Mental Health and Resources

I'm on my Psych block now. I'll give my final thoughts on the rotation when I'm further into it, but for now, I'd like to take a minute to express my deep frustration with the availability of medical services in this country and my area in particular. Long story short, we need more beds, more services, and more resources in general.

I have plenty of frustrations about the medical system in general. That's kind of the point of this blog, to get those frustrations out constructively. A lot of my concerns relate to the actions of physicians as a group, as well as physician-dominated organizations including medical schools. I think we, as a profession, hold a lot more blame for the problems in medicine than we're generally willing to admit, and that we have a lot more power to push forth positive change than we currently exercise. I try to advocate for internal changes within the profession of medicine ahead of or in conjunction with changes outside of the medical profession. I especially try to avoid lobbying for more money to be thrown at any particular problem, because resources are finite and while money can paper over a lot of structural problems, they don't solve them either. Those structural issues need to be tackled regardless and doing so may remove the need for more funding.

Not so much when it comes to mental health. The state of mental healthcare in my region is receiving a lot of scrutiny, justifiably, due to a number of frankly horrible situations that have occurred recently or not-so-recently. A lot of these criticisms have been directed towards the government, particularly the provincial government, and I largely agree with those criticisms. Some of the criticism has been directed towards the hospital I'm training at, the physicians and other healthcare workers involved in care for those with mental health, as well as the school I attend. For once, I can't agree with these criticisms. The hospital has clearly tried to prioritize mental health. Employees and physicians have largely just tried to make the best of a bad situation, accepting what is objectively a poor situation because no better alternatives exist. Even the school has gone out of their way to increase the number of Psych residents to help with the workload and encourage more Psychiatrists to stay in the area.

When valuable 1-on-1 therapy is virtually impossible to achieve without insurance or significant independent funding, when long-term care facilities are routinely unavailable, when the mental health ward is operating above 100% capacity (even after accounting for those waiting for long-term care), when wait lists to see an outpatient psychiatrist are on the order of months or years... even monumental changes in the organization of services aren't going to cut it.

Psychiatry does have its share of problems that can be laid at the feet of physicians, of that I have no doubt. However, it's pretty clear that more resources are needed. I don't see mental health being substantially improved without more inpatient beds as well as more supports both in and out of the hospital.