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Post by Admin on Jul 19, 2016 15:57:58 GMT -4
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Post by Lauren Eppert on Jul 19, 2016 21:23:25 GMT -4
Just three days into my clinical rotation, the need for psychiatry within our general population and world is extremely evident. Patients are constantly bustling in and out of the waiting area and exam rooms, each with their own personal backgrounds, misfortunes, highs and lows, and stories to share with their respective medical provider at PACT Atlanta. It is extremely saddening to learn that the opportunity for people to obtain treatment for mental health disorders is rare and becoming less available. As society allows psychiatry to move into a positive light within the health care network, the accessibility grows further away. Unfortunately, I cannot provide a solution to the misfortune, as copious amounts of funding and extensive interaction with people who may not understand the importance of the field proves necessary. At this point, as health care professionals and citizens of our city, county, country, and world, I believe that we all we can do is continue advocating for the field. Since psychiatric help and therapy may not ever be accessible for all, I hope that we as students each take these statistics and use them as a reminder of the importance of empathy, counseling, and “taking the extra second” to enrich our patient visits, despite the field of medicine we enter in the future.
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Raghda Al Anbari (MS4)
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Post by Raghda Al Anbari (MS4) on Jul 19, 2016 21:25:24 GMT -4
Ideally, psychiatrists are working so hard to treat and avoid mental health crises. But they do occur and require effective interventions to alleviate their consequences. The word “crisis” is almost identical with terrible outcomes characterized by a devastating loss of control and an unexpected disruption to the natural order of things. Interesting thing to know that “crisis” is actually derived from the Greek word meaning “decision” so really mental health crises have the possibility to turn into recovery if appropriate decisions are made and response plans are in place. The probability of positive outcomes is greatly higher by the presence of supportive acute mental health services. Official organizations are facing a number of difficult decisions in attempting to redirect the mental health system away from crisis-oriented care toward a system that optimizes consumer health and functionality. Efforts to build a more community-based system will be challenging. Some researchers believe that the “old” system serves as a help, delaying investments in new approaches. Others believe that stabilizing inpatient psychiatric bed capacity in the short-term is critical, given that community-based programs may take time to develop. The degree of breakdown in mental health services aggravates these tensions and suggests that the transition to a community-based model will not be smooth and for that reason we are seeing a lot of challenging to these changes, some include, but not limited to acutely ill patients wait days or even weeks for a psychiatric bed to open so they can be admitted; some eventually are released to the streets without treatment. In the absence of needed treatment and care, individuals with acute or chronic disabling psychiatric crisis increasingly move to hospital emergency departments, jails and prisons. These situations impact negatively as a result. This also will contribute to a number of costly and sometimes dangerous social problems, including jails and prisons overcrowded with patients who are acutely ill and untreated, emergency departments overcrowded with patients in psychiatric crisis, increased homelessness, and increased violence. In some communities, this will cause the hospital emergency departments to be so overcrowded that ED visits from individuals with mental illness is badly affecting access to emergency medical care for other patients, causing longer wait times, driving patient frustration, and limiting the availability of beds to other emergency conditions. We need to call for a suspension on further public hospital bed closures until a sufficient number of psychiatric beds for acutely and chronically ill individuals is available either in state hospitals or community facilities.
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Post by David Vu on Jul 19, 2016 22:40:14 GMT -4
This article echos the sentiment of an article we had a few weeks back. Bottom line is we simply lack the funding. The grand idea of reducing beds and sending off these mentally ill patients into a more social or out patient setting is fine but they forgot the other end of the agreement where they were supposed to have increased the funding for the out patient setting. It creates the problem that we see is directly correlated. These mentally ill are then institutionalized not in the hospital setting but the jail cell instead. The only way we can correct this problem is to reverse this trend, spend the money, and like anything else in the world right now, make it known.
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Post by Heather Le on Jul 19, 2016 23:13:51 GMT -4
As we know, there has always been a shortage for doctors - and there is most definitely a shortage for psychiatrists. However, even if we were to increase the number of psychiatrist that doesn't necessarily mean that in return there will be an increase in bed in order to provide adequate care for those who need it - low funding will always be a problem. With that said, there needs to be a solution especially, since careful screening is being done more meticulously for under diagnosed patients. Once they are correctly diagnosed, this may further our shortage of beds.
