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Seattle, WA

Over the past 50 years, I have seen mental health facilities shrink
drastically. Prescription drugs have become the overwhelming treatment of
choice, despite their limited efficacy for vast numbers of patients.
Prescriptions, written quickly by psychiatrists who are often only allowed a
few minutes with each patient satisfies the need to ""treat"" a patient. These
drugs have their role, but it is limited. Drugs are being used as substitutes
for inpatient treatment. Now, very troubled people are send out of inpatient
programs in a handful of days while they are still lost, bewildered, and
sometimes enraged. Many forms of person to person treatment have developed
over the years and have become quite effective, but public institutions eschew
such treatment. It is too expensive (and the person to person therapies don't
have the powerful lobbying of big pharm to help them out.) Thus, the helpful
but limited effect of psychotropic drugs, have become the main and often only
treatment offered. Only the well-to-do can get a comprehensive treatment
program.

We used to do much better than this. What went wrong? States are saving money
be not offering inpatient hospitalization. Insurance companies only offer a
pittance for psychotherapy. This is easy to get away with. The mentally ill
are not a large voting constituency; they don't organize. The real juice for
change has to come from a concerned citizenry.

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