Rosalee -look at section on how IHT works. I state there ,that one of the differences between IHT and hospital treatment is that the environment factors are thoroughly identified. On my website there is a section on this with hyperlink to Dr Paul Polak’s papers-he was a pioneer in this regard
As for how psychiatry is practiced in Canada, I say this: in our IHT Hazelglen, I saw patients for one hour each time and in my private office practice I saw them for an hour each time usually.
I retired from full time practice in 2007. Since then I have noticed that it can be hard to get good psychiatric follow up with long appointments. There seems to be more of a shortage of manpower . Some psychiatrists still practice like I did -especially in their private office practice .
From the comments here , it is not clear to what degree the readers are speaking for themselves -ie they personally would not want to be a patient in an IHT service, and to what degree they are talking on behalf of all mental health service users- ie such services as IHT should not exist-for anybody- and MIA shouldn’t even allow such blogs to appear
If it is the latter, then it would behove the readers to familiarize themselves with the literature on IHT as it pertains to service user satisfaction, rather than just assuming all service users would think like they do
The research in England ( and it is almost all English ) shows overall , pretty good satisfaction; when there is dissatisfaction , it is often not with the IHT model itself, but with how a particular staff conducted themselves or when things did not run efficiently .
Common reasons for satisfaction were the holistic , relatively non-medical approach of IHT , the personal relationship with their assigned staff, practical help with daily problems , involvement of patient’s social network and family , and its flexibility . There are two papers about this on my website and other studies can be found early with Google.
Hazelglen had very high levels of satisfaction in a questionnaire
Like most things in life, there is likely a spectrum of opinions among service users about ” psychiatric treatment” ranging from complete rejection of it, to substantial acceptance. It looks like readers of MIA are very much universally at the complete rejection end. Service users who are generally accepting may be less likely to read sources like MIA i suspect .
Opinions likely vary country by country . I have no experience working in the US. In Canada one sees the usual range of opinions but in my experience over five decades is that there is pretty good acceptance of ” psychiatric treatment ” in the population . I wonder if managed care is a factor in service users dissatisfaction . I read about ” 15 minute med checks” that psychiatrists are apparently restricted to doing in some settings. In Canada, I am free to spend 45 -60 minutes with my patients – in which I will do counselling, prescribe medicine, discuss practical problems -anything that is required- all paid for by medicare
You are correct. Megan was a survivor of childhood abuse . Childhood abuse is a risk factor for a large number of mental, physical and social problems as the ACE ( Adverse childhood experiences ) CDC Kaiser Permante study showed . But Megan was not just an abuse survivor -( if she was I would have referred her to a local service for abused women); she had a serious mood disorder . So, in the same way that physicians have to treat the physical consequences of childhood abuse such as heart disease, they have to treat the psychological consequences.
Megan got help with her psychological problems , and she also got counselling for her abuse experiences – which- without our help in the first place would likely have not come to light
Privacy laws in Canada, especially as they apply to health care, are very strict. So, no, we would not share any information with anyone without the patient’s permission
As for the DSM,I am not a fan. I don’t find it useful and agree with most of the criticisms of it
If you have time, please click the link to the Dr Sahidharan video, that Sam ( comment just before yours ) mentions. This video conveys the ethos of home treatment . Responding to your question, it all depends on who is referring the patient to the home treatment service; it’s possible some referers may tell their patient that they will have to be admitted if they do not agree to home treatment. But we would not continue to treat that patient if they did not want it; it would be unethical and impractical. It is hard for me to convey what home treatment is like in such a short article. The patient experience is very different to hospital . Have a look at my website for articles that describe home treatment
I had hoped to make it clear in the blog that home treatment services are ONLY intended for people who agree to receive help in their home; that they have complete control as to whether they participate or not and can change their mind any time
Under ” How does home treatment work-” fourth paragraph, I say that” home” can mean a crisis residence; it can also include women’s shelters. Of course we would never arrange home treatment for someone abused in the home. I regularly visited patients in the local women’s shelter.
