Mental Health Industry Corruption Within The Usa!

[anthony]

Is it just me, or has the mental health industry within the USA gone completely nuts with corruption through over-diagnosing people with things they just don't have? I suspect it about getting people in the door for counselling & medication prescription, to generate revenue for themselves, in an attempt to avoid as much as possible the financial issues within the country.

When I start seeing people coming onto this website with a PTSD diagnosis because their partner cheated on them, I really begin to wonder about the integrity of the US mental health system at all. Other countries all around the world are suffering due to the Global Financial Crisis (GFC), but it seems the USA went that step further, and decided to shift into corruption for self capital gain across the mental health industry.

Any type of physician, in my view, is a person you look towards as a morally sound person, someone of statue you are trusting with your health, with your secrets (in the case of mental health), of which I know nobody who expects to be exploited for capital gain. In most countries it is simply illegal and the mental health practitioner would lose their qualification to practice, yet it seems stupidity is coming primarily from the USA.

Researching DID, PTSD and CPTSD for instance, no other country in the world has significantly changed in the levels of patients diagnosed, ie. if you stub your toe, your not diagnosed with PTSD, or because you feel sad, depression, etc. It seems only the US is having these epidemics of PTSD, CPTSD, DID and so forth, yet funnily enough, the treating practitioners also as a majority are in private practice, scooping up enormous sums of money from insurance. Do you wonder why the US insurance system is the way it is? And when I say epidemic, this is ruling out the military aspects of PTSD due to deployments. These are civilians who are being classified as epidemic.

Why am I raising this? Well... the primary reason is due to my own decisions on where I shift the forum towards, based on what occurs with the mental health industry. For example, when this forum started many years ago, those being diagnosed with PTSD where those who met the first two criterion for starters, being they are veterans, sexual abuse, sexual assault, serious MVA's, survived a building collapse in earthquake, where in a serious natural disaster and escaped with their life barely, mugging at knife or gun point, kidnap, hostage, etc. These are the serious trauma's as defined by psychology as abnormally traumatic life events, being outside the normal expectancy of what is endured in life.

Normal is expected that relationships come and go, everyone must die, so losing a grandparent / parent of old age does not fit abnormally traumatic, it is reasonably expected to break a bone/s when growing up in childhood, to be bullied in school to societies view of normal, to explore sexually as a child with other children of same / similar age, and the list goes on. These are not abnormally traumatic events as deemed by psychology. If it is reasonably expected in a lifetime, then it is normal, thus does not fit PTSD.

Saying that, society broadens definitions as we learn, as society grows, though where is the line in the sand drawn? Where do I draw the line in the sand running this forum for some of the stupidity from diagnoses out of the USA at present, which can only be seen a capitalism and profiteering through misdiagnosis. Go and have a look at some depression forums, they are seeing the same things as seen here, where people are being diagnosed with major depression, or depression in general, because they feel sad at that given time. Feeling sad is an act, a motion, its not part of depression. Feeling sad and being depressed, two very different things. Anxiety forums... same being seen... the list again continues.

Where has patient best reasonable care gone? Where did in the best interest of the patient go? When did pharmaceuticals as the first line of defence for things become normal? When did diagnosis become a cool thing in order to generate revenue occur? Lets face facts, anyone who has been on an anti-depressant will tell you that the majority make you more depressed than without them. Whilst this happens in pieces all across the world, the US is the primary offender when you review diagnostic statistics.

------------------------------------ Line In Sand -------------------------------------------

The average global percentage for lifetime PTSD is around 5% - 7%. These are the worst cases, also being most here who participate. The average percentage for diagnosis of PTSD is typically around 10% - 12%. The USA is hitting up around 30% diagnosis, but their lifetime percentage has not changed, which means they are diagnosing PTSD more than 150% of original statistics, then claiming that entire percentage go into remission after months of treatment, which is also being reflected in more recent studies, also showing 100% treatment rates no longer meeting PTSD after 3 months of treatment, ie. remission. Really? :eek: I want some of what their getting if that's the case.

