Meds have use, but psychiatric system is fubar

Copy_Cat wrote:

Cheze2 wrote:So what happens is that person x can be admitted for something relatively minor, while person y waits until something very serious occurs

Why ? Insurance benefits. Title = "Psychiatric Coercion and Restraint " http://www.youtube.com/watch?v=2ifitvaIe7k Great comments by viewers.

Do you have insurance ? "No I don't" would be my awnser and then use it to pay the hosp bill later.

Cheze2 wrote:That was a little over the top. It makes the assumption that what may have occurred to one person happens to all people, which isn't necessarily the case.

Protracted_Fermata wrote:The nub of both of your crticisms is really that psychiatric remediation is relatively ineffective compared to other more successful branches of medicine such as general surgery. If psychiatry was able to produce full and permanent remissions in mental illness in all people with little or no adverse effects neither of you would be here moaning and complaining about psychiatry.

I would agree that psychiatric treatment is indeed relatively ineffectual, often a matter of hit-and-miss and the treatments are often fraught with adverse effects. I've been subjected to everything modern psychiatry has to offer: MAOI through to atypical antipsychotics, counselling through to bilateral ECT and I remain depressed -- my MDD is treatment resistant. Psychiatry has most definitely failed me. But reason and fairmindedness compels me to temper that conclusion with how others have faired with psychiatry and with the history of western medicine.

Many fellow depressives have benefitted from psychiatric treatments. I know that because they have told me and I have also witnessed remissions when I have been an inpatient. These people aren't on forums like this, they are instead living their lives so you never learn of their opinion. That is not to say that the treatments they received were not problematic, even when ECT produces a full remission it does produce temporary cognitive impairment which can be quite severe and maintenace ECT may be needed, so the cognitive impairment may continue.

So psychiatry is
(a) unable to treat all conditions equally effectively;
(b) unable to treat all people with the (apparently) same condition equally effectively;
(c) unable to offer treatment that has a favourable ratio of therapeutic benefit to adverse reaction for all patients and for all conditions.

Clearly we are far from an ideal psychiatry. But is there any good reason to claim malevolence or conspiracy in any of this? I think not. This isn't the first time in the history of medicine that a branch of practice has been inadequate. Consider venerology in the 16th C., that is, prior to antibiotics, antifungals and antivirals. The treatments for syphilis (http://en.wikipedia.org/wiki/Syphilis) were ineffective and harmful and it was a fatal condition. Mercury was a common treatment for syphilis from the 16th C. to the 18th C. (http://www.ncbi.nlm.nih.gov/pubmed/23485862) and they had no idea how congenital syphilis was acquired. The idea of microbes being a cause of disease did not become established until the 19th C. (http://www.im.microbios.org/0901/0901001.pdf) so the venereologists prior to that were groping in the dark. But they were operating at the limit of the science and technology of the day. What is the impediment to accepting that psychiatrists today are operating at the limit of science and technology?

The unsatisfactory state of psychiatry today is completely explicable with reference to available knowledge and technology. Postulating malevolence or conspiracy is -- in my view -- entirely superfluous. Also, implicit in these conspiracy theories is the strange notion that humans can and should know everything about everything now.

There is no super psychiatry somewehere on the planet that doesn't have deficiencies (a), (b) and (c). This is as good as it gets for the time being. The psychiatry that we have in the USA, UK, Australia and New Zealand is state-of-the-art, just as it was state-of-the-art to be injected with mercury in the 16th C. if you had syphilis. Eliminating deficiencies (a), (b) and (c) from psychiatry would produce a very high standard of remediation -- perhaps higher than that currently available from any other branch of medicine and this will eventually come. The history of medicine shows that we are slowly progressing towards more effective and less harmful treatments (treatments for STIs are a good case study) and this progress is also happening in psychiatry but admittedly it is happening quite slowly. But this does not entail that psychiatry (in the "Anglosphere") is "fubar". Yes, it is lacking, as were many branches of medicine and as some are today (eg. neurology). But iredeemably damaged? I don't think so.