> There are no mental health facilities in the small town where I live.
There are some excellent suggestion in this thread, but the above comment seems inadequately addressed. The absence of adequate mental health facilities is a serious barrier. Virtual, remote and phone-based mental health interventions are useful tools, but often ineffective on their own. In-person support nourishes our need for connection. I say this from experience. My father, who lived in a rural setting and suffered from alcoholism, died unexpectedly after his in-person addictions support ceased during the pandemic and was replaced with phone-based counseling. Your situation differs in many important ways, but it is important to be realistic about interventions and their effectiveness.
In the absence of mental health facilities, I would encourage you to consider religious groups in your area. It's important to recognize that organized religion provides many social goods even if we may find their claims questionable. If organized religion is anathema to you, I would encourage you to approach it in a secular manner. Not as a source of truth but instead as a collection of myth, practice and wisdom that has nourished the souls of many before you.
I know this can be hard for some people to seriously consider, but I would encourage you to at least give it a try. I have never found a human settlement that had no religious group and often there are many to choose from. Consider finding the group with the most beautiful building or greatest reverence for particular human endeavor (art, music, meditation, etc). Once you find one you can tolerate best, then commit to it for a fixed period of time and take its rituals seriously. This means attending weekly sessions (all of them - you have the time), volunteering (build those connections), and ideally finding people you enjoy being with. And think seriously about the foundational document or creed that the group considers. Ancient creeds may be dressed up in religious wording but these sacred resources have guided humanity long before us and will do so for a very long time. You may find yourself enlightened when you consider that some of these ancient prophets and religious thinkers were struggling at the forefront of human thought to write down ideas for which words did not exist. At the very least ask "What are these authors trying to say?". Consider being charitable given billions of humans have found these religious ideas worthy of preservation over thousands of years. You never know, you might even come to value them too.
For example, one thing you will almost always learn from these ancient, sacred texts is that the good things of life such as a wife, children, home and meaningful work were attainable to men much, much older than you. These blessings of life can be yours as well.
You are never as alone as you think you are, and thing are never as hopeless as they seem. Getting started will be hard I am sure. Breaking the chain of negative thought will require effort. Life contains suffering and pain, yes. But the good things you desire are worth the struggle. If you can find nothing good in yourself to admire, then simply begin with admiring your desire for a wife, children, a home and meaningful work. These are admirable things and admirable is the man that desires them. My hope is you will admire yourself as I admire you.
I think that folks who live in a healthcare-wealthy region or are healthcare-wealthy themselves don't understand that a sizable chunk of Americans have neither mental healthcare nor the resources to fund prolonged therapy out of pocket.
And free practical, usable, community mental health does exist - but - again, mostly in healthcare-wealthy regions. In most US counties, residents tend to lack access to reliable public mental healthcare.
I imagine that's not what they would say unless the patient were already of a religious bent. The mental health benefits of going to church are unrelated to the religion itself, but are related to having a supportive community and regular socialization. There are many other ways of getting those benefits.
A good therapist would recommend whatever method the patient would be most likely to adhere to.
> People with psychiatric disorders need spiritual journeys. Spiritual journeys heal and cleanse the mind, heal and cleanse the soul. Do not try to strip that away.
No opinion on the article or yours but where are you getting this opinion? Why or how, do psychiatric disorders need spiritual journeys.
Not all people believe in spiritual journeys or are capable of it. There is noting scientific about what you're suggesting that I'm aware about as well.
> Or the part about There are "no mental health facilities in the small town where I live"
HN is hugely biased towards people who live in cities. A lot of the posters simply do not understand how a lot of us outside the cities live, and the resources they take for granted that we don't have access to.
For me the drive to the nearest therapist is measured not in minutes, but hours. That's impossible for someone who has to work full time.
> it's that there was a solution for the problems it is trying to solve. A community. And the friends that come with it.
Very wrong. I have some familiarity with therapy, and in a way, community is actually detrimental when it comes to mental disorders.
Depression is a typical example. When somebody suffers from therapy, friends (community) will give all sort of cheesy advice like "relax, go out, do sports". This is detrimental because it's frustrating, but especially, because it triviliazes a serious problem (people not going to therapy because of stigma, when they should, is a real problem).
No amount of community can address a problem like depression, and this should be crystal clear.
Mental disorders, like serious illnesses, require a knowledgeable and systematic approach in order to be addressed.
Surely, modern isolation is causing mental health problems in the population, but community may be the solution to those specific problems, not to disorders in general.
> please ASAP reach out to a professional. I am very sure such a hotline exists pretty close to you.