So where do I draw this figurative line within the sand for this forums future direction?

Well... as the DSM V criterion has now amended and taken care of this major issue with a significant change in the wording of the PTSD and ASD diagnosis, it seems there is no requirement for me to extend this forum to cater the broadening of what some physicians are currently performing of PTSD, as it will all come to a stop very shortly, as the new diagnostic criteria is now being used for performance feedback across the globe. So whilst the current misinterpreting of criteria continues through self broadening, its life is extremely short, and fundamentally end as the DSM V criterion begins to role through. You can see from the immediate difference, what change this will make to the PTSD diagnosis and has removed the self broadening abilities for the most part:

DSM IV Criterion A (Must be Met)

The person has been exposed to a traumatic event in which both of the following were present:

1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
2. The person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior

DSM V Criterion A (Must be Met)

The person was exposed to one or more of the following event(s): death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation, in one or more of the following ways: **

1. Experiencing the event(s) him/herself
2. Witnessing, in person, the event(s) as they occurred to others
3. Learning that the event(s) occurred to a close relative or close friend; in such cases, the actual or threatened death must have been violent or accidental
4. Experiencing repeated or extreme exposure to aversive details of the event(s) (e.g., first responders collecting body parts; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.

That is a major difference between initial criterion that must be met, through the wording. It has immediately limited the diagnosis to the following traumatic circumstances: "death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation". There is no inbetween in those words. #3 really hits home the entire surrounding possibilities for learning of the event, and exclusively limiting it to specific people who you had some emotional connection with for serious injury, and more specifically, "must have been violent or accidental" in nature. Very clear, concise wording that can no longer be interpreted to someone who's spouse has cheated on them, or stubbed their toe, or learnt the friend of a friend of a friend killed themself and want to use that to malinger or self label.

I love that ASD has finally filled the gap as well, being:

DSM IV Criterion Acute Stress Disorder (ASD)

The person has been exposed to a traumatic event in which both of the following were present:

1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
2. The person's response involved intense fear, helplessness, or horror

DSM V Criterion Acute Stress Disorder (ASD)

The person was exposed to one or more of the following event(s): death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation, in one or more of the following ways:

1. Experiencing the event(s) him/herself
2. Witnessing, in person, the event(s) as they occurred to others
3. Learning that the event(s) occurred to a close relative or close friend; in such cases, the actual or threatened death must have been violent or accidental
4. Experiencing repeated or extreme exposure to aversive details of the event(s) (e.g., first responders collecting body parts; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies or pictures, unless this exposure is work related.

Along with 14 symptoms, eight of which must be met... ASD will hopefully begin to fill its gap correctly between posttraumatic stress and posttraumatic stress disorder.

Frustrated? Yes. Optimistic towards the future of the diagnosis? Absolutely.

 

[intothelight]

Anthony,

I agree with everything you have written, but nothing will change here until "integrity", and not "greed", is put back into the mental health care system. There are huge profits for the drug companies in finding the next miracle "feel good" pill. The sheer number of anti-depressants that are prescribed, and the increase over the past twenty years, should be nothing but a source of embarrassment to the medical field.

The sad thing is resources will become strained and the people that really need the therapy will be left out in the cold. Already the VA is overwhelmed, and private practice will take the private insurance that has the best provider pay rate. So many veterans are just fed a cocktail of meds without sufficient follow up.

That is why this site and the information it provides is so critical.

Keep fighting the good fight.

Deb

 

[cherryblossom]

Sadly (from my perspective), the USA still has a massive influence over the rest of the world. The www clearly has a place, but it also sends out so many 'untruths' to the world. And it's my opinion that alot of these, when it comes to health care, originate in the US. I don't say that to offend people who live in the USA, but it really does seem to be the case. I think it has evolved because it is a first world country where ciizens are expected to pay for their health care. Simply, the vast amounts of money involved in health care, leads to all sort of 'false', or badly researched claims, in order to make money.