Sometimes- because home treatment actually discovers previously acknowledged abuse -as was the case with Megan
Rosalee -look at section on how IHT works. I state there ,that one of the differences between IHT and hospital treatment is that the environment factors are thoroughly identified. On my website there is a section on this with hyperlink to Dr Paul Polak’s papers-he was a pioneer in this regard
As for how psychiatry is practiced in Canada, I say this: in our IHT Hazelglen, I saw patients for one hour each time and in my private office practice I saw them for an hour each time usually.
I retired from full time practice in 2007. Since then I have noticed that it can be hard to get good psychiatric follow up with long appointments. There seems to be more of a shortage of manpower . Some psychiatrists still practice like I did -especially in their private office practice .
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From the comments here , it is not clear to what degree the readers are speaking for themselves -ie they personally would not want to be a patient in an IHT service, and to what degree they are talking on behalf of all mental health service users- ie such services as IHT should not exist-for anybody- and MIA shouldn’t even allow such blogs to appear
If it is the latter, then it would behove the readers to familiarize themselves with the literature on IHT as it pertains to service user satisfaction, rather than just assuming all service users would think like they do
The research in England ( and it is almost all English ) shows overall , pretty good satisfaction; when there is dissatisfaction , it is often not with the IHT model itself, but with how a particular staff conducted themselves or when things did not run efficiently .
Common reasons for satisfaction were the holistic , relatively non-medical approach of IHT , the personal relationship with their assigned staff, practical help with daily problems , involvement of patient’s social network and family , and its flexibility . There are two papers about this on my website and other studies can be found early with Google.
Hazelglen had very high levels of satisfaction in a questionnaire
Like most things in life, there is likely a spectrum of opinions among service users about ” psychiatric treatment” ranging from complete rejection of it, to substantial acceptance. It looks like readers of MIA are very much universally at the complete rejection end. Service users who are generally accepting may be less likely to read sources like MIA i suspect .
Opinions likely vary country by country . I have no experience working in the US. In Canada one sees the usual range of opinions but in my experience over five decades is that there is pretty good acceptance of ” psychiatric treatment ” in the population . I wonder if managed care is a factor in service users dissatisfaction . I read about ” 15 minute med checks” that psychiatrists are apparently restricted to doing in some settings. In Canada, I am free to spend 45 -60 minutes with my patients – in which I will do counselling, prescribe medicine, discuss practical problems -anything that is required- all paid for by medicare
Report comment
You are correct. Megan was a survivor of childhood abuse . Childhood abuse is a risk factor for a large number of mental, physical and social problems as the ACE ( Adverse childhood experiences ) CDC Kaiser Permante study showed . But Megan was not just an abuse survivor -( if she was I would have referred her to a local service for abused women); she had a serious mood disorder . So, in the same way that physicians have to treat the physical consequences of childhood abuse such as heart disease, they have to treat the psychological consequences.
Megan got help with her psychological problems , and she also got counselling for her abuse experiences – which- without our help in the first place would likely have not come to light
Report comment
Privacy laws in Canada, especially as they apply to health care, are very strict. So, no, we would not share any information with anyone without the patient’s permission
As for the DSM,I am not a fan. I don’t find it useful and agree with most of the criticisms of it
Report comment
If you have time, please click the link to the Dr Sahidharan video, that Sam ( comment just before yours ) mentions. This video conveys the ethos of home treatment . Responding to your question, it all depends on who is referring the patient to the home treatment service; it’s possible some referers may tell their patient that they will have to be admitted if they do not agree to home treatment. But we would not continue to treat that patient if they did not want it; it would be unethical and impractical. It is hard for me to convey what home treatment is like in such a short article. The patient experience is very different to hospital . Have a look at my website for articles that describe home treatment
Report comment
I had hoped to make it clear in the blog that home treatment services are ONLY intended for people who agree to receive help in their home; that they have complete control as to whether they participate or not and can change their mind any time
Report comment
Under ” How does home treatment work-” fourth paragraph, I say that” home” can mean a crisis residence; it can also include women’s shelters. Of course we would never arrange home treatment for someone abused in the home. I regularly visited patients in the local women’s shelter.
Sometimes- because home treatment actually discovers previously acknowledged abuse -as was the case with Megan
Report comment