Challenges To Mental Health Recovery

3 major challenges to mental health recovery confront the mental health provider these days, and those 3 challenges are:

1. neuroleptic drug use,
2. pessimism among mental health professionals, and
3. the paternalistic practices that come of this pessimism

Neuroleptic drug use

Although a patient’s chances for a full and complete recovery are much better without neuroleptic drugs, better known as antipsychotic drugs, than are his or her chances with such drugs, doctors of psychiatry are lax to acknowledge this fact.

Psychiatric drugs tend to be the panacea of psychiatry. The drug cocktail, or a regimen of multiple psychiatric drugs, has proven to be absolutely the worse course of action a doctor might take, and yet some of these doctors use such drug cocktails on a good number of the patients who walk through the doors of their offices. Over prescribing and over dosing are also frequent occurrences.

Despite the fact that some improvement may be seen in the patient in the short term using such drugs, in the long term the drug is always detrimental. Neuroleptic drugs impair brain function, and the longer the patient is kept on such drugs, the less is the likelihood that the patient will be able to recover from the incapacitating effects of these drugs.

The Pessimism Of Mental Health Professionals

Mental Health professionals have been reluctant to think that recovery for people suffering from severe mental illness was even in the realm of possibility. Negative prophesies have a way of fulfilling themselves in the absence of positive efforts to stave such outcomes off. Some professionals have managed to get around the fact that complete recovery even occurs by focusing on attitudinal change alone.

Recovery is not drug management. If the patient cannot manage without a psychiatric drug, the patient has not recovered from his or her ailment. Often the ailment is actually the effects of the drug itself, and withdrawal must be done under supervised care, or the patient is likely to experience a further resurgence of what are characterized as the symptoms of disease.

Recovery is not a treatment modality. Partial recovery is not complete recovery. Complete recovery, and recovery from the disruptive consequences of hospitalization, as much as from any disease, must become a concern of treatment providers

Paternalistic Practices

Hospitalization, as a rule, is a very disruptive process. People who are admitted into the hospital for any appreciable length of time can lose their jobs, their homes, their places of residence, their physical health, their family and their friends. Recovering from this change in circumstances can be as difficult as recovering from any emotional disturbance the patient may be seen as having.

The parenthetic realm of rehabilitation can actually impede this process of recovery by removing the patient from the realm of significance. ‘Learned helplessness’ is a term that refers to the detrimental effects of long term hospitalization. At the end of a hospitalization, of any length, the patient sometimes enters a community treatment program that is often little more than a continuation of the ‘helplessness’ training the patient received in the state hospital.

Social security benefits and health insurance for the poor (Medicaid and Medicare), coupled with high recidivism rates, serve as disincentives for patients to seeking employment. Rehabilitation programs are often vastly inadequate while the adult patients within such programs are often treated like children. PACT teams have been assembled to help the needy, deemed incapable of doing so, take care of their basic needs. These factors can prevent patients from standing on their own two feet, and from attaining a measure independence from the community mental health system.

Replacing warehousing people in the state hospital with warehousing people in community treatment programs is not getting people back on their feet. We can and should do better. The goal of treatment must become that of getting people out of treatment entirely, and of reintegrating them into the community at large. When treatment providers get this aim of community reintegration back into their sights, overcoming this destructive paternalism that prevents such a development from occuring will have to become part of their objective as well.

Conclusion

Am I suggesting that the treatment can be worse than the disease? Emphatically, yes! We must be careful lest we waste any more money than we have already done on treatment programs that do more harm than they do good. Having lost sight of recovery as the objective of treatment–where it has been lost–we must regain this sight, and take the necessary steps to make its attainment a possibility.

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