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Wouldn't their interest be in the opposite? Wouldn't they want people to think that doctors have the answers rather than doctors failing at helping with mental

Wouldn't their interest be in the opposite? Wouldn't they want people to think that doctors have the answers rather than doctors failing at helping with mental health issues?

faeriechangling 3y ago
That would be in their interest, but being concerned about things like declining mental health metrics only happens if there is public pressure for the mental health field to be accountable by some sort of empirical measure. What I sort of wish people did more was hold the mental health field, from pharmaceutical conglomerates to individual practitioners, to some sort of standard. What we have now is either the field is succeeding because self-reported mental health is improving, or it’s succeeding because self-reported mental health is going down which means mental health AWARENESS is improving. I feel how the mental health field has spun things like gradually increasing suicide and drug addiction rates (proof of mental health underfunding!) has been broadly successful for the field. What I would like to see mental health practioners just start treating a patient population and for them to improve so dramatically that they discontinue treatment and live “normally”. Or maybe their lifespans measurably improve. Or suicide rates plummet. What I see instead is this sprawl of mental health services which are big on promises, big on “pro-awareness” rhetoric, and short on results at the societal scale.
- nradov 3y ago
  Every mental health drug on the market was approved based on improvement in some sort of metric. Measuring improvements in lifespan or lack thereof is impractical because it takes too long for any differences to become apparent in study populations. Suicide rates are also difficult to study because the baseline annual rate is very low even in mentally ill populations so that also requires large, long-term studies to see statistically significant effects. We generally have no way to cure the root causes of mental health conditions severe enough to qualify for an official DSM5 type diagnosis. Discontinuing treatment is often not a realistic goal, although in some cases patients can learn coping strategies which reduce the need for medication or frequent talk therapy sessions. This stuff is just fundamentally different from treating a medical condition like type-2 diabetes where there are clear biomarkers and results are often clear within months.

Wouldn't their interest be in the opposite? Wouldn't they want people to think that doctors have the answers rather than doctors failing at helping with mental health issues?

faeriechangling 3y ago

That would be in their interest, but being concerned about things like declining mental health metrics only happens if there is public pressure for the mental health field to be accountable by some sort of empirical measure. What I sort of wish people did more was hold the mental health field, from pharmaceutical conglomerates to individual practitioners, to some sort of standard. What we have now is either the field is succeeding because self-reported mental health is improving, or it’s succeeding because self-reported mental health is going down which means mental health AWARENESS is improving. I feel how the mental health field has spun things like gradually increasing suicide and drug addiction rates (proof of mental health underfunding!) has been broadly successful for the field. What I would like to see mental health practioners just start treating a patient population and for them to improve so dramatically that they discontinue treatment and live “normally”. Or maybe their lifespans measurably improve. Or suicide rates plummet. What I see instead is this sprawl of mental health services which are big on promises, big on “pro-awareness” rhetoric, and short on results at the societal scale.

nradov 3y ago
Every mental health drug on the market was approved based on improvement in some sort of metric. Measuring improvements in lifespan or lack thereof is impractical because it takes too long for any differences to become apparent in study populations. Suicide rates are also difficult to study because the baseline annual rate is very low even in mentally ill populations so that also requires large, long-term studies to see statistically significant effects. We generally have no way to cure the root causes of mental health conditions severe enough to qualify for an official DSM5 type diagnosis. Discontinuing treatment is often not a realistic goal, although in some cases patients can learn coping strategies which reduce the need for medication or frequent talk therapy sessions. This stuff is just fundamentally different from treating a medical condition like type-2 diabetes where there are clear biomarkers and results are often clear within months.