Mind The Flying Kippers

6 02 2011

Random Title? Yup, but then Random Title is one I’ve used before, besides, there may be someone out there in the world who looks at those four words, ducks and avoids getting savaged by vicious flying kippers.

So, I’ve been a little busy, not terribly busy (as the lack of completion on some of the linked pages in the above menu system will testify), but when your mind feels like it’s full of static ‘a little busy’ tends to be acceptable. The result is the theory of how things should go.

With regards to diagnosis I believe that the faster and accurate the diagnosis, the less cost incurred, not just in medical terms but in life terms. So the basis of my adjustment for diagnosis was as follows;

Primary care providers, commonly GPs in the UK, your family doctor elsewhere in the world, should have access to properly proven diagnostic systems. At the moment there is a common usage of the CORE system which scans for depression and anxiety, there are systems to scan for other mental health problems. Whilst these systems need to be properly meta-researched and tested, they can help prevent misdiagnosis at an early level. Don’t get me wrong, these are not designed to replace the rest of the system, but they should allow a faster transfer towards the proper diagnostic system for patients.

Also in reference to diagnosis is the concept that there may be a way to use an MRI scan, backed up with Voxel-Based Morphography, to detect the differences in those with the major conditions. Why use a method which would cost quite a bit of money? It’s because whilst psychiatrists are paid a lot of money, most of their diagnostic knowledge is based on the experiences of the patient along with their own knowledge which may be outdated thanks to the very rapid pace of advancements in the field. Instead of guessing, wouldn’t it be better to know? To have a first diagnosis without seeing the multiple diagnoses that is more common than some would like to admit.

Psychiatry should also be making room for psychology as it’s quite common for those with a psychiatric diagnosis to have a concurrent psychological issue going on. The sooner a psychologist is brought in for a view then the sooner any talking therapy can commence and possibly improve the rate at which people stick to the treatment profile and achieve recovery (not a term I’m fond of but it fits to a degree).

The care aspect of things is definitely important, only a little less if not equally as important as a fast and accurate diagnosis. Most of the care system is relatively well done but there is a few little modifications to what is.

‘Knowledge is power’ has for many centuries been the maxim of those in the know about such things, for mental health that is very true. Knowledge about what your diagnosis means can be quite sketchy thanks to the profesionals, the attitude seemingly being that their job is to diagnose, they don’t have the time to spell it out for you. With the amount of knowledge out there it should be possible to provide info packs to patients so that they can take info away, look at it at their leisure, and come back to ask questions later. A simple yet very helpful way to help.

Advocacy. I’ve said this for a long time that all mental health patients, especially the newly diagnosed, should have access to advocacy services as a prerequisite rather than by putting up a poster and hoping that no-one actually contacts them. As the impact of a diagnosis can be quite huge then it only makes sense to offer this in order to reduce any possible impact on the patient and those around them.

Finally it’s treatments time (cue dimming and brightening of the lights with a weird voice saying ‘Medication time. Medication time’). It’s quite simple and straightforward…

As well as the usual medication, there should be a definite increase in the application of talking therapies, something that even the UK government has been picking up on. There just needs to be more, far more with much faster access to it, it’s that simple.

Reckon that’ll do for now.

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4 responses

7 02 2011
Rachael Black

Null,
I’m in the US, so am not familiar with the CORE system.

When I was first diagnosed as ‘clinically depressed’ at age 30, it was only after physical diagnostic tests (ie blood tests, thyroid test, etc) that this was determined.
Wasn’t diagnosed as bi-polar until age 40.

When diagnosed as ‘clinically depressed’ (almost 20 years ago -smile-) psychiatrists not only prescribed meds but ALSO performed the clinical therapy.
My father was a psychiatrist and in his last years complained that if he had it to do over again now, he would never have gone into medicine.
The reason: he was no longer was able to spend time with patients and really help them, due to the way private insurance companies now work in the US. All he did the last 10 or so years was prescribe meds or -mostly- try to get patients off of their meds and into therapy.

These days If you are currently diagnosed as depressed, bi-polar, schizophrenic or as any other psychological disorder you MAY be able to go to the psychiatrist for meds and MAY be able to afford a psychologist for therapy. But if you’re like most Americans you have no insurance, and if you do it does not pay for the amount of care needed to HELP with these conditions.
Fucking sad state of affairs in this country for the mentally ill.

Your idea of an advocate is brilliant!
Not sure that the MRI procedure would be of much help, at least not yet. Hopefully some day.

Great thoughts. enjoyed this posting very much.

7 02 2011
nullfuture

Thanks Miss R, I guess that’s why Obama is trying to create a version of our NHS, it aint great care but it is care, and they tend to target things more than an insurance company ever would.

The CORE diagnostic method is simply a survey with tick boxes and then a little bit of maths to say how depressed or how anxious you are. Seeing as most people with bipolar initially complain of depression then this can lead to a misdiagnosis, as you know from experience.

As for the MRI, it’s closer to being useful than you think, a little more verification and VBM should be able to see the differences in the brain that are becoming accepted as valid method of spotting bipolar and schizophrenia. I’m not saying it’s 100% but it would certainly take guesswork out of the picture.

As for kippers… maybe you should spread the rumour about how the UK is plagued by hordes of viscious flying kippers and see how many people buy it.

7 02 2011
Rachael Black

heheheheheh. Will pass the word on Killer Kippers.

Need to read up on the VBM. Thanks for the heads up.

As for the new national insurance program proposed by Obama and approved (although gutted by the Republicans)….
It was voted DOWN by another house of our government 3 days ago.
Chalk up another reason to leave the US -sigh-
We will never have a health care system available to all citizens here. Americans think ‘socialism’ when they hear ‘national’ anything. Yeah, fuck Norway, Sweden and Denmark -face palm-.
Most people here don’t understand the difference between a societal, philosophical or economic difference. They immediately think “FASCIST!”

As for CORE: sounds like the battery of tests given (if you can afford to take them -seriously- because each test costs approximately $150.00 each) once you HAVE been diagnosed by a shrink.

Wish that the US would follow the UK and apply some of these tests PRIOR to general practitioners (family doctors, as you pointed out) just prescribing meds that may or may not help. CORE sounds like a good idea.

The standardized tests given here in the US are:
MMPI, MBTI, Revised Neo and a few others.
The government disability department (SSD) relies on the MMPI mostly. Naturally you can Wiki all of these.

When I was given the MMPI (to receive disability benefits -which come out of the taxes you have paid your entire life and allow you to live in a rat infested slumhole and eat dog food) I scored a prefect Bi-Polar. I WIN! -grin-

7 02 2011
Rachael Black

Oh, and LOVED the title. you do realize that maybe one percent of Americans know what a kipper is?!

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