mental health "advocates"

[OldPsychDoc]

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Sad article from WSJ...

 

[whopper]

An unfortunate occurrence.

I do though continue to think MHAs are a good idea & can work. I've seen them in action at a few different places.

At the place I'm working at now, the advocates are doing their jobs just right. They listen to both sides of the story & will advocate things that make sense. Given the way our field is, one could get paternalistic & start to push for something that is over our limits.

I have though seen places where the advocates were bullied or seen as the enemy by other mental health staff. This lead to an antagonism that hurt the performance of both the advocates & the staff.

MHAs should not advocate to the point where its not beneficial. Someone who is clearly a danger to themselves should not have an advocate arguing for their discharge.

Mentally ill are as the article points out, very vulnerable to abuse. The field does need third party oversight.

 

[Solideliquid]

That is really unfortunate, and its stories like this that make me want to pull my hair out when our social workers tell me things like "he doesn't want to take the medication, and that's his choice we should respect that" regarding the psychotic young man in the next room without a shred on insight into his disease.

In fact I'm treating a young man (age 20) in clinic now that is most likely has CPT schizophrenia and he recently just agreed to take quetiapine, but when this was too sedating, he agreed to try a low dose of ziprasidone (only 20mg BID but it's a start) for which I'm truly grateful.

 

[whopper]

If you're having a problem getting the guy to take meds, I suggest trying Risperdal M tab, Zyprexa Zydis or Abilify discmelt. They all by the way have less dosage ranges vs Geodon, and you'll get to a therapeutic dosage range more quickly if this patient is only allowing for minimal dosages.

The 20mg of Geodon will probably do little if anything for the psychosis. Seroquel's dosage needs to get around 400 or higher for any antipsychotic benefit to start.

 

[antihero]

I identify more with the need for autonomy of my own body, than I do with the negative consequences of not being able to treat potential killers. It's a question of what you fear the most. I want to be able to see a psychiatrist, and know that my interests are paramount, and not the utilitarian perspective of what is good for society. If you take the interest of society far enough, you are back in eugenics-hell. Why not simply kill off those 50% of schizos with a poor prognosis.

 

[antihero]

For some stupid reason, hitting the return button doesn't bring about a break on my comp. Sorry about that.

 

[TheWowEffect]

Interesting to note that most of these MHAs are extreme left-wing liberals. I see this posture of individual freedoms in direct contradiction with their stand on universal health care, universal pre-school, more welfare, more government etc. Some good food for thought.......