Saturday, March 13, 2010

Kevvie's healthcare reform

Oh, pull-eeeze.
Health care is the easiest piece of crap to clean up and repair but no doubt the dipshytes in office will find a way of screwing everything to make a buck for their mates, to massage someone's over-blown ego somewhere and/or to keep in sweet with some farked up trade agreement with Upper Comebuckta West in supplying only their brand of napkins with all inedible hospital dishes.

Mental health needs to be separated from general health.
It needs to stand alone.
Yes, again.
We need to go back, if you will, in part to the 'old days' but without the bullshyte stigma, disrespect and power trips that were enjoyed by all and sundry (think hubbies getting quickie divorces, custody of kiddies and all the moolah by getting the missus declared stark staring bonkers).
All of the mental institutions ( aka the nut houses) were sold off to the highest bidder, bulldozed and the prime real estate turned into tract housing (yawn) while the bajillions that poured into govt coffers somehow equated 5 mental health beds in the local public hospital...
Ahuh.

Ask any doctor working in A&E at a public hosp what the major problem is with mental health patients and you'll find it is the fact there are 2 issues at work with each hosp admission, what is called a dual diagnosis; the patients have a mental disorder and use prescribed medication for awhile but it makes them feel blunted and dead, like they're cut off from those around them by a thick wall of glass.
So, instead of prescribed meds they start using non-prescription meds like alcohol....or illegal drugs.
This is called self-medicating and, soon, they're not self-medicating to control their mental disorder, they're self-medicating to feed their drug habit which is controlling them.
But on each admission to hosp the doctors have only the time, resources and budget to deal with the mental disorder...a band-aid solution of having them in for 1 week patched up, back on the meds (prescribed ones) then released to the big wide world.
Sometimes they might be escorted to a half-way house if they're waiting on a court appearance, sometimes they're escorted by the police straight down to the local cop shop to be charged, then (probably) released to go back to their ritualised routine behaviour of self-medicating.
Which (usually) involves breaking the law in some way but sometimes they're absolved of their crimes as they were 'under the influence of drugs at the time of the offence' therefore their judgment was impaired and they can't be held responsible.
Pfft.

Other times you have people attempting to gain help for their mental illnesses only to be brushed aside cos the local public hosp 5 token mental health beds are full, have been full for the past 12 months and will continue to be full for the next 12 years or until the world comes to a crashing halt.
The out-patient mental health system attempts to pick up the slack of those not hospitalised but again it's under-funded and not coping leaving many on a waiting list to see specialists for urgent problems that need addressing yesterday.
But that's ok cos when they flip right out they'll get the care and attention they need via the police/fire/ambulance/all of the above and then feature on the 6.30pm news to boot.
Or their victims will feature.

Private health, I hear you say?
Yeah, the maximum hosp stay is 2 weeks.
Oh, it makes such a world of difference to be able to turn years of mental illness around in a heartbeat, don't you think?
Yes, wishful thinking wrote that policy.
Which is why we used to fib about reasons for admissions.
After 2 weeks the payment from the private health chappies is 'stepped down', as in 'whoa that's a shyte-load less you're paying for me to get better despite the fact I have top private health insurance!'.
And the 'step down' rate varies with each diagnosis.
Medical diagnosis' had a better step down rate so we'd often determine a medical reason for admission for a psych patient we knew would need more than 2 weeks.
Reception staff knew it, we nursing staff knew it, the doctors knew it and the patients knew it.
Strangely, this wasn't covered in our nursing training.

Kevvie, fix the mental health system, you'll save a motza in prevention that you can channel back into other areas.
Like sticking batts in Garrett's belfry...

6 comments:

Debby said...

And when you get done fixing things there, get your hinder over to America and begin fixing out system. PLEASE.

Brian Hughes said...

"Yes, wishful thinking wrote that policy."

No...I think you'll find that greed ghost-wrote it, actually...like it does with most important and ultimately buggered-up decisions.

Cazzie!!! said...

I see this all first hand, you are talking my talk... and yet I feel like I speak on deaf ears when I make remarks..now I do not feel alone with my thoughts and feelings on this issue. Thankyou!

Andrew said...

Nice work, but isn't Kombucta spelt with a K? Maybe the old ways weren't great, but what is happening now seems worse.

River said...

Yes please, fix the health system. Also education.
Then there's the housing problem, with skyrocketing rents and less government subsidised housing since the old housing commission places are being repaired and sold off.

Jayne said...

Absolutely, Debby!
I'll be there on the soonest plane, please have bacon and eggs waiting :P

You mean to say that insurance companies are just there for making share holders a whacking great profit, Brian?
Kinda like a bank?
Which would explain why neither make people better.

Damn, was hoping you'd say there'd been some improvement, Cazzie :(

Medicate and forget, Andrew, cheapest, easiest and more streamlined for factory healthcare, hmph.

Ooo, careful, River, the Vic Govt is going into partnership to build more housing....*shudder* be afraid.

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