[androidgirl]

It's crazy how far behind the US is on mental healthcare.

I have been battling depression for a long while now. My insurance can only get me to see an in network therapist four times every year!!! I can only see a psychiatrist once every six months.

This is with paying an already ludicrous sum each month for healthcare. I feel like I'm burning money, the most pressing healthcare issue I have, I cannot get help for.

Regardless, I have been working really hard on improving alone.

[dorchadas]

I think there's two issues contributing to this in the US. The first is, obviously, as you mentioned, health care costs and insurance. But I think the bigger issue is stigma. Everyone talks about how it should be acceptable to go get mental healthcare, but it still isn't. A lot of it has to do with the culture of individuality and consumerism that has been forced down Americans throats since birth. I think it's especially bad for men (and I am not saying it's not bad for women, but I can only comment on my male perspective), as there's the thought that we should be able to hide our emotions and do it alone; that we should be able to overcome everything through sheer willpower. Basically, the Protestant mentality is driving us all insane. Sadly, I don't really know of any good way to go about changing social norms in this regard.

[philliphaydon]

There is a bigger issue in the US than health care cost and stigma. And that’s the kickbacks Doctors get for prescribing drugs to begin with. America has the single largest prescription drug problem in the world.

[jdietrich]

> I can only see a psychiatrist once every six months.

Most British patients with depression or anxiety have never seen a psychiatrist. The default is to treat in primary care, with only the most severely ill patients being referred to a psychiatrist. Patients often have to wait many months for specialist treatment, even if they have a severe and enduring condition like schizophrenia or bipolar disorder. Access to treatment for eating disorders is frequently rationed on the basis of Body Mass Index - if you're not literally on the brink of death, you're on your own. There are frequently zero beds available in mental health inpatient units in the entire country. Many patients experiencing acute mental health crises have been sent hundreds of miles for treatment, because there are no beds available anywhere near them.

Mental healthcare in the UK is a slow-burning crisis due to a lack of funding, increasing demand on services and a shortage of trained staff. Psychiatrists, psychologists and mental health nurses are leaving the NHS in their thousands. Suicide and homelessness amongst patients with mental health problems have risen sharply, with the police playing an increasing role in managing patients in acute need. All too often, there's simply no help available.

Against this background, I'm extremely sceptical about social prescribing. If it's anything like the Improving Access to Psychological Therapies programme that was supposed to revolutionise mental health care in Britain, it'll be the cheapest possible band-aid rather than a serious effort to provide better care.

https://www.theguardian.com/society/2017/jul/07/nhs-bosses-w...

https://www.nhsconfed.org/news/2016/10/is-mental-health-cris...

https://www.mind.org.uk/media/494424/we-still-need-to-talk_r...

[jm__87]

I've read and followed the advice in both "The Depression Cure" and "The Mindful Way Through Depression" and can say both helped quite a bit. I personally did not find that therapy did much of anything for my depression (though I will say CBT for sleep was a life saver for me, so it was worth it just for that).

Depression is a pretty tricky thing to deal with, but I personally find that keeping a daily meditation practice helps a lot. Ultimately, being more mindful throughout the day means you'll ruminate less and dealing with the psychological component of depression is like 90% of the battle. Mindfulness will not improve your life in any of the areas that might have led you to feel depressed in the first place (e.g. feeling alone because you are alone, feeling like you have not accomplished enough, etc), but it will allow you to break away sooner from the rumination associated with these feelings so you can work on improving your life in some measurable way instead of wasting time feeling miserable.

I also think depression can just be a tradeoff for some people with a given mindset. Some people are very hard on themselves when they fail. These people are probably going to have a better chance at being successful since they are always taking responsibility for their failures and trying to improve themselves, but they are also going to have a higher chance of becoming burnt out and depressed as a result of the high expectations they have placed on themselves. The state of being depressed is obviously extremely counterproductive to what they were trying to achieve in the first place - eventually the goals shift from trying to start that business or get that promotion to just trying to get out of bed in the morning, and ruminating on this setback only feeds the depression. Ultimately, cutting out the rumination is how to resolve this in the short term, and mindfulness is the tool for doing that. In the long term, these people need to realize they are only human and have limitations and figure out how to take better care of themselves or learn to not be so hard on themselves in the first place.