(no subject)

[threeplusfire]

I am trapped at work, tired and hungry. Arguing with APS workers over who has jurisdiction over a suicidal mentally retarded man is stupid if you ask me. Listening to hysterical people berate me, question my intelligence, insult me and generally be insane is not my idea of a good Saturday. At this point, I would rather be talking to the schizophrenics from the state facilities about their CIA implants, the devil and the cancer that the doctors put in their psych meds. Anything has to be better than this nonsense.

Comments

Re: APS worker

[tsarina.livejournal.com]

APS is a government agency actually, run by the state and supported with federal funds. With any sort of government agency, nothing is ever entirely perfect but most all of the APS workers I know bust their asses out there in the field.

In addition to abuse by family or caretakers, APS also handles issues that we call self-neglect. A person who can't afford medications, or is living in substandard conditions, a person who isn't managing their mental illness and placing themself in dangerous situations, etc.

Re: APS worker

[genus-loci.livejournal.com]

Yes I agree with you - as a government agency there is only so much they can do because of budgetary and political constraints.

Regarding people who can't afford medications (or healthcare) - that rarely exists here. 75-80% get free prescriptions (most of the rest are entitled to it free but just can't be bothered making a claim). Healthcare is free to everyone here (we borrowed money from the Americans decades ago to bring that about).

or is living in substandard conditions, a person who isn't managing their mental illness and placing themself in dangerous situations, etc.

There are very few cases of substandard housing over here. Regarding mental illness - in many respects it's the Cinderella of the National Health Service regarding funding. Similar cases also vary considerably in how they're dealt with depending on how well a patient/carer can manipiulate the system to give the required results. Regarding management of mental illness - it's a tricky ethical area. Often people with mental illness are seen as dangerous by others merely because of unexpected behaviour (eg arrested by police because of behaviour attributable to their mental health condition).

People who have contact with mental health are supposed to (ha!) be followed up regularly. However, until we move on from drugging mentally ill people or forcing them into hospital the world isn't going to change.

Thankfully the world however has moved on a bit from the days when people with epilepsy were locked up in hospitals because they were seen as being mad. However care in the community (the current lower cost policy) has its downsides as a successful outcome partially depends on a lot on appropriate involvement by professionals eg nurses, social workers, voluntary & community bodies etc.

This can only be done with the cooperation of the person involved.

Which behaviours would you put under the umbrella of self-neglect? Would you class neurological conditions eg epilepsy, autism, Aspergers etc as coming under mental health or not?

Re: APS worker

[tsarina.livejournal.com]

As far as the issue of self mental health neglect - I'm referring to situations in which people are doing things that are dangerous or harmful. Wandering in traffic naked, assaulting a neighbor with rocks and cans on food after accusing the neighbor of being with the CIA, holing up in the house with dead rotting animals, malnutrition brought about because of delusions of poison in food - these are examples of situations we have dealt with. Most often the situations we are see are when people go off their medications or begin abusing drugs/alcohol as a way to handle their illnesses.

Epilepsy is not classified as a mental health condition, nor are most other seizures. Autism, and Aspergers would fall into our spectrum of mental health and mental retardation because they are conditions that directly impact a person's cognitive abilities. (I am not a medical professional, for the record.)

Re: APS worker

[genus-loci.livejournal.com]

Ahh the threshold of what is dangerous/harmful is much, much lower here. I'll give one example - bipolar patient visits his daughter who works as a teacher at a school - takes along a camcorder with him so ends up arrested. That's more of a perception of danger thing though because it was a school.

Regarding people who are not taking their medications eg not complying? How can you be sure that a) it isn't a misdiagnosis and b) they're on the right medication in the first place? Oversight of doctors by other health professionals isn't really done particularly effectively as it requires medical expertise. Often things are prescribed by accident that are specifically contraindicated in patients and end up making them ill or in severe cases dead - sometimes through temporary, inexperienced doctors whose mother tongue is not English.

A patient won't continue to take medication that makes them worse or has lots of undesirable side effects and you can't force people to take medication. A few bad experiences with doctors can turn people with a mental health problem away from the system itself.

Regarding drugs - it's a problem that's very difficult to solve.
Alcohol is unfortunately what a lot of people abuse when they face problems in life (I had a neighbour who was an alcoholic for many months as well as a father who drank too much when I was younger). Some people don't like accepting things and have a hard time coping.

Autism and Aspergers used to fall under mental health here too - but now it goes mainly under neurology.

The problems with the drug abuse (which are many) often escalate when a person starts stealing from others in order to fund their habit.

There is a big overlap between epilepsy and autism. About 25-33% of people with autism are epileptic, 6-7% of people with Aspergers (at least from what I remember).

Epilepsy is also associated with a greater risk of certain mental health conditions too (other than autism/AS).

Anyway, I'll stop writing now, before I veer into specific case studies again or get too political about the topic. :) Don't worry I can tell you're not a medical professional by the way you write about the topic. You have plenty of experience in this area though - which makes you better informed on the topic than a lot of doctors are & the public at large.