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Post by Ali Alizadeh (MS4) on Jul 19, 2016 23:44:54 GMT -4
A prevalent theme, which as previously discussed in past articles, has been a major issue since the era of JFK. In theory, “deinstitutionalizing” in favor of community-based treatment options is an ideal worth striving for. The great difficulty lies in our dynamic, ever-shifting political/socio-economical system we have in place were obtaining funding is nigh impossible. It has become that clear that action is rarely taken preventively in most matters regarding the state until it becomes a full-blown crisis. With deinstitutionalizing w/o proper funding for viable outpatient care settings, a bottleneck is created, leading to the aforementioned crisis. Despite this lack of progress, we as members of the medical community we can do our part to further educate the general public and those around us to the multiple facets of mental illness. Demystifying behavioral health illnesses is a vital step, along with supporting program funding, in what will prove to be a very long and difficult road ahead.
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Post by Jamila Pham on Jul 19, 2016 23:47:46 GMT -4
It’s a shame that the amount of beds are being cut from the psychiatry department. Psychiatric issues are just as important if not more urgent than many different medical problems. Decreasing the size of inpatient setting to favor an outpatient treatment could be a possible answer to help people with mental illness, but another issue that needs to be addressed is how is the patients going to pay for this treatment? Many people aren’t getting the help they need because they don’t have the means for their treatment and many insurance companies do not cover mental health. This issue leads back to the problem of funding. Our resources are being cut dry and this leads to the consequences of many people not being able to get the help they need to receive.
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Post by Jshammaa on Jul 20, 2016 1:39:39 GMT -4
11.7 beds for 100,000 people. Wow. We already discussed the fact that many people can profit from being institutionalized and some can profit from getting medical treatment not necessarily being afflicted by a purely psychiatric condition. Some people just need to get out more and play Pokemon Go, without getting hit by a car or falling off of a cliff. The majority of the people needing these beds in these institutions are not in these beds by choice. Outpatient treatment is good, but for the manic bipolar patient who feels great and decides that he or she doesn't need medication, jail is most likely where they will end up. The jails of the United States are already full and are only getting fuller, the beds available for people with psychiatric needs are full and people who are capable of hurting others are roaming around freely. Some of these people are probably keeping to themselves and some are trying their best to be a contributing member of society. Where did the government go wrong? Did profit and greed of jail owners in this country get too greedy? Have hospital owners decided to cut back on certain services due to government actions with the recent healthcare reform? These are questions which could lead to very interesting debates, but I digress. I do believe that reform should be applied to Medicare and Medicaid at the very least to fund and help people get the help they need and for as long as they need it. And at the very least, the numbers of these beds should be increasing. I hope the $75 Million demonstration project started by the Affordable Care Act expends the funds necessary to continue to fund the program for another 3 years and many more hereafter. If the participating states have collected data demonstrating that it has been helping, more states should get involved and take on this endeavor to increase inpatient treatment facilities.
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Post by Jose Lobo on Jul 20, 2016 10:05:27 GMT -4
The decline in psychiatric beds in hospitals is becoming a problem. As our population grows more each and life spands increase, the prevelance and incidence of mental illnesses can only increase with time. Meaning we will need more hospital beds. Although, funding such beds can become difficult, the government needs to find a solution to this problem. There are many people who are in need of proper treatment, and in country where we believe is the greatest and richest, it is extremely sad that we can not manage our health care accordingly, especially to those psychiatric patients in need.
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Post by Anjani Singh on Jul 20, 2016 17:11:19 GMT -4
This article basically states that shortages of funds truly make a difference. Things like Medicare and Medicaid, insurance companies as a whole, are taking over the practice we all call medicine. If funds are not there, patients cannot get the adequate care they need. It is quite unfortunate that it has come to this. Besides funds, psychiatry seems to have a lower priority in other’s minds, including insurance companies, so they hold lesser value for further treatment, including an inpatient treatment setting. With these kinds of mindsets, patients will not only be able to receive worse treatment options, but they will unwilling to get better because it seems like everything, including these kinds of systems such as stigmas or insurance companies, do not even want them to get better due to such shortages of beds and funds provided. The last sentence of the article stating that compassion is what is needed to care, is 100% correct. If there was more emphasis on compassion and wanting to do right by the patient versus getting funding, this issue would not be an issue. This was an enlightening article and I think that everyone could learn the value of treatment and patient care from it.
