Exposing Fractures in Mental Health Services due to the Light-Rail Homicide in Charlotte
In the realm of mental health, a complex web of issues surrounds the treatment and care of individuals with serious mental illnesses. This article aims to shed light on some of the key points surrounding this topic.
Firstly, it's important to note that a strict legal framework governs coercive medical interventions, such as the involuntary administration of anti-psychotic medication. However, the assumption that these interventions always work is not always accurate. Anti-psychotics don't always work, with efficacy rates ranging from 50% to 87% after one year.
The recovery-oriented psychiatric hospital system, which costs around $180,000 per person per year, is one of the resources often assumed to be the solution for those who refuse treatment. However, it's essential to acknowledge that not everyone recovers from mental illness, and a shift away from this paradigm is necessary to create lower-cost, long-term environments for those who do not.
The connection between crime and mental health is undeniable. Untreated psychosis and schizophrenia increase the risks of violence and criminal activity, especially when combined with illegal drug use. This is a population that faces a higher risk of criminal activity, homelessness, and forced hospitalization.
Courts require that patients receiving involuntary treatment be released to less restrictive environments as soon as their symptoms abate sufficiently, regardless of their likelihood of further deterioration or treatment refusal. This cycle involving emergency rooms, psychiatric holds, jails, and preventable crises is common for people with serious mental illness who are resistant to treatment.
The larger problems, however, are getting patients to take their medications as prescribed and ensuring long-term compliance with treatment plans. When individuals repeatedly refuse medication or their symptoms fail to improve, broader latitude is needed for psychiatrists, including sequestering the patient in a psychiatric institution.
It's worth noting that most Medicaid patients have no out-of-pocket costs for antipsychotics. This suggests that the lack of treatment is not always a result of a lack of resources or access.
Devon Kurtz, the director of public safety policy for the Cicero Institute, is at the forefront of advocating for change in this area. Despite a lack of information available about his previous career, his current work is focused on finding solutions to the challenges faced by individuals with serious mental illnesses.
In conclusion, while the legal and psychiatric systems are predicated on overestimates of the efficacy of pharmaceutical interventions, it is clear that more needs to be done to address the complex issues surrounding mental health treatment and care. A comprehensive approach, considering both pharmaceutical and non-pharmaceutical interventions, is necessary to ensure the best possible outcomes for those struggling with serious mental illnesses.
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