Mental health in primary care

magicherbs

First of all I'd like to point out I'm not a Doctor or Mental Health professional, nor am I a patient of these services. However, I would like to ask the questions:

Why is mental health so badly managed in primary care (and probably every level of care) in Ireland?

It seems that the average GP has this kind of primitive understanding that the current popular SSRIs and to a lesser extent the TCAs are some kind of magic herbs, that work in an unknown way and eventually benefit people with all types of depression. Is there really such a scant evidence based or understanding of the processed underlining them?

I am really just so surprised that people that appear to have such mild depressive symptoms seem to be hoofed onto the magic pills so suddenly. You pop up to the gp on the monday, complaining of being tired and moody, hating your self, and he gives you a a bag of lexapro and asks you to come back in a few weeks for more.

Would you get away with that if you had a dodgy heart? Here, let's have a quick listen, here you go , magic pills come back in a few weeks for more.

Okay okay, we'll let the GPs away with it, they are excellent at the sore backs and the sore throats and the swabs and the babies. But surely the psychiatrists would know better...

Ok they've done their medical degree, worked in a hospital for a few years and decided it's for them, take a couple of years training, develop expertise, become really skilled and take over.

That's what you'd think. What you really get are these people who should never have done medicine, who don't enjoy it and chose pysch as the only way out of it but keeping their big salaries. They are generally work shy, don't like taking patients on, don't like treating patients and generally hate their jobs. Is it true psychiatrists have the highest suicide rates of all doctors?

Ok they're not all like that, there must be some exceptions . But what do you get? You seem to basically get three archetypal pyschs. The guy that dismisses pharmaceutical treatment of all kinds and prefers pyschological methods, but when questioned, they seem to cascade into other magical practices like homepathy and angels and demons and acupuncture. People that think Schizophrenia is just a construct of bad nutrition and lack of exercise and think talk therapy will help them through.

Then you have the higher order Wizards. The guys who could write a 100 page essay on every drug on the market, who swears by them and insists there's a pill for every ailiment. They'll tell you about GABA and 5-HT and Dopamine and this and that and everything inbetween. They'll take patients and sedate them up to their eyeballs.

The final sterotype seems the gombeen witch doctor, who wants to cure illness with fire and brimstone. Feeling a bit depressed? How about an ice pick to the pre-frontal cortex? Feeling a bit psychotic ? About 10000 volts of electricity? Social conduct disorder? how about a lobotomy?

i think they're going to look down on us in a 100 years and think this was really the dark ages of mental health. No society. No culture. No treatment. just crowded masses of mentally unwell being treated in an entirely haphazard way.

How many GPs have heard of the biopychosocial model? how many think it isn't complete bollox? how many are trained in psychotherapy ? how many think their counselling skills are already the best in the business? how many psychiatrists are in the same boat? How much psychology is done in medicine? how much is done in pyschiatry? Is it needed? How much of pyschology is more under-qualified quackery? saying the rosary via Freud?

I think the slogans are 'seek help' if you have mental illness, has anyone assessed the quality of the so called help ? there's a clinical audit for ya.

RobFowl

I think this is fairly low level trolling and am closing it.
If the OP has a convincing argument to reopen it they can PM me.