Seeking Help for a Mental Health Problem

The hardest part of overcoming a mental health disorder is recognizing that you have one. Many people go through life vaguely aware that something is wrong, but ignoring all of the warning signs. Since individuals with undiagnosed mental disorders have much higher rates of depression and poverty than the general population, it is imperative that anyone seeing signs of mental illness seek help. But many are afraid to go to a doctor or psychiatrist, fearing expenses, judgment or even the loss of their sense of self. Still, medical help is often the only way to return to normal function.

If you suspect you’re having mental health problems, you should first assess how long you have been showing them. If, however, the symptoms have been persistent since young adulthood, it is likely a mental disorder and will need psychiatric evaluation. Patients feeling anxious should remember that seeking help is not an admission of weakness, but more an attempt to improve daily life. You may need to shop around for a local psychiatrist who takes your insurance. If you have no insurance, call a few offices and ask them about programs for the uninsured. You may be surprised by your options.

Most psychiatrists have a working general knowledge, but specialize in certain topics such as abuse or anxiety disorders. If you can’t find someone in your area who works with your particular problems, don’t despair. A trained psychiatrist should recognize all but the most obscure of mental disorders, and know how to treat them. It may be difficult to open up to a stranger at first. It’s alright to wait for trust to build up before you begin tackling the big issues, but try to always be truthful with your therapist. You aren’t harming anyone but yourself if you mislead him or her.

Mental disorders can be a crippling, lifelong condition, but only if you let them. By seeking help, you can regain control of your own life and brain, and start to function normally again. Don’t wait for a wave of suicidal depression to see a doctor, and remember: mental disorders are not a sign of mental deficiency. It is important to visit the doctor as soon as possible, because the earlier you get help the more chance you have of getting better. A doctor may wish to run a MRI scan, an ultrasound scan and other tests on patients exhibiting sudden changes in behavior.

The Oregon Plan: Health Care Rationing in a Medicaid Population

The Oregon Medicaid program in the 1980’s instituted a type of rationing of health care that determined a finite list of services that were provided to an expanded number of recipients. This was novel in that it openly and overtly admitted that the resources available to pay for services in their state’s Medicaid program were limited, and that they were going to spend those dollars on the services that were determined to be the most cost-effective.

By doing this they attempted to provide a level of health care services to all residents who were below 100% of the federal poverty level, while reducing services for which the individuals currently receiving health care insurance through the state’s Medicaid program. The reduction was accomplished by not paying for services that fell below a cutoff for cost effectiveness of the service.

Essentially all health care services were analyzed and a measurement of the benefit and cost of the services was given a grade. All of the services were put into a list from the most value for cost being #1 on down to the least value for the cost. Then an estimate of the number of persons who would require the services was used to calculate the cost of each service. The number of dollars available for Medicaid was used to determine which of the services would be covered.

The services that were not covered were at times controversial, and at times heartbreaking. Certain transplants and therapy for some cancers brought great anguish to patients in need of these services. Initially the decisions about which services to cover were made based strictly on the best evidence available. As these various emotional issues came up legislation mandating coverage of various conditions eroded the integrity of the list of covered services.