Okay guys. Please. Stop suggesting professional mental healthcare as if it's something pretty much everyone has access to. In most US counties, therapy exists for those who can afford pricey insurance policies or can pay out of pocket - and that's it.
Some hotlines are staffed with mental health pros. NSP Lifeline is one. Smaller ones tend to be staffed with local volunteers. Either way, a hotline call isn't a solution. It's crisis intervention, at most a single step.
Honestly, for people who live without access to mental healthcare, telling them to just go get professional help is is effectively sending them on a snipe hunt.
source: 30 years care giving for someone with mental illness in one of the thousands of poor US counties.
> But they [doctors] believe the causes are a tangled mix of economic, social and emotional problems that they — with 10- to 15-minute slots per patient — feel powerless to fix.
Would more time by doctors solve this problem? I expect not. People suffering from SLS need case workers, and training, and mental health workers, and something. But they probably don’t need doctors performing this task. It’s a hard problem to solve.
There’s an expression “they need Jesus” that I think fits, but not in a religious sense. People need help, but it’s a wicked problem because they really need a social support network. I’m not sure what the secular version of church is, but I think people need it to break out of a downward spiral by not having friends and family to help make good decisions and support when needed.
> provider services for mental health are much smaller than they could our should be to serve our population
As I responded to your sibling commenter, I don't think my original point was clear. I'm asserting that those existing provider services suck and are ineffective, and that what is needed is a paradigm shift in how mental health care is formulated and delivered, not a spread of those existing services.
> Yes, it is true if OP lives in America then the healthcare situation is a lot more difficult, but OP would already know that.
Speaking of suffering observations. Why do you assume most people who live in areas without available mental healthcare are aware of that?
> Practically every country in the world has some form of accessible mental health care.
The language there qualifies any country with a therapist. I think what you meant is that the vast bulk of the population, in all 195 countries (excepting a handful), has reliable, practical access to mental healthcare.
As I consider African populations and folks who live in economically disadvantaged South and Central American nations I find myself filling with skepticism over that claim.
> Sadly I live in a 3rd world country, where mental illness is not an illness. I can get little help from people. Our healthcare system simply doesn't work at all
My first suggestion would be to try and find professional help there, even if it's difficult. Did you search? Even if the healthcare system is bad, this doesn't mean that there are no good psychologists at all. If you've got nobody to ask, you can search for a professional association or for a college where clinical psychology is taught, and start from there.
> I am very sure that there is INITIAL help very close for free in terms of money;
A hotline call (where available) can avert an immediate crisis but is not able to address underlying challenges. Recovery needs extended time with mental healthcare professionals. All indications are that most of Earth's population doesn't have access to that. For them, the advice of "Just Go Get That Free Help" isn't helpful.
I'm not saying we shouldn't help. I'm saying that assuming they have access isn't helpful - unless we actually know they do.
To be helpful, we need to ask if they know of services in their area. If they don't know, we can offer to look if they're willing to share their general location. If we strike out (not unlikely), we can learn more about them and their region - see if some obscure solution can be unearthed.
It takes time to provide the help that folks actually need.
(note: Evidence that most of our 7.8 billion have reasonable access to usable mental healthcare is absolutely welcome).
>(And if it's sadness or fear or anxiety, expect to have everyone suggest spurious religious interpretations instead of physical explanations, which, honestly, as a devout Christian, I now find really damaging both to peoples mental and spiritual health.)
Yep, I've seen this with Christians: "you have mental problems because you have demons in you!" This kind of thinking is extremely common in rural America these days.
>If you aren't lucky, you may even need your own well.
Wells are pretty expensive. Sure, the water itself is free, but the electricity to run the pump is not, and even at the frequently cheaper electric rates that rural areas enjoy, it adds up.
>You'll also have to burn trash or contract a company to come take it.
When I was growing up in rural areas, the common thing was to save it all up and haul it to the dump yourself every week or so.
All in all, you make a lot of excellent points that remind me a lot of the time I've spent in rural areas.
>What's the alternative? Prayer circles? Ayahuasca tourist traps? Cannabis? Homeopathy? Give me a break.
PPD aside, if we're talking about the issues that psychiatry seeks to alleviate, every one of those 'solutions' has had thousands of advocates/adherents/patients that claim to have gained positive effect.
and before I get considered a proponent of any of those; i'm not -- but I recognize the cohort of people who claim to have gained benefit just as I recognize the group who claim to have benefited from psychiatry.
mental health needs not be a monopoly; many people go through issues that they fix through specific personal events or patterns that are specific only to them.
You can complain about the style of thinking that you encounter on HN without disparaging the things that have helped people outside of clinical settings.