The human race want to protect their health, and many will try to do so, whatever the financial cost. This leads to all sorts of badly researched information, that is then sent world wide over the web, in order to make money, often from vulnerable individuals.

I just hope that the governing bodies, maintain their standards, so that the 'sufferer' of any ailment can access relevant, correct and useful information to their condition.

On a more personal note, it worries me greatly that PTSD is 'thrown about' in conversation, and almost 'joked' about. I have been frequently aware of the phrase "Posttraumatic Stress", being used in soap opera's and UK drama's, over the last few months. Generally as some sort of joke, which does nothing to give validity to genuine sufferers.

 

[anthony]

The research and validity is demonstrating that most other countries haven't changed their standards, except the US. I have to give credit to most countries for not lowering their own medical standards. It is all primarily coming from the US surrounding the dilution and misdiagnosis of mental health all of a sudden. It was like some of the research I came across on DID, and its all coming out of the US... and the facts backup that its motivated through private practice. DDNOS for example, which is given if you have symptoms outside of DID and the other handful of dissociative disorders, is correct, however; if you said you have DDNOS or from a physician, are treating someone with DDNOS, nobody would care nor give a second glance. If you have fought to fit a person into the DID diagnosis instead, and pushing for it to broaden its scope, then you can obtain prominence and statue within both your profession, and as a sufferer, as proven most with DID love to tell others they have it, when in fact they don't. Those who truly do have it, are like those with real PTSD, being its kept as quiet as they can without bringing attention to themselves. True DID sufferers are no different than that of PTSD sufferers... except extremely rare and unlikely you would ever truly meet someone with actual MPD.

In private practice, practitioners in the US are charging health insurance approximately $25,000 per annum to treat, so if greed is your motivation, then diagnosing DID to anyone who is convinced they have it, or faking having it, is in their best interest. Their morals have gone out the door, and hopefully insurance companies do more stringent investigations into health claims from these practitioners.

The people coming onto this forum of late, being diagnosed with PTSD because of a relationship breakup, cheating partner, a friend of a friend died, and they are being diagnosed with PTSD. Seriously... these practitioners should have their licenses pulled, their qualifications yanked, and never be allowed to practice in the health industry again. I think psychiatrists who have shifted from actually performing some psychiatric work with their clients to this 5 - 10 minute appointments at $200 each, to re-prescribe medication, also should be reviewed. That promotes an industry of prescribed medication vs. mental health treatment and care. They have zero intentions of ever wanting you to stop taking medication, whether you need it or not, because in these short appointments it would be physically impossible for them to obtain a clear clinical assessment on whether the person even required to be medicated any longer, or whether they should be tapered off at that point, as they have lost touch with the ongoing mental health of that patient, and instead opted for a prescription refill relationship.

Its not a broad brush statement, but those who fit within it, know it. Those who are patients of these physicians, also know it. Action should be taken against them IMO.

The USA needs to take lessons from Germany, who have the opposite approach, being you have to seriously be ill for them to recognise official mental health issues. They aren't ignorant to them, but they don't just hand them out, which is proven to promote malingering.

 

[Deleted member 5760]

Yeah it does s*it me I must say. Not because I don't have sympathy or empathy for the pain of someone who stubbed their toe --- but because, well, when resources are limited it takes away from genuine cases. I think that's exactly why someone with genuine PTSD has to jump through so many loopholes (unneeded STRESS) - because there are so many people claiming it who simply do not fit the criterion.

I KNOW it sounds horrible and unsympathetic - but sometimes I wanna look at someone who says something like 'yes, so and so said they were depressed and didnt want to be alive anymore' and go 'ohhhhh right. Watch a human body fall 5 storeys onto concrete and THEN we'll talk'

(god that sounds horrible hey)

The other thing I don't think people understand is that my reaction does not come from a sense of wanting to prove my pain is bigger than their's. If it were a competition - I'd be more than happy for someone else to take first prize!!

Another comment I will make in relation to this thread - and I can only speak for myself:

I played it down.

