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Re:Reinventing the E.R. for America’s mental-health crisis by outlace on Saturday July 22, 2023 @09:03PM (#36831586)
Something is seriously wrong with our culture the past 10-15 years to have contributed to such a dramatic rise in mental illness.
Re:Reinventing the E.R. for America’s mental-health crisis by nmfisher on Saturday July 22, 2023 @09:39PM (#36831786)
I can't talk about culture but in Australia, this definitely correlates with the spread of methamphetamine.

Meth-induced psychosis is a very real thing.

Re:Reinventing the E.R. for America’s mental-health crisis by LilBytes on Sunday July 23, 2023 @03:39AM (#36833333)
* * *
Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Sunday July 23, 2023 @03:39AM (#36833338)
So is methylphenidate-induced psychosis, mania, and suicidal ideation.
Re:Reinventing the E.R. for America’s mental-health crisis by zer8k on Saturday July 22, 2023 @09:07PM (#36831617)
Is there a rise in mental illness or more people simply being diagnosed now? We're more aware of mental illnesses, leading to more diagnoses, leading to what appears to be a spike in mental illness. I haven't dug deeply into this but I wonder if studies on this have attempted to separate the two. Psychology is notorious for it's crisis of reproducibility. I take everything related to mental illness with two heaping scoops of salt.
Re:Reinventing the E.R. for America’s mental-health crisis by bill_joy_fanboy on Saturday July 22, 2023 @09:38PM (#36831782)
One way to cut the nonsense is to look at things that can't be fudged.

Suicide is an example. You can't "overdiagnose" suicide unless you outright lie that it happened. The rate for suicide was something like 10/100K in 2001 and is hovering at 14/100K now. This is a significant increase.

If more people are killing themselves, it's almost certain that there are far more people are also miserable or struggling than there used to be.

This seems like pretty direct reasoning, but I suppose it could be flawed.

Re:Reinventing the E.R. for America’s mental-health crisis by duped on Saturday July 22, 2023 @09:47PM (#36831815)
> Suicide is an example. You can't "overdiagnose" suicide unless you outright lie that it happened.

People have been outright lying about suicides for a long time.

Re:Reinventing the E.R. for America’s mental-health crisis by bordercases on Saturday July 22, 2023 @10:28PM (#36832032)
If it's counted as an accident rather than a suicide then the numbers are still high.

If it's counted as a suicide rather than an accident then maybe. I would then ask who is lying.

If it's faking deaths then that's the coroner system which you would have to question.

Re:Reinventing the E.R. for America’s mental-health crisis by duped on Sunday July 23, 2023 @11:37AM (#36836338)
Or we have gotten better about recording suicide today and they were under-reported years ago.
Re:Reinventing the E.R. for America’s mental-health crisis by hezralig on Saturday July 22, 2023 @09:49PM (#36831829)
Do you mean in regards to under-reporting to save face?
Re:Reinventing the E.R. for America’s mental-health crisis by EgregiousCube on Saturday July 22, 2023 @10:03PM (#36831906)
"Died cleaning his gun" etc, yeah.
Re:Reinventing the E.R. for America’s mental-health crisis by Groxx on Saturday July 22, 2023 @11:56PM (#36832425)
You absolutely see this in insular communities - lots of attempts to hide abuses or family politics that led to a suicide, by hiding it behind accidental death of some kind.
Re:Reinventing the E.R. for America’s mental-health crisis by duped on Sunday July 23, 2023 @11:43AM (#36836392)
Yes. Also if you put yourself in the shoes of a coroner/investigator, how do you determine if it's a suicide vs an accident? And would you get the context you need from the family/friends/colleagues of the deceased, keeping in mind they might not tell you, or lie because they don't want their loved one to be remembered as someone who lost their battle with mental illness?

It's kind of undeniable that there's a rising mental illness crisis in the US and undoubtedly more suicides, but keep in mind that suicide, like all symptoms of mental illness, is hard to track accurately. Especially as the stigma towards mental illness is starting to cede.

