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> "Some of the help and therapy I eventually received was excellent, but as much as my recovery was supported by the NHS, it was also fuelled by my determinatio

> "Some of the help and therapy I eventually received was excellent, but as much as my recovery was supported by the NHS, it was also fuelled by my determination never to have to rely on it again." When I read this line, it hit home. I've been in and out of NHS treatment for years for other (not anorexia) issues. I never ever want to rely on the NHS again. They failed me so much I now avoid having to interact with anyone in the medical field. I deliberately avoid going to my GP for anything. Mental health care in the UK is so bad that you really wouldn't believe without first-hand experience. It needs to be scrapped and started again. I don't want to rant here on Hacker News too much (almost never comment) but this hit a nerve and I'm angry just thinking about the mental health care the NHS pretends to provide.

toomanybeersies 9y ago
People love comparing countries for their non-mental healthcare (physiological care?), but I never seem to hear about countries that actually have good, functioning mental healthcare systems. New Zealand has what could be described as a well-functioning (most of the time) healthcare system, if you break your arm, it's not a worry at all. But the mental healthcare system is a complete shitshow. It's an absolute disgrace, especially considering that NZ has the highest youth suicide rate in the world.
- klank 9y ago
  Perhaps it has more to do with us (i.e. humans) not having a deep understanding of mental health treatment? I mean, we really don't understand the mind very well at all. It's not just a clinical understanding either. We culturally approach mental health differently than other health. Get cancer and everybody rushes to your aid. Have anorexia and people ask questions about why we should pay for "self-inflicted" injuries (devil's advocacy couched, but still the question is posed). Thankfully the cultural stance is changing. It wasn't long ago that the question about "self-inflicted" injuries wouldn't have even had to be couched in devil's advocacy.
  - deleted 9y ago
    [deleted]
  - lickedydiff 9y ago
    I'm a clinical psychologist in the US, and it is a complete total shitshow, a combination of stigma and bigotry from outside the system, and self-inflicted nonsense from within. People misunderstand and have trouble thinking of mental health to begin with, so you end up with general attitudes of "people just have to pull themselves up by their bootstraps" or "just get over it," not understanding that the problem is often that people lack that ability. Other times it's just sheer lack of empathy for people who have had to deal with more difficult circumstances (or even just different circumstances). And then there's the recurring idea that behavioral sciences should just be like all the other sciences, or that it's not worth paying attention to because we don't have it all figured out like basic Newtonian physics. On the other side, within the field it's a mess too. There should be many more professional models, for example, and a lot more to offer, but territorial battles screw it over for everyone. Psychologists, for example, shoot themselves in the foot with bullshit licensing requirements for reasons I don't understand (maybe to appear more rigorous? to keep competition from entering the field?), requirements that are even more stringent than for MDs in certain ways. There's also no reason psychologists shouldn't be able to learn to prescribe--many people enter clinical doctoral programs with as much natural sciences as premeds, and leave having all sorts of neuro-genetic-chemical-physiology coursework and research experience, often more than MDs in the area of neurobehavioral sciences per se. But psychiatrists bristle at the competition, and certain segments of psychologists want to control the field with their romanticized idea of what psychology "should be," again, for reasons I don't understand. On top of that, there's various trends in treatment that have led to screwing clients over, to put it bluntly. I can't tell you the number of times I hear colleagues (not all, but a sold number) argue that treatment should be limited for its own sake, to prevent dependency or to encourage change. Sometimes that's true, but you wouldn't say that a cancer patient in need of treatment should have their treatment stopped just to teach them a lesson. And drugs are great for some people, but not for others, and in general, the administration of those drugs has become divorced from any kind of real monitoring of peoples' situations. Add to that the fact that many people's problems derive from the collapse of societal safety nets, which also means lack of funding for mental health services, and, well, you get the point.

toomanybeersies 9y ago

People love comparing countries for their non-mental healthcare (physiological care?), but I never seem to hear about countries that actually have good, functioning mental healthcare systems. New Zealand has what could be described as a well-functioning (most of the time) healthcare system, if you break your arm, it's not a worry at all. But the mental healthcare system is a complete shitshow. It's an absolute disgrace, especially considering that NZ has the highest youth suicide rate in the world.

klank 9y ago
Perhaps it has more to do with us (i.e. humans) not having a deep understanding of mental health treatment? I mean, we really don't understand the mind very well at all. It's not just a clinical understanding either. We culturally approach mental health differently than other health. Get cancer and everybody rushes to your aid. Have anorexia and people ask questions about why we should pay for "self-inflicted" injuries (devil's advocacy couched, but still the question is posed). Thankfully the cultural stance is changing. It wasn't long ago that the question about "self-inflicted" injuries wouldn't have even had to be couched in devil's advocacy.
- deleted 9y ago
  [deleted]
- lickedydiff 9y ago
  I'm a clinical psychologist in the US, and it is a complete total shitshow, a combination of stigma and bigotry from outside the system, and self-inflicted nonsense from within. People misunderstand and have trouble thinking of mental health to begin with, so you end up with general attitudes of "people just have to pull themselves up by their bootstraps" or "just get over it," not understanding that the problem is often that people lack that ability. Other times it's just sheer lack of empathy for people who have had to deal with more difficult circumstances (or even just different circumstances). And then there's the recurring idea that behavioral sciences should just be like all the other sciences, or that it's not worth paying attention to because we don't have it all figured out like basic Newtonian physics. On the other side, within the field it's a mess too. There should be many more professional models, for example, and a lot more to offer, but territorial battles screw it over for everyone. Psychologists, for example, shoot themselves in the foot with bullshit licensing requirements for reasons I don't understand (maybe to appear more rigorous? to keep competition from entering the field?), requirements that are even more stringent than for MDs in certain ways. There's also no reason psychologists shouldn't be able to learn to prescribe--many people enter clinical doctoral programs with as much natural sciences as premeds, and leave having all sorts of neuro-genetic-chemical-physiology coursework and research experience, often more than MDs in the area of neurobehavioral sciences per se. But psychiatrists bristle at the competition, and certain segments of psychologists want to control the field with their romanticized idea of what psychology "should be," again, for reasons I don't understand. On top of that, there's various trends in treatment that have led to screwing clients over, to put it bluntly. I can't tell you the number of times I hear colleagues (not all, but a sold number) argue that treatment should be limited for its own sake, to prevent dependency or to encourage change. Sometimes that's true, but you wouldn't say that a cancer patient in need of treatment should have their treatment stopped just to teach them a lesson. And drugs are great for some people, but not for others, and in general, the administration of those drugs has become divorced from any kind of real monitoring of peoples' situations. Add to that the fact that many people's problems derive from the collapse of societal safety nets, which also means lack of funding for mental health services, and, well, you get the point.