Not on purpose. I don't think I realised how bad my circumstances were. It took me 2.5 years to get diagnosed. I had other people (including an ex) say to me 'I think you've got PTSD' and I'd look at them like they were mad. I wasn't lying. I was in complete denial. I did not want to be in that line! Well now here I am and I cant stand it. And I wouldn't wish it on my worst enemy.

 

[PerfectEmpire]

I abhor the DSM and the current state of our healthcare system. According to the DSM there are 50 things wrong with me and all of them are endogenous, when in reality the symptoms are the result of chronic, twisted, childhood psychological abuse. Where's my recognition? At least people with combat PTSD can have one, clear, formal label. Those of us with CPTSD are left in the dust. I suspect that this is because "why add a diagnosis where the problem isn't something that can easily be medicated?"

CPTSD is a "there is something wrong with society" diagnosis rather than a "some people are born with xyz and need medication" or "sometimes bad things happen to good people" diagnosis. Do you see what I'm saying? They have no interest in treating us unless it's easy money. And why make a label so that you can diagnose something if you can't make $$$ off of it? Also, to formalize CPTSD would imply to society that certain maltreatment of children is unacceptable. In the US, most people still think it's okay to hit their children. To formally imply that currently lawful practices (yes, lawful, especially in Texas) are indeed harmful beyond all mentionable belief by formalizing CPTSD criteria would be socially unacceptable.

Sorry, reading this just really upset me. Partially because it reminds me of the sorry state of our system, but mostly because it makes me feel as if my suffering is being invalidated because I do not clearly and easily fit into the PTSD label...and looking through the DSM-V site, I see no improvements that are relevant to me. If I missed something, let me know. Because I am really, really upset and feeling terribly invalidated by the system. Where's my pretty, happy label for everything I've been through? Without a DSM diagnosis that defers my issues to "trauma", I feel as if everything is my fault and I'm just some guilty, bad fraud of a person who deserves to suffer because she's a "fake".

All in all, I guess I don't need a document to tell me that I'm suffering. The validation from my husband and therapist is what really makes the difference in the grand scheme of things. Still, this post has left me rather incensed and offended (not by you personally).

 

[anthony]

PE, there is no such label as CPTSD, so you should have officially been diagnosed with PTSD already, and likely added with a dissociative disorder or more like, Axis II personality disorder, which is what CPTSD really is about in the first place.

I believe the new structure of the PTSD label has changed sufficiently to correctly place childhood abuse within it. I was never sure that CPTSD should have its own label, because then where do stop! Combat PTSD, Rape PTSD, Complex PTSD, etc etc. If you begin reaching out into new versions, you begin opening a very nasty box that will likely collapse down the road as everyone wants to expand their label with new symptoms to be recognised uniquely, instead of all recognised collectively.

I wouldn't say the DSM IV invalidates CPTSD, because it was written in 1994 and Judith Herman only just started bringing to light the complexities with childhood / longevity of trauma in 1992, being more at the public spotlight and APA attention. There was a text revision in 2000, but still not even close to enough time for anything to significantly change. Lets face it, it takes medical atleast a decade or more of discussion and trial to make a decision on something. They do that for protocols and consumer safety.

Whether CPTSD makes it or not, we'll wait and see, but I do doubt it considering its not out for use in the trials already... so that would make me conclude that the expansion of PTSD into more children is the end result, along with the new PTSD diagnosis for those under 6 years of age, which is still called PTSD.

CPTSD does already fit, being PTSD + Personality Disorder/s. That is the complexity outcome for long term trauma, being a personality disorder majority occurs, and at the lesser spectrum, a dissociative disorder NOS or such.

 

[kers]

Anthony, can you explain where the PTSD rate of 30% comes from?

 

[catjudo]

I think psychiatrists who have shifted from actually performing some psychiatric work with their clients to this 5 - 10 minute appointments at $200 each, to re-prescribe medication, also should be reviewed. That promotes an industry of prescribed medication vs. mental health treatment and care.