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Post by Sarah Weber ms3 on Jul 21, 2016 10:00:58 GMT -4
Deinstitutionalization was intended to allow psychiatric patients to be cared for by support programs within the community. While the plan had been to allow patients to integrate into their communities and escape the isolation of an institution, the support programs to allow this process rarely appeared. Families often took on the burden of caring for patients full time, and I wonder if the move to deinstitutionalize increased the number of psychiatric patients who now also suffer from homelessness, which contributes to mental illness.
One of the arguments in favor of deinstitutionalization was that facilities were inhumane. Some were and some weren't, but I imagine the idea that all facilities were cruel has contributed to the stigma that follows psychiatric patients today, especially if they are fortunate enough to find an inpatient bed when they need one.
I think one of the things I find most concerning about this article is the fact that while there have been trial programs to increase the number of beds, there was no money to study the effect of the increase. This lack of data will make justifying the expenditure of money difficult, while evidence that increasing inpatient capacities was good for the community as a whole might have motivated states and communities to buy in to similar efforts. I hope that this experiment in increasing the number of beds does not end the way deinstitutionalizing did- with patients falling through the cracks, and little information being collected on its effects.
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Post by naqitaalexander on Jul 21, 2016 12:21:57 GMT -4
An underlying issue which has been dominant in more than one of the articles posted is the stance of the following: "deinstitutionalizing mental illness in favour of outpatient treatment" - has this been effective? does this approach remain effective in all psychiatric cases? Does this negatively impact patients who actually require in-patient care or rehabilitation?
In saying this, more often than not in my experience even at PACT Atlanta it has become evident that providing in-patient care to individuals who may benefit from it, is not only a costly exercise but puts a strain on an already insufficient resource in terms of bed capacity. Just merely glancing at the numbers where, "fallen by 17 percent since 2010 — from 43,318 in 2010 to 37,559 this year" means that this is a genuine concern to a growing population. Furthermore, "That has left just 11.7 beds per 100,000 people, far below the count in other developed countries" which essentially indicates to me that the execution of effective health policy has been unsuccessful to this point. Not only will this influence the well being of patients in the near future but it will also limit healthcare professionals who seek the best possible treatment outcome for the patient.
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Post by Fenil Patel on Jul 21, 2016 14:44:28 GMT -4
This article similar resembles the previous read we had. Seems like this is all because of lack of enough funding for the mental illness treatment. However, even if we were to increase the number of psychiatrist that doesn't necessarily mean that in return there will be an increase in bed in order to provide adequate care for those who need it. t has become that clear that action is rarely taken preventively in most matters regarding the state until it becomes a full-blown crisis. The degree of breakdown in mental health services aggravates these tensions and suggests that the transition to a community-based model will not be smooth and for that reason we are seeing a lot of challenging to these changes, some include, but not limited to acutely ill patients wait days or even weeks for a psychiatric bed to open so they can be admitted; some eventually are released to the streets without treatment. The only way we can come up with the solution of this problem is to actually invest in this psychiatric mental health condition and bring more beds for the proper treatment.
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Post by Prashanthi on Jul 21, 2016 15:12:21 GMT -4
Given the continuous rise in mental illness, it is alarming to see the amount of decreased attention that mental health institutions are receiving. Hopefully, the 75 Million Dollar allotment to address these issues carefully assess and prioritize the crucial needs for basic human health care. This is yet another example of the lack of emphasis that is placed on the seriousness of mental health issues. With a better understanding, a heightened public awareness may help raise further funding as mentioned in the article. Compassion is crucial in understanding any type of suffering and with more donations and contributions hopefully the alarming rate of 11.7 beds/100000 patients will be solved, if not improved.
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Gabrielle Givens, MS3
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Post by Gabrielle Givens, MS3 on Jul 21, 2016 16:43:08 GMT -4
I believe that this article relates back to the article a few weeks ago that touched on the fact that many people are not able to get the psychiatric help that they deserve. With the number of beds reaching a historic low at psychiatric facilities, you can directly relate this to the dwindling psychiatric care in our country. The patients are the ones who will suffer the most from this change. This will cause many facilities to discharge patients sooner than what is best for the patient just in order to free a bed. I know just in my short time in this rotation I have heard of several cases where a patient could have benefitted from a longer stay at a psychiatric facility, but was released. Our country needs to understand how important psychiatric care is in order to address these needs, such as less beds in psychiatric facilities and dwindling facilities for psychiatric care period.
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