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Comment by lbrito | Hacker News Reader

I always thought of these apps as a sketchy byproduct of US's weird/malfunctioning health system -- kind of like how people use painkillers to forget about their toothache instead of going to a dentist.

Can't pay for a medical doctor to treat your mental health condition? Here's an app!

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>... kind of like how people use painkillers to forget about their toothache instead of going to a dentist.

I used to use whiskey for this when the pain became unbearable. Would take half a shot, then invert and tilt my head, letting it sit for a minute on one side of my upper jaw. Sometimes I'd spit if there was a lot of blood. Did the trick though, was usually enough relief to get me through until the toothache went away.

For a time I probably had more alcohol intake from that then I did actually drinking, despite it being a seldom occurrence.

Note: I say this being fully aware of how dangerous some types of untreated toothaches can be, so if you can afford care, get it. It might save your life.

I did something similar when my wisdom teeth came in shortly after I turned 21. When it hurt, I would drink, and when it stopped hurting, I stopped drinking.

It's not just about pay. Even if it was 100% affordable there's a shortage of mental health workers compared to demand. See the NYT Article from a few days ago [1]. The solution we have right now couldn't scale.

I'm not saying that an app, or technology in general, can fix everything, but surely we can drum up some sort of support tool that doesn't leave people high and dry, and doesn't rely on an impossible scaling up of a limited supply of skilled professionals doing 1:1 therapy. I'm not saying you can ever replace 1:1 therapy or even in-person therapy, because I don't think that's how we've evolved to need care, but I know that there is research to support that meta-level awareness of your own mental health is an important step.

There's (probably) not a silver bullet tech solution out there, and I think it's frankly a minefield and a losing battle for most startups, but definitely for investor-backed startups. I think this space really needs open standards and privacy-first solution that keeps people in charge of their own data, while also giving better tools to the experts who are out there now, and enables at least a minimal level of several options for therapy (self-led, group, facilitated, etc) for the varying levels of need, to free up 1:1 sessions for those in the greatest need rather than just the highest bidder as capitalism often favors.

[1] https://www.nytimes.com/interactive/2021/12/16/well/mental-h...

My concern is these apps will make the situation worse, I don't buy the argument of "something needs to be done so lets just do the easiest thing"

People are not on any meaningful scale in the US using pain killers to avoid dental care, unless you mean something like aspirin. Or rather, as someone who worked in public health related tech for many years, I've never see any data or heard anyone mention anything like that.

> People are not on any meaningful scale in the US using pain killers to avoid dental care, unless you mean something like aspirin.

You've contradicted yourself there. "They aren't, but they are with this one painkiller."

Not really a big contradiction unless you want to be really pedantic. Over the counter painkillers and prescription painkillers are very different beasts. Painkillers as a social ill pretty much exclusively refers to the latter. Nobody would say “I’m on painkillers” while taking aspirin.

> Nobody would say “I’m on painkillers” while taking aspirin.

Really? That's exactly what one would say in my country... though they'd more likely to be talking about paracetamol. The strongest one that most people know about is Panadeine Forte (paracetamol + codeine).

People usually mean something else by "painkillers", and I wnet on to explain that there doesn't seem to be any evidence behind the claim.

My bad, I meant any drugstore analgesic, OTC or not (I'm not in the US). I assumed painkiller was a synonym. I wasn't aware of the connotation.

You might be proving his point if painkillers have been so normalized that aspirin is not considered a painkiller any more.

“In 2019, before the coronavirus pandemic made dental visits difficult, a third of adults under 65 hadn't had a dental exam or cleaning in the past 12 months, according to the report from the U.S. Centers for Disease Control and Prevention.” - from Internet.

I am seriously impressed that 2/3 of US adults have had dental care within a year.

I live in New Zealand, which is fairly first world, but I don’t think we would have a figure that high. Note we have social health care, but that doesn’t include dental work (except for emergency dental care and limited care for people on benefits.)

In New Zealand more adults haven't been to a dentist in the last year than have.

These numbers are for New Zealand for the years 2017/18

https://www.health.govt.nz/publication/annual-update-key-res...

>Nearly half of adults (47%) with natural teeth visited a dental health care worker in the past year, down from 52% in 2006/07.

I've seen it all the time, not asprin though more usually lidocaine and other oral OTC oral painkillers

being able to go a dentist and get work done right when you need one is a privilage/luxury

My mom couldn't afford it, she spent years not being able to go to the dentist and eventually got the money to do some root canals. It almost certainly is a thing.

I've been to a few Psychologists, and two Psychiatrists.

I asked the first one about his fee. I went in not knowing. I had this horrid anxiety that just wouldn't go away. He says, "pay me what you think I'm worth."

I was in such angony, but did't want to piss this guy off. He had a good reputation. He offered no medication, and had this rediculious theory my anxiety was post traumatic syndrome from the '88 earthquake.

Anyway ge told me his fee was $450.00. I paid it and left.

I saw a Phd. Psychologist I found in the yellow pages. I talked and talked. I cried, and cried. Nothing was stopping the daily anxiety.

I ended up finding a Psychiatrist who didn't rape me on price. He put me on two very addictive drugs, and I've been on them decades. The mandatory appointments are tedious. I get absolutely nothing out of them. I've been on the same dose, so I think i'm just addicted, and any perceived pharmaceutical help is placebo.

Anyway--unless you hear voices (really bad voices that are bothering you greatly I added that tidbit about voices because they found schizophrenics do better long term without meds), or ready to commit suicide; I would stay away from the entire profession.

Oh yea, in your twenties and thirties, they are rough decades. If you don't bust a gasket consider yourself lucky.

If I had a do over, I don't think I would have ever seeked help. It's kinda a joke. It's definitely an art.

Same here, I would have never paid if insurance didn't cover it. I also realized a lot of my problems were due to being young and I think I would have gotten over it all anyway.

Damn, I'm really sorry to hear you went through all that.

The amount of anxiety I've had to _accept_ treatment into my life is because of stories like this. It's been a different though helpful journey for me, but also a lot of questioning, self tracking (to have some reassurance of a change in state over long periods of time), and a little experimentation.

That sounds incredibly rough.

But as a simple counterpoint to this, I'm getting a lot out of therapy, as are most of my friends who are in therapy. It's not doing what I thought it would - it hasn't fixed my depression overnight, or cured my irritability - but it's providing a different framework to think about the world and relate to people, and I like who I am an awful lot more than I like the person I was.

It's expensive for me, at 60 bucks a session on a not-particularly-high wage, and I regularly revisit the idea of stopping, but I think I'm still getting something useful and insightful out of most appointments, so I'm keeping on going.

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