I honestly believe it is our insurance industry that has driven this shift. Insurance companies do not want to pay for a psychiatrist to do more than med management. If you want to see someone for longer than 10-15 minutes, then they want you to see a therapist (=cheaper) for that. Problem is when you're seeing a psychiatrist for only short visits they don't get the whole picture and can miss important things. In my experience, the only psychiatrists left in this country who see patients for full length appointments and actually talk to patients, provide some therapy and understand what is really going on with the patient are psychiatrists who do not accept insurance. If they accept insurance then the insurance company gets to dictate how they practice medicine. By not accepting insurance they can care for their patients in the way that they best see fit. Unfortunately, most people in our country cannot afford to pay $200+/visit with a psychiatrist instead of a much lower co-pay to see a psychiatrist who accepts their insurance.

 

[anthony]

Anthony, can you explain where the PTSD rate of 30% comes from?

Pick your source.... its only getting worse, and I was being kind actually, as its anticipated being a lot higher than 30%, for example alone:

PTSD statistics in children and teens reveal that up to more than 40% have endured at least one traumatic event, resulting in the development of PTSD in up to 15% of girls and 6% of boys. On average, 3%-6% of high school students in the United States and as many as 30%-60% of children who have survived specific disasters have PTSD. Up to 100% of children who have seen a parent killed or endured sexual assault or abuse tend to develop PTSD, and more than one-third of youths who are exposed to community violence (for example, a shooting, stabbing, or other assault) will suffer from the disorder.

When you begin adding up the groups alone, (children, adolescents, adult) they don't come close the the lovely generalized statement often made of 7% - 9% of Americans will endure PTSD within their life. Actually, the facts are vastly different than that, being 7% - 9% are likely to permanently suffer PTSD. This doesn't even account for those diagnosed and gone into remission for symptoms over months or a year or two.

When you begin looking broader, across the world, the permanent stats average out a bit lower, as other countries bring down the US stats slightly, to more reasonable 5% - 7% will permanently endure PTSD for the remainder of their life, during their life. It could be 30, 40, 50 years of age... nobody can definitively prove such things.

Jump into Google Scholar and begin reading through journal studies, how they have 100 PTSD patients in the trial and 80% + no longer fit PTSD... the numbers don't make sense in those such studies, or even close to making sense when you begin adding up the bits and pieces on PTSD, group numbers, etc. I don't think we really know the true number right now, but the US is out of control with its diagnosis of PTSD... and hopefully the DSM V changes will stop that in its tracks, changing the stats back to the existing: 3% - 5% will suffer PTSD permanently, 10% - 15% will endure PTSD at some point in their lives.

The stupid thing to all of this, is that most posttraumatic stress dissipates by itself through nothing other than time, which is proven in many studies who use wait list as their placebo, and often around 40% - 70% of the wait list will no longer have PTSD symptoms between 3 & 6 months waiting.

 

[goingonhope]

Any type of physician, in my view, is a person you look towards as a morally sound person, someone of statue you are trusting with your health, with your secrets (in the case of mental health), of which I know nobody who expects to be exploited for capital gain.

If only our views and what clearly ought to be, ..matched what is. Whether it's the US MH systems, medical system or health insurance industry here, this all is too damn real, and too damn scary. Excuse me, but this, it and the corruption it's all so

sad, and hurts the many, (countless hurt); That's what it is,

sad.

 

[amethist]

PTSD caused by cheating spouse, never in a million years.

I kicked my ex husband out in 1994, and was diagnosed with depression. I was given mild anti-depressants and counselling. I was also told to go to work, look after my girls the best I could, keep busy, don't sit wondering what I had done wrong. I had not done anything wrong it was him not me.

I was heart broken at that he had done this to me, was left with 2 girls one 9 one 12, a house with a mortgage to pay and unpaid bills to catch up with. It took me 2 years to get back on my feet properly.

But my life was never in danger, nor were my girls. Devastated, hurt, lonely and depressed yes, but that was as bad as it got.

Did I meet any of the DSM IV or V criterion. Did I heck as like.

So who ever has suggested that being cheated on by anyone can cause PTSD needs serious re-training on what can and does cause PTSD.

Amethist