Investing more money into this doesn't solve the societal issues which come from drug addiction, lack of economic opportunity, a failing education system, etc
I would rather see us focus on fixing schools and the economy than spend billions on these programs that have dubious outcomes
Luckily I don't live in the US where there's a high risk of being shot by police if you call for help for mental problems or getting put away because of good insurance, but if I did I would pick the police over the risk of getting medicated by overworked and poorly educated hospital-workers. The police might pass you on but that is still a risk I'd willingly take if I had to pick Police or direct to the social-system in the US. Of course I would rather take a loved one to someone I knew would give them proper care in the first place but most that call the police does not have that option or we wouldn't have this problem in the first place.
In other words, the problem isn't as black and white as you appear to make it. The solution is educated police working with a better social system, not sending social-workers to do a job they aren't educated or prepared for. If you look at much better (but still not perfect) systems you will mostly see that even when mentally sick people that are already in the hospital get violent they still call the police as it isn't their job to pacify dangerous individuals. That is the job of a well educated, not over-worked, police-force.
https://www.psychologytoday.com/us/blog/out-the-darkness/201...
Law enforcement doesn't know how to cure criminality, either. And it's much worse when it comes to mental illness.
> At best it knows how to medicate it and alleviate symptoms while causing very serious or deadly side effects.
Law enforcement isn't even that effective, at criminality or mental illness.
> Investing more money into this doesn't solve the societal issues which come from drug addiction, lack of economic opportunity, a failing education system, etc
Shifting resources into this from law enforcement responses to mental health issues does solve the societal issues that come from law enforcement’s egregious mishandling of mental health issues, plus saves money that can be used to deal with those other problems because it's cheaper per call handled. Also, alleviating mental health symptoms does mitigate many of those problems, which are, in many cases, direct consequences of mental health symptoms.
> I would rather see us focus on fixing schools
As if anyone knows how to do that.
> and the economy
Wasting less money on sending police to encounters where police presence is actively harmful is, among other things, fixing the economy.
No but I am sure places with more law enforcement are more lawful than places without it.
I'll also mention that rural places tend to have fewer cops and are seen as having a generally lower crime rate. (I didn't look up the numbers, but this is the stereotype).
I realize this is just a sidenote, but I just want to address this point for anyone who's struggling with problems like depression or other serious mental issues. Getting help can be a lifesaver, and sometimes medication is part of it.
Properly prescribed by a professional who knows what they're doing, medication to treat depression can in some cases literally change your life. It's not the only way to address mental issues, you absolutely should couple it with therapy. It's not for everyone. That's why a professional is involved. But stigmatizing people who take medication to help manage their problems is incredibly harmful.
Most people that get antidepressive medicine isn't heavily depressed and shouldn't get medicine at all:
>Conclusions: The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.
https://jamanetwork.com/journals/jama/article-abstract/18515...
>My guess is that future generations of psychologists will look back at our over-prescribing of psychotropic drugs with incredulity too, amazed at our blind enthusiasm for largely ineffective and damaging treatments, and at how such barbaric methods could become so widespread.
https://www.psychologytoday.com/us/blog/out-the-darkness/201...
The problem with overmedication is when the drugs don't work, or don't work properly. A competent professional would work with you to find the drugs that work for you, not say “here, take this, not interested in hearing your symptoms”. It's usually possible to know when you've got a bad doctor, and usually possible to seek a second opinion.
Better to seek help than suffer alone.
The problem is that often medication is prescribed very quickly and virtually no supervision happens. This is a very bad combination in general, but especially if the patient is suffering from a mental illness. These drugs literally list things like suicide among their side effects and it is extremely irresponsible to prescribe them to someone and then tell them to check back in 3-6 months or so. But this represents standard practice.
The drug isn't causing suicide. It's just unfortunately taking a patient through a risky period.
Many people do not understand that anti-depressants don't work instantaneously. They take time. That is where the risk comes from.
Really? They should just keep on suffering and do what? Snap out of it by the power of their will?
> Most people that get antidepressive medicine isn't heavily depressed
And let it evolve to chronic "mild" depression and possibly more severe mental illness, instead of treating it with an off the shelf anti-depressant today..