Re:Reinventing the E.R. for America’s mental-health crisis by e1g on Saturday July 22, 2023 @09:48PM (#36831823)
Yep, suicide rates increased by 20-30% across all races, ages, and genders over roughly a decade between 2006 and 2018 https://www.cdc.gov/nchs/products/databriefs/db464.htm
Re:Reinventing the E.R. for America’s mental-health crisis by harimau777 on Saturday July 22, 2023 @09:52PM (#36831849)
I think you are probably correct that suicide is a decent proxy measurement. It is possible that it could be skewed by changes in how likely people are to honestly report suicide; as opposed to calling it an accident.
Re:Reinventing the E.R. for America’s mental-health crisis by bordercases on Saturday July 22, 2023 @10:28PM (#36832036)
In which case the skew is positive.
Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Saturday July 22, 2023 @10:44PM (#36832110)
If suicide is directly correlated to mental illness, then what of euthanasia and assisted suicide? Anyone who applies to end their own life would be incompetent to make that choice, due to mental illness.
Re:Reinventing the E.R. for America’s mental-health crisis by dredmorbius on Saturday July 22, 2023 @10:54PM (#36832167)
Those modalities should be discernable when looking at data by age (assisted death tends to occur at older ages) and, with a slightly greater data burden, comorbidities.

When looking at data, an otherwise healthy 20 year old, and an 80-something with multiple chronic and/or terminal Dx's, would stand out.

The challenge in looking at population-level data is that the Dx may well not be available, though other indicia might suggest this (e.g., residence is an assisted-living or long-term care facility). In practice, studies are frequently limited to available data, and proxies are frequently used. These may not be appropriate for specific individuals, but at scale, the law of large numbers and general correlation are your friends.

Re:Reinventing the E.R. for America’s mental-health crisis by bill_joy_fanboy on Sunday July 23, 2023 @12:03AM (#36832455)
Like you said, I think looking at younger ages is sufficient.

In 1999, teen (15-19) suicide was at around 8/100k, and it's now around 11/100k. It's lower in absolute numbers than in the general population, but there's still a disturbing uptick.

https://www.charliehealth.com/research/the-us-teen-suicide-r...

Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Sunday July 23, 2023 @01:17AM (#36832746)
It would be interesting to know how many people committing suicides were on SSRIs or antipsychotics, etc. at the time. These drugs are known to induce suicidal ideations (and ideations of violence, aggression, and homicide) and have carried black-box warnings. Sometimes, the cure is worse than the disease. Oh sorry, not a cure.
Re:Reinventing the E.R. for America’s mental-health crisis by Timon3 on Sunday July 23, 2023 @04:32AM (#36833558)
At the same time it would be interesting to know how many had these ideas before SSRI. If you've been feeling suicidal for a long time, and SSRIs haven't improved your condition, you might feel hopeless enough to commit the act - without SSRIs being any kind of cause.
Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Sunday July 23, 2023 @06:23AM (#36834037)
The fact of having a prescription for psychotropic drugs is a knowable thing, albeit jealously guarded by HIPAA and lawsuit-averse manufacturers. Perhaps it is less knowable whether the victims were taking those drugs and had "therapeutic" levels in their systems at time of death.

But it would be extremely unknowable whether or not they had experienced suicidal ideations, and how long they had had them. Because the most you will get is a note in the medical chart, based on a verbal claim by an unreliable narrator.

Re:Reinventing the E.R. for America’s mental-health crisis by Timon3 on Sunday July 23, 2023 @06:55AM (#36834218)
Then it seems like a pretty terrible idea to just assume they increase the likelihood of social ideation more than they prevent, no?
Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Sunday July 23, 2023 @08:19AM (#36834662)
Tell that to the pharmaceutical manufacturers who ran clinical trials, received guidance from the FDA, and have been required to black-box-label the drugs according to the suicidal ideations which were scientifically proven to increase due to taking the drugs. I don't know where you got "assume"?
Re:Reinventing the E.R. for America’s mental-health crisis by dredmorbius on Saturday July 22, 2023 @10:50PM (#36832144)
NB, this the fundamental reasoning behind Emile Durkheim's seminal and foundational work on sociology, Suicide: A Study in Sociology (Fr.: Le Suicide: Étude de sociologie, 1897).

The reasoning being that it's very difficult to hide bodies, and that statistics on suicide tend to point to some very deep-rooted pathology within a society.

Yes, it's possible to fudge those statistics somewhat (the distinction between "accidental" and "intentional" deaths being salient), but far less so than other indicia of psychological trauma, particularly at population levels (the focus of sociology).

<https://en.wikipedia.org/wiki/Suicide_(Durkheim_book)>

Re:Reinventing the E.R. for America’s mental-health crisis by NoMoreNicksLeft on Sunday July 23, 2023 @02:13AM (#36832959)
> Suicide is an example. You can't "overdiagnose" suicide unless you outright lie that it happened.

But you can do that. Throughout much of the 20th century (in the United States, at least), the cops might be willing to just call it an accident (he was cleaning his gun) or an unsolved homicide. Ostensibly to spare the family shame or to allow the family to bury them in the cemetery of their choice.

