more diverse places in this United States of America. I feel sure the view of the mental health landscape will look a lot different from other points of view.
We should be talking about how we have been treating mental illness, how we should be treating it and how we get from where we are to where we need to be.
That discussion also implies some understanding of what “mental illness” is and how people develop a mental disorder. What a mental illness is, implies a view of what causes it, how it progresses, how to treat it. The view you take of this phenomenon also influences you view of the possibility it could be cured and if so how.
Knowing what mental illness is and what needs to be done about this leads us to the answer to my first question about who should be treating this problem.
We also have the added problem that no matter how sure we are of causes and treatments we need to know who is going to pay for these efforts. How treatment is delivered is strongly controlled by those who handle the money.
Let’s take a look at some of these questions and together see if we can find some solutions.
For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended books.
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