Huston, we have a problem . . .

OIS-No doubt there is much to what you say-but I still have to say, it is mostly just the evil of today.

We`ve cursed and chased God out of our school rooms, our government buildings, our daily lives-then we cry out-My God, Why Hast Thou Forsaken Me?

Unless we see a MAJOR revival, and SOON, this country is on it`s last legs.

This, and may I also suggest more attention to encouraging folks to seek mental health care more than we are doing now? If these people would come in contact with a provider who at least halfway knows what they are doing, they would be contained and helped to the greatest extent possible, so that others may be protected as well. I don't know whether it is stigma, lack of insurance coverage, lack of employer support, or a combination of the 3 and more than that, but apparently lots of folks who REALLY needed mental health care never sought it or stayed in treatment...

Old Ironsights--I applaud you many times over for your advocacy and support of those battling mental illnesses!! You are so right about the meds--for many folks, long-term use of therapeutic psychoactive meds such as antipsychotics or antidepressants, as well as psychotherapy for many, allow them to lead at least a semblance of a normal life. I wish stupid insurance companies, including Magellan ( ) realized this and didn't hassle folks (and their providers!) who really need these meds and interventions on a long-term basis (let alone short-term basis for some companies!). It's not only crazy, it's discrimination, and it shouldn't be tolerated by anyone. The psychologists I work for are SO sick of and insulted by having their professional judgment constantly second-guessed by some uninformed insurance bean counter who wants to save a buck over caring for those who pump all kinds of money into the insurance company. I could go on forever...

That is a problem. There are things that the physicians just can't/don't see - because they don't live with the affected person.

Unfortunately, the way "patient information" works is so screwed up that if you tell the doctor about an episode or trigger, the doctor has to tell the patient that he was told & who told it, making the family member the "badguy". Yet the doctor is also prohibited from telling the family how to help the patient manage their illness... even thoug failing to manage it correctly could lead to a dangerous situation for everyone around the patient.

The system is crazier than the patients IMO.

Actually, we can communicate directly with the family if the client signs a release form explicitly stating that we can communicate regarding the client's case with family members explicitly named on the release form.

Sounds like you have a good clinic/office. We work through Madison Center up here in MC, which isn't bad, but we mostly do med management with limited counseling/analysis sessions.

I suspect a large part is also played by the diffculty in finding a trustworthy professional in the field. Not just in the mental health profession, but in most, it's difficult to sort through the phone book and find a plumber, mechanic, remodeler, or doctor who is really among the competent practitioners of that trade.

In some cases, some diligence can be applied by the shopper in finding referrals from former customers, but even with lots of diligence, that's harder to do with medical practitioners, and probably hardest of all with mental health professionals. I've heard all kinds of advice given to others while waiting in lines, about the best OB-GYN in town, or the best chiropractor, podiatrist, or pediatrician. Never heard any advice provided so casually about the best mental health practitioners to see.

I suspect, from the apparent number of failures and the number of successes after switching doctors, that the rate of competency must be similar in the mental heath field to the general medical field. Still that leaves the patient taking a stab in the dark to find the provider that they can trust to be capable of making things better, not worse. In many of those other fields, including other areas of medicine it's easier to tell fairly quickly if the medicine is effective, and the dosage correct. Trust must play a much more important role on choosing a mental health professional, I suppose. And the evaluation of that choice is often in the mind of a person with a tenuous grip on reality, at least at the time of need.

I suspect that most of us have found contacting professional organizations to be a disappointment in providing actual help in making such choices. They tend to support full anyone whose dues are paid up and who is not currently under indictment.

I have no idea what the answer is to this problem. Maybe you professionals can give some advice as to the choosing of a professional mental health provider. A lot of the resistance I've seen among troubled acquaintances who might have benefited from talking to a professional has been the perception that there a good many providers who took up the profession because they were so familiar with it, having been under a providers care for so much of their own youth. I'm confident that there are many very competent people in the field, and from the intelligence reflected in your posts and the fact that you're apparently balanced enough to be an outdoorsman, I'd trust your judgment on the matter to be more worthy than any other source I can personally think of.

So how do we select a good one, if you're booked up or too far away?

I agree with Russ. What about HI group rates for the anxiety following the close of deer season??? ;D ;D ;D

HIPAA and mental health has always been a bit of a stumper...

I mean, if you are mentally incompetent (by reason of medical disorder) how can you be competent enough to give permission?

Arrgh.