Furthermore, there seem to be factors that cause upswings and downswings in the suicide rate. There were alot more people jumping out of skyscraper windows in 1929 and 1930 than there were in 1925 and 1926, for instance (though we might expect the opportunity to have been roughly the same). Now, that doesn't directly rebut your argument here. But it would mean you'd need to show that if there is an upswing today that it has lasted longer or otherwise been worse than similar ones in the past, or that it doesn't seem to have the same sorts of causes.

If possible, it might actually be better to pick some other measurable event/behavior than suicide. Psychotic breaks, schizo episodes, or voluntary commitment.

Re:Reinventing the E.R. for America’s mental-health crisis by bmitc on Saturday July 22, 2023 @09:34PM (#36831760)
There is absolutely a rise. We live in a continually more digital and disconnected world, disconnected from each other and nature.
Re:Reinventing the E.R. for America’s mental-health crisis by coding123 on Saturday July 22, 2023 @09:22PM (#36831685)
I don't know there seems to be a few things culminating - the pandemic and inflation. There are a lot of people that did not get the $10-25k pay raise that was necessary. Lots of people have gone homeless. Being without a home is one reason you can lose your shit. Also with the pandemic a lot of loved ones are gone forever. Some lost parents that takes a huge hit on ones mental state.
Re:Reinventing the E.R. for America’s mental-health crisis by diogenescynic on Sunday July 23, 2023 @12:46AM (#36832607)
When I was a kid growing up in the '90s, there was only one visibly homeless person and he was just a schizophrenic guy who pushed a tv around in a shopping cart. Now, there are tent cities and visibly mentally ill using drugs openly in most cities on the west coast. Something has definitely changed.
Re:Reinventing the E.R. for America’s mental-health crisis by teekert on Sunday July 23, 2023 @03:12AM (#36833206)
Yesterday I spoke to a couple, they were having second thoughts about their holiday because there was no mobile internet and no wifi and they booked a week. At first I though their kids (11 and 16) were complaining (couldn't imagine otherwise), but no, it was the 40 y/o parents.

That's what addiction looks like to me, my wife and me were pretty shocked.

Re:Reinventing the E.R. for America’s mental-health crisis by babyshake on Saturday July 22, 2023 @09:08PM (#36831620)
At best, our technology messes with our heads somewhat. At worst, it leads to serious mental illness. Silicon Valley is creating the digital equivalent to forever chemicals in our drinking water.
Re:Reinventing the E.R. for America’s mental-health crisis by ProllyInfamous on Saturday July 22, 2023 @09:15PM (#36831657)
The juice ain't worth the squeeze.

Social media has disconnected us all.

DNGAF. Amen.

Re:Reinventing the E.R. for America’s mental-health crisis by keithalewis on Saturday July 22, 2023 @09:24PM (#36831704)
If you don't have anything to add to a discussion on social media then don't post.
Re:Reinventing the E.R. for America’s mental-health crisis by ProllyInfamous on Saturday July 22, 2023 @11:28PM (#36832321)
I'm just sharing personal perspective.

As a recovered uppers abuser (sober over 14 years) I am grateful to care more than most peopls are willing to in such an unjust society.

"It is no measure of health to be well-adjusted to a profoundly sick society."

Re:Reinventing the E.R. for America’s mental-health crisis by bombcar on Saturday July 22, 2023 @09:08PM (#36831622)
I wonder how much can be attributed to legalization/decriminalization of drugs. Because if someone is on drugs but that is “fine” now are the classified as a mental illness incident?
Re:Reinventing the E.R. for America’s mental-health crisis by dietketchup on Saturday July 22, 2023 @09:28PM (#36831727)
So you are talking about illicit drugs? Likely, none at at all. At least in the US, drug use is not considered sufficient to diagnose a mental illness. I'm honestly kind of confused by your question. What is a mental illness incident? I've never heard this term.
Re:Reinventing the E.R. for America’s mental-health crisis by flangola7 on Saturday July 22, 2023 @09:28PM (#36831725)
Have you actually googled this at all? This reads like a question made in total ignorance of legal recreational substances, as well as their effects.

I'm trying not to be insulting, but as someone who's social circle nearly universally consumes recreational drugs (not counting tobacco or alcohol), this comment is cringe-inducing how out of touch with reality it is.

To answer your question, 0% can be attributed to it. Alcohol has been legal forever, but medicine still recognizes what alcohol-related addiction, psychosis, and liver cirrhosis are. Medical diagnoses don't really care if the drug involved in a drug related symptom is legal to purchase or not. There are people who don't consume drugs of any kind and have many mental illnesses, and there are people who consume many drugs and don't have any mentally illnesses at all.