Medication helps lots of people and it's very effective, very quickly. If someone is suffering a lot of the time they don't need to be and this narrative of "only meds when it's severe" is why so many people go undiagnosed, untreated and later develop worse conditions in which they may not have a chance of full recovery.
Treat it when it's early, meds in moderation and with supervision.
In the US in particular it seems bizarre that this discussion has descended into worry over being locked up in mental health facilities given a prison population so large it compares unfavourably to most authoritarian dictatorships.
I couldn't find an exact number in the five minutes of searching I was willing to put in, but the budget seems to be in the single digit millions, a far cry from billions.
Heck, we are still slowly discovering body parts.
The brain is one of those things we still don't know a lot about despite the seemingly broad knowledge we have. Some of the knowledge we have is fairly recent and can be thanked, in part, to modern scanning. I don't know how we can expect folks to have a definite test for this when there is so much we don't know.
Psychiatry doesn't know how to cure mental illness and oncology doesn't know how to cure cancer, but they both work a lot better than the supplement aisle.
The evidence is mounting that vitamins may actually be just as good a treatment for most people with mild depression or other similar ailments vs SSRIs and other psychiatric drugs.
Sources:
SSRIs don't work better than placebos for mild to moderate depression Study https://www.ncbi.nlm.nih.gov/pubmed/18303940
Low B12 and Folic Acid are associated with Depression Study https://journals.sagepub.com/doi/abs/10.1177/026988110504889...
Vitamin D can treat seasonal depression Study https://europepmc.org/abstract/med/10888476
B-12 levels are associated with ability to recover from depression Study https://bmcpsychiatry.biomedcentral.com/articles/10.1186/147...
Magnesium helps to handle depression Study https://journals.plos.org/plosone/article?id=10.1371/journal...
I whole-heartedly agree with this. I was on anti-depressants at some point of my life. At that time I did something very stupid that jeopardized my life. I was lucky enough to get out of it unscathed. Although I am still traumatized by the incident.
Please be very careful taking anti-depressants.
It also depends on the medication as people have different reactions to different medications, even if they're in the same family of drugs (e.g. SSRI, SNRI, etc.). Some people will have the side effect you mentioned (e.g. suicidal ideation), but feel much better than before the medication after a few weeks. Those same people may not feel any difference on a different medication, even on the highest dosage, and never feel any improvements. Then there's a wide range of reactions in between. Unfortunately, it often takes a while to find the right medication for someone and the journey to do so is rarely pleasant.
This is one of the hardest things about psychiatric pharmacology. There's no go-to medication because you're trying to alleviate symptoms for something that you don't know the exact mechanisms involved (i.e. everyone's brain is different and a "chemical imbalance" or the cause of it in one person isn't the same as another's, even if their symptoms are the same).
With all of that said, I'd definitely recommend attempting cognitive-behavioral therapy before going to medication as a supplement or alternative to CBT, especially if the depression is mild/moderate. For those with severe depression (like me), however, they may not have the motivation/drive/confidence to consistently see a therapist. In those cases, medication might alleviate the symptoms enough for them to do so, which is what happened in my case. Although I don't continue CBT, mostly due to time constraints, I still take anti-depressants to maintain what I've climbed out of so far.
None of this even mentions those with severe, treatment-resistant depression in which the only relief they get is maybe from electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS). The former sometimes doesn't work and the latter's effectiveness tends to range from months to weeks and dependent on specific pulse train protocols for those cases.
Since a lot of the benefits of these drugs may be the placebo effect, that would be a pretty odd thing to say since they could undermine their treatment.
Psychiatry is like a science that hasn't been invented yet. If someone is seriously depressed it may be worth a shot to try drugs but the psychiatrist will have no real clue what the drugs will do, just educated guesses based on flawed studies.
Source on this? Keep in mind that psychiatry doesn't only deal with mild to moderate depression, but some really severe disorders.
In my opinion, where you can't definitively diagnose, you are already set for failure in the cure.
Here is some context: http://wayneramsay.com/diagnosis.htm