Re: Suicides
 

Had not come across BPD before. It sounds horrific. Are you sufferer or a shrink? It's a tough issue on mental health costs, there is only so much public money to go around, and I suppose with MH the more provision there is there more take up there will be. Some cases will be legitimate but many will not. If the treatment is non-medicated, then the costs could in theory be reduced by increasing the number of therapists.

Re: Suicides
 

Thank you

Re: Suicides
 

Oh, I know that. Child Welfare issues used to be a large part of my practice. I stopped it as I was sick of the Courts taking everything the caseworkers said as gospel and not looking at the facts.

I simply wonder what can be done to address mental health issues, if putting them in an institution is wrong and leaving them in the outside world is wrong too. Does any country have a model system that should be adopted everywhere?

Re: Suicides
 

It tends to be the other way around. Medication is often used as the quick fix, where as counseling/therapy, which in many instances proves to be more beneficial is not so readily available and can (depending on length of treatment) be more expensive.

Re: Suicides
 

I suffer from it and currently untreated. I am pretty well known to the mental health system, I end up in the ER on a pretty frequent basis for one reason or another.

Anyhow in Canada only medication and psychiatrists are covered by and large, there are plenty of psychologists and therapists, but they are not covered.

Private out patient costs run around 120-170 per hour at a private facility, with group sessions running 96 per session over a 26 week period, so 96 a week.

In BC as far as I am aware only Vancouver General has a program covered by medical services, but last I was made aware, have to reside in Vancouver.

Mental health in Canada is largely community based, and you are restricted to what your community offers.

Community based mental health is supposed to be better, but really it just prevents people from getting help if they dont have the financial means to relocate to a community that offers what they need.

If I have a heart issue, they can send me anywhere in the province no issues, but with mental health getting care outside your community is difficult.


This is how my basic psychiatrist appointment goes, each visit lasts about 5 minutes.

The doctor will have the prescription already written out.

Typically just ask if I am suicidal, I say no or yes depending on my mood.

If I say no, I get prescription and leave.

If I say yes, doctor runs through a few questions to see if its safe to let me go, or if I should be sent to the hospital.

Psychiatrists in Canada and elsewhere no longer provide therapy as you see in movies and TV.

That takes time and effort and well the longer the spend with each person the less people they see, and thus their income goes down.

Re: Suicides
 

jsmith thanks so much for having the courage to talk about this.

Re: Suicides
 

Same format when I went to a US psychiatrist. I would say 2 mins max. He billed the insurance at $150 each time.

I was allowed therapy on insurance though.

Re: Suicides
 

Is there a scale of suicidal? I see many people talk about it on the media these days, recently an old BBC actor mentioned it in relation to a false charge that he might face. Obviously people with serious MH conditions are suicidal at times, but there must be scales of it?

I agree with ExKiwi that you are very brave to discuss this on the open forum. But education is a good thing, which I imagine is part of your reason. Please don't feel obliged to answer any of my questions if you don't want to. Even if for once I am "on thread topic".

Re: Suicides
 

Yes, there's a specific assessment procedure that is followed when someone presents with suicidal thoughts/intent etc, taking into account various factors based on their perceived level of risk.

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Thanks, and actually for those who thought I started the thread today - check the date;)

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+1

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As I have said, my daughter had to see a psychiatrist after I discovered she was self harming - this was at a stage where I was lucky if she didn't fly off the handle if I said, hello to her, let alone anything else, I couldn't talk to her at all, I then noticed cut marks - not something any Mum wants to see on a child.

Her Psychiatrist would see her for 30-40 minutes and then call me in to talk about a few things, write a prescription and off you go, come back in a month - (this was once we were over with the weekly sessions).

Both my daughter and I have had to see a completely different counselor for a completely different experience shall we say, I get at least an hour with her (daughter got signed off), sometimes two depending whether or not her next appointment cancelled.

So not all these people are get 'em in get 'em out.

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+2

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The only way to change things is to bring them into the open. For example, borderline personality disorder has one of the highest suicide rates of any mental illness, around 10%, yet treatment is very difficult to obtain in Canada if you cannot pay for it yourself.


Its probably the worst mental health condition to have treatment wise in Canada because of the lack of treatment, it simply exists in so few places and where it does exist and where it is covered by provincial health plans, the waiting lists can be 1-3 years long.

Good article here. BC oriented.

"“The current evidence is that treatment is effective, and the primary intervention seems to be some type of psychotherapy,” Livesley says. “But that’s not how most patients are treated, especially here; most are treated with medication. American Psychiatric Association guidelines for treating BPD recognize psychotherapy as the main treatment and pharmacotherapy used as adjunctive treatment. Interestingly, the new guidelines out of the U.K. [the National Institute for Health and Clinical Excellence] don’t recognize medication at all for BPD."

Re: Suicides
 

My wife worked in mental health assessment and admissions in Alberta and yes, a huge proportion of 'repeat customers' were BPD.

People were routinely fobbed off with medications, which although sometimes appropriate for secondary symptoms, never really addressed the BPD itself. So the same people would inevitably end up back at the psych unit, E.R or fairly often in police cells.(lots of homeless/street people are BPD).

Self harm/suicide attempts were, as you point out, very common, inevitably leading to stays on psych wards. The irony is, that by not offering sufficient long term psychotherapeutic treatments (DBT, SFT), mainly because of cost (and no doubt in part the Canadian, 'that's how we do it here' thing), the health authorities and other bodies probably end up pissing away far more money than if they actually provided the more appropriate treatments in the first place.