Re:Reinventing the E.R. for America’s mental-health crisis by dec0dedab0de on Saturday July 22, 2023 @10:25PM (#36832018)
It is well documented that marijuana can cause psychosis in some people that are predisposed for it. I know quite a few people, my self included, that started using cannabis way more often after it was legalized.

I think it's reasonable too assume that legalization of a formerly forbidden substance will increase overall use of that substance. I also think that it is reasonable to assume that increased use of a substance will increase the amount of people suffering the potential side effects.

That said, I think social media, the economy, the pandemic, pollution, and the war on terror drugs have done way more harm than legalized weed.

Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Sunday July 23, 2023 @08:26AM (#36834702)
Psychotropic pharmaceuticals can have strong interactions with legal and illegal drugs alike. If you're taking most types of these, you won't want to smoke pot or drink alcohol. Also, since you can't depend on the ingredients and dosages of illegal or unregulated drugs, there is really no telling what drugs you could or couldn't take in concert with your psychotropics.

And then there are questions of whether you'll tell your psychiatrist. I've seen a quite accepting, non-judgemental attitude about recreational drugs, but can you count on this to be consistent? Do you want this on record in your medical chart? Do you want to try and consistently lie about activities quite germane to your mental health?

Re:Reinventing the E.R. for America’s mental-health crisis by 1234554321a on Saturday July 22, 2023 @10:00PM (#36831893)
20 years ago a mental illness, now they changed the name and it’s not an illness anymore so everything is ok.
Re:Reinventing the E.R. for America’s mental-health crisis by edrxty on Saturday July 22, 2023 @10:47PM (#36832129)
Do you mind elaborating on what you're referring to so I don't have to assume the worst?
Re:Reinventing the E.R. for America’s mental-health crisis by AndrewKemendo on Saturday July 22, 2023 @11:22PM (#36832292)
9/11 and the Global War on Terror pretty much killed anything like optimism and kicked off the rise in authoritarianism worldwide.

Throw in the 2008 recession and collapse in generational mobility worldwide.

Add to that global media/internet access and increasing alienation with the increase in inequality worldwide.

Finally top it off with a fat pandemic and you have at least two generations (X and Millennials) totally get their future put on hold while everyone older cashes out.

Everyone younger is looking at all this in horror and are just waiting us out while innovating humor in the most refreshingly gallows way.

Re:Reinventing the E.R. for America’s mental-health crisis by diogenescynic on Sunday July 23, 2023 @12:45AM (#36832602)
It's the potency and accessibility of drugs, now you can get fentanyl or meth that are dozens of times more pure and cheaper and available all over with virtually zero consequences. If you want to use drugs, there are no cops or doctors who are going to intervene and your family can't just force you into rehab. This new reality is simply sum of the cumulative bad decisions we've made--get rid of mental institutions, make health care unaffordable, tie insurance to employment so mentally ill and drug addicts have a harder time getting access to treatment, the breakup of the nuclear family, more females working and less time to raise their kids, decriminalize drugs, decriminalize sleeping outside in public places, decriminalize theft... this is the end result.
Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Sunday July 23, 2023 @03:41AM (#36833352)
> get rid of mental institutions

which dispense drugs,

> make health care unaffordable

so patients can't afford drugs,

> getting access to treatment

which starts and ends with drugs.

Re:Reinventing the E.R. for America’s mental-health crisis by noelwelsh on Sunday July 23, 2023 @03:09AM (#36833187)
The root cause is, I think, inequality. See, for example, https://equalitytrust.org.uk/health

"A much higher percentage of the population suffer from mental illness in more unequal countries; differences in inequality tally with more than triple the differences in the percentage of people with mental illness in different countries.

Rates of depression in US states are associated with income inequality (after adjusting for income, proportion of population with a college degree and proportion over 65). The more unequal the state, the higher the prevalence of depression."

Re:Reinventing the E.R. for America’s mental-health crisis by NoZebra120vClip on Sunday July 23, 2023 @03:35AM (#36833315)
> income inequality

Then is this the corollary to "Money Can't Buy Happiness"?

Re:Reinventing the E.R. for America’s mental-health crisis by stevenicr on Sunday July 23, 2023 @01:55PM (#36837849)
or maybe the opposite? Or maybe I misunderstand the statement.

A lot of money seems to buy happiness, and when that pile of money is used to raise the price of housing / food / transportation - then those who do not have the big pile of money feel like they are hopeless and are often treated as such which has secondary effects.

Re:Reinventing the E.R. for America’s mental-health crisis by alex_lav on Sunday July 23, 2023 @03:21AM (#36833254)
I believe it is very clearly social media. Humans aren’t intended to have fake-insights into what people around them pretend to be doing