Ask HN: How do you seek mental health help voluntarily?

2 points by cloudedcordial 3y ago ↗ HN

Have anyone seek mental health treatments voluntarily? If yes what prompt you that you are the one suffering? During this day and age in Canada, the government cannot force anyone to receive treatments or to enter a mental health facility. One must realize that they are suffering from a mental health issue and seek help.

On one hand, two of my mom's friends realized something was off on their end: They became extremely anxious to be by themselves at home and/or could not function properly in their daily lives such as getting out of the bed. They went to their family doctors who transferred them promptly to the specialists. They knew that the prescription medication and the therapy have been helping them. In addition, they spoke to their friends such as my mom that mental health illness is real.

On the other hand, one of my friend's acquaintance has not been unable not keep a job, has shown some delusional behaviour and had anxiety outbursts. My friend could not convince this person that, for example, they were the only one who "saw a person behind the garden gate." They mentioned how someone have been following them. Lastly, they also mentioned how "their family locked her up in a mental health facility" but they signed the papers, left the facility and stopped taking the medications.

My friend and I called the local health unit's mental health hotline looking for ways to help this person. The advice given to us was that we could only guide this person to go to a doctor voluntarily. Forcing someone to receive treatment would increase the trauma. Call 911 only if the person becomes a threat to someone's lives.

We felt powerless as we saw their decline over the last 10 years. We saw how the only way to get them to a hospital has been something that qualify for an emergency 911 call.

Nomentatus 3y ago ↗

Very, very sorry to say this is where we are in Canada, and have been for some time.

Very often brain damage (of whatever kind) is precisely what prevents people from realizing they have brain damage, and addressing that (in whatever way.)

We allow drug users to continue to damage their brains; and mental illness to spiral far out of control (often into substance abuse.)

The old way was lousy too, for what that's worth: idiot gatekeepers often locked up in institutions those who didn't belong and treated them very badly.

retrac 3y ago ↗

Many jurisdictions in Canada have mental health crisis teams now, intended to cover this particular gap. At least in Ontario, someone who is exhibiting an on-going degeneration of ability which is interfering with their ability to care for themselves counts as "a danger to themselves". A nurse specialising in mental health and a plainclothes police officer, usually. They'll come to the home or place in the community and talk with the person and concerned relatives/friends and decide how to proceed from there. If the person can't get through a conversation explaining how they're going to address their basic needs going forward, they might get committed for further evaluation. "mental health crisis team" and "assertive community treatment" are things to search for to see if something like that exists in your area.

But it is, practically, still very hard. As I understand it, it has as much to do with shortage of psychiatric hospital beds as an unwillingness to commit against a person's will. When a moderate-severe case presents and they've done their overnight evaluation and file to leave, a physician can block that and start a legal process for prolonged involuntary treatment. But physicians are faced with an ugly choice here. Is it really bad enough to justify using one of very few available beds? Keeping in mind that there are many people who want to be hospitalised and are waiting for a bed.

Generally, I think you highlight one of the biggest holes in the system. A person has to degenerate for quite some time before it's severe enough that there might be an intervention. It would be much preferable to arrest the slide before they're homeless and isolated and malnourished. The damage caused in the meantime can often not be reversed fully even if assertive treatment is begun and carried through with.

cloudedcordial 3y ago ↗

There was a healthcare reform at around the 1970s concluded that the individuals must consent to receive treatment. I don't know the details of the before-and-after of how the healthcare systems provides the services. Nowadays, the adults can refuse medical treatments: One of the family friends considered not receiving an organ transplant and it's ok. I don't know if one can be forced to receive treatment for infectious diseases such as tuberculosis. Even if there's a rule, I don't know if such a rule is enforced.

Perhaps the hole in the healthcare system is that the practice assumes that all adults have a sound mind and can make decisions. Having a rule to force people to do something (such as taking vaccines) put a bad taste in many people's mouths. We Canadians are too nice to tell someone that the fault is on you - As an employer, we could just document how the job does not "fit" someone instead of telling them that "you have a mental illness."

Indeed, my friend's acquaintance (let's call them "G") has run into law enforcement at least twice. An arrest may not be a strong reason to get a psychological evaluation. For one of those incidents, the police called my friend at 10pm asking if G lives in the address. My friend told the police that she knew G but they didn't live here. The police thanked my friend for the info but could not disclose how or why G was with the police at that moment due to privacy laws.

There are organizations in the community providing mental health services. They all required the person to agree to receive the service.