My Mental Health Care on Base: A Perfect Storm

Sarah Davies Photo

Sarah Davies, Families for Depression Awareness Volunteer

I like to think that my issues with the mental health care on our Army post are the result of a perfect storm. I live with Bipolar II, which I know how to self-regulate for the most part. There are times, however, where either I know I need to check in or my primary care manager (PCM) recommends a visit. At our current duty station, I have seen both a psychiatrist and psychologist at the recommendation of my PCM. Both visits have left me wanting better care. The psychiatrist put me on an anti-depressant, which is contra-indicated for Bipolar as it can spin me into a manic state (which it did). I stopped taking the meds and asked to be seen by a psychiatrist to figure out a self-care plan without medication. I saw him one time—during which he allowed me to speak for maybe five minutes out of an hour. He asked for my background—during which I mentioned my college education—and he went off on a tangent about a woman he dated that went to my alma mater and how attractive the women there seem to be. My lack of confidence in his ability to listen to me, his one job, kept me from returning.

I mention all of this because I believed my bad experiences were just a result of those doctors not listening to me; like I said, a perfect storm of incompetence that I was unlucky enough to be part of. When I said that to my husband, he countered my assessment. It’s just a regular storm. It’s what too many spouses and service members face when they go to mental health [services].

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In Honor of Veterans Day, Here’s How Our Servicemen and Women Can Get the Mental Health Help They Need

Michelle Kees Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this post.

Michelle R. Kees, Ph.D., University of Michigan

On November 11th, our country will pause to celebrate a courageous, resilient group of men and women—our nation’s Veterans. In the words of the U.S. Department of Veterans Affairs, Veterans Day is a day to honor these heroes for “their patriotism, love of country, and willingness to serve and sacrifice for the common good.”

As they return home from foreign conflict, these men and women deserve to succeed and thrive in their civilian lives, but may need physical, mental, and/or emotional support in order to do so.

On this important holiday, we wanted to share information about some of the challenges Veterans are facing as they make the transition to life at home—and the programs that are in place to help them.

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Decision Aids Can Be Developed to Successfully Support Shared Decision Making in Clinical Encounters

Juan P. Brito Campana, M.D, MSc. Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this post.

Juan P. Brito Campana, M.D, MSc.
Annie LeBlanc, Ph.D.
Mayo Clinic Knowledge and Evaluation Research Unit (KER)

As recent CFYM posts have indicated, shared decision making (SDM) is good for patients, doctors, and the system itself. But if we want SDM to become the norm in exam rooms nationwide, we have to support clinicians by giving them the means to make it happen.

We can do this by providing tools that allow physicians to communicate effectively and engage in meaningful conversations about their patients’ preferences, needs, and values.

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Patients Need to Be Involved in Policy-Making

Photo of Tony Coelho

Tony Coelho, former Member of Congress, author of the Americans with Disabilities Act, and lifetime disability advocate

Since the age of 16, I’ve suffered from seizures. I’m now 74 and six decades of experience as a patient has taught me a lot about the healthcare system. I’ve seen firsthand how it’s evolved to suit the financial interests of the most powerful players and often ignore the needs of patients.

Unfortunately, many of the decisions that affect patient care are made at the policy level, often by bureaucrats with little or no clinical experience. When decision-makers ignore the patient perspective — including individual exam room experiences — care can become sterile, mechanized, and ineffective.

In order to create a system that better treats patients, we need legislators and decision-makers to create laws and regulations that value and support patient input. By bringing patients to the policymaking table, we can create a stronger healthcare system that addresses the needs of the individual and ensures more effective care for everyone as we move forward.

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Mental Health and the Presidential Election

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Julie Kornack

Editor’s note: We received this post from an author who supports Hillary Clinton for President. CFYM extended an invitation to the Donald J. Trump for President campaign to submit a statement of the candidate’s positions on mental health care, but received none. Please see the note below the article for more information.

Mental health should be a nonpartisan issue; it affects nearly one of every five adults across all demographics. Each of us surely knows someone struggling with depression, schizophrenia, addiction, or another all-too-common condition. Why would there be two sides to the proposal to give people access to mental health services?

In my job, I have spent years working with both Republicans and Democrats to increase access to treatment for individuals diagnosed with autism spectrum disorder, and I have been fortunate to experience a great deal of bipartisanship. Ever since the passage of the Affordable Care Act (ACA) in 2010, though, access to health care has become a hotly-politicized issue, with the very people who are most helped by the ACA often being the most vocal opponents of it, duped by the Republican Party to act against their own self-interest. When presidential candidates float health care proposals, they get my attention because – in a world with few sure things – this is what I know for sure: this election will change your health care.

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Why Shared Decision Making Should Apply to Informed Consent

Erica Spatz Photo

Based on an interview with Erica S. Spatz, MD, MHS,
Assistant Professor of Medicine, Yale School of Medicine

Imagine that you’re about to be wheeled into surgery. You’ve fasted for 24 hours, you’re in a hospital gown, and you’re awaiting the doctor’s arrival. Then the nurse brings in some paperwork, and you’re asked to sign a form acknowledging the risks of the procedure. You see some potential side effects or consequences that concern you—but at that point, how likely are you to refuse the procedure?

For many patients, that last-minute signature is the only experience they have with informed consent. Legally, however, informed consent is defined as the process in which a patient learns about and understands the purpose, benefits, and potential risks of a medical or surgical intervention.

In my view, that discussion should begin long before surgery day, so a patient has time to balance the risks and benefits before moving forward with a decision.

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Telemedicine Can Help Solve Our Mental Health Care Crisis

Photo of Matt Mishkind

Care for Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this post.

Matt Mishkind, PhD, Rachel Griffin, APN 

In the age of the smartphone, communication is easier than ever. We have face-to-face conversations with people thousands of miles away and access information with the swipe of a finger. And this amazing technology isn’t just for playing Pokemon Go or posting to Facebook—it has the potential to change the delivery of mental health care in this country.
With Skype and other teleconferencing software available on every smartphone, tablet, and computer, telemedicine has become an important industry. By using technology to connect a patient and a provider at a geographic distance, telemedicine can expand access to care for underserved communities, make treatment more convenient for patients, and improve efficiency across our healthcare system.

For thousands of patients in need of mental health care, from veterans to elderly patients to those with disabilities, tele-behavioral health can offer a life-changing solution.

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Insurance Coverage Doesn’t Guarantee Timely Access to Care

Picture of Simon F. Haeder

Simon F. Haeder, Ph.D.
Assistant Professor of Political Science, West Virginia University

With a national shortage of healthcare providers and insurance companies continually seeking to contain costs, it’s no secret that networks are shrinking. And as more patients opt into Affordable Care Act plans, there’s a lot of chatter about whether patients with marketplace plans (most of whom are lower income and rely on subsidies) face restricted access to care.

But when it comes to actually comparing these new marketplace plans to traditional commercial plans, there’s not much in the way of data. So, my colleagues and I decided to conduct a secret shopper-style survey of 743 primary care providers throughout California.

Our findings were revealing. While there was little difference between commercial and marketplace plans, both performed poorly. Less than 30% of patients—for both plans—were able to get appointments with the primary providers of their choice.

The research proved insurance coverage doesn’t necessarily guarantee timely access to care. In order for our healthcare system to improve, we must start giving patients accurate information and adequate networks so they can access the care they need and deserve.

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