Mental health and well-being is one of the most mysterious things that we study, if a suicide or otherwise bad decision is staved off by chanting in makeup and visiting exotic locations then so be it, that's what worked for them.
And another aside : psychiatry will never incorporate extreme things that may help certain individuals, nor should they -- but that means that the breadth of things that are helpful is greater than the breadth of things that will ever fall within the umbrella of clinical mental health; so you should probably hold off on judging things based on whether or not the industry has adopted them.
>I think part of the issue here is that, in the past, mental health institutions itself had their own huge issues. There was a large movement to move away from mental health institutions, at least in the US, in the 1970s as a result (https://en.wikipedia.org/wiki/Deinstitutionalisation).
There was a new generation of drugs people thought would end the need for institutions. I don't think they even considered the possibility people with mental illnesses would, in a state of mental soundness, decide not to take the drugs necessary to keep them there.
There was also a bit too much optimism when it came to assessing the effectiveness of the drugs.
>Perhaps consider that the problem is not as simple as it appears to you.
I dont think its a simple problem. It is one without an optimal solution. I just think the downsides of having the stuff around are preferable to having people ruining their mental health out of financial desperation.
I also believe that the reliability would go up with time, people are able to learn quite a lot.
> There is some segment of the population that would pity your perspective as the disillusionment of an abused spouse. I don't. I get it.
Thanks, I often wonder if this is healthy practice myself as it can be rather personally-abusive to be so mission-centric, but then I see the consequences of the alternative: consider how many people in the US alone consume psychotropic drugs just to cope with depression despite having access to so much of everything but being so inherently listless and distracted.
I won't bemoan about the pitfalls about the Human Condition, but I will say that despite the hardships and loss I still see this as a worthwhile endeavor and wish to be part of it all, especially when you understand the implications it may have for the Species if we get this right.
Which right now as we're seeing the blow-back of something significant (albeit minor in the grand scheme of outbreaks) like Coronavirus is really alarming.
>I think it's incredibly irresponsible to tell people that things like yoga, meditation, exercise and diet changes are a replacement for professional mental health help.
People probably made this kind of sentiment about lobotomies, and farther back things like bloodletting and leeches.
>Therapy is a mostly USA thing. Most cultures don't do it.
First off, that's a bold statement that I need something to back it up, unless it's just your opinion.
For the sake of argument, let's say it is true, though. Is the more likely reason that there are different societal pressures, expectations, and outlets inherent in different cultures, causing different mental health outcomes and needs?
There are some excellent suggestion in this thread, but the above comment seems inadequately addressed. The absence of adequate mental health facilities is a serious barrier. Virtual, remote and phone-based mental health interventions are useful tools, but often ineffective on their own. In-person support nourishes our need for connection. I say this from experience. My father, who lived in a rural setting and suffered from alcoholism, died unexpectedly after his in-person addictions support ceased during the pandemic and was replaced with phone-based counseling. Your situation differs in many important ways, but it is important to be realistic about interventions and their effectiveness.
In the absence of mental health facilities, I would encourage you to consider religious groups in your area. It's important to recognize that organized religion provides many social goods even if we may find their claims questionable. If organized religion is anathema to you, I would encourage you to approach it in a secular manner. Not as a source of truth but instead as a collection of myth, practice and wisdom that has nourished the souls of many before you.
I know this can be hard for some people to seriously consider, but I would encourage you to at least give it a try. I have never found a human settlement that had no religious group and often there are many to choose from. Consider finding the group with the most beautiful building or greatest reverence for particular human endeavor (art, music, meditation, etc). Once you find one you can tolerate best, then commit to it for a fixed period of time and take its rituals seriously. This means attending weekly sessions (all of them - you have the time), volunteering (build those connections), and ideally finding people you enjoy being with. And think seriously about the foundational document or creed that the group considers. Ancient creeds may be dressed up in religious wording but these sacred resources have guided humanity long before us and will do so for a very long time. You may find yourself enlightened when you consider that some of these ancient prophets and religious thinkers were struggling at the forefront of human thought to write down ideas for which words did not exist. At the very least ask "What are these authors trying to say?". Consider being charitable given billions of humans have found these religious ideas worthy of preservation over thousands of years. You never know, you might even come to value them too.
For example, one thing you will almost always learn from these ancient, sacred texts is that the good things of life such as a wife, children, home and meaningful work were attainable to men much, much older than you. These blessings of life can be yours as well.
You are never as alone as you think you are, and thing are never as hopeless as they seem. Getting started will be hard I am sure. Breaking the chain of negative thought will require effort. Life contains suffering and pain, yes. But the good things you desire are worth the struggle. If you can find nothing good in yourself to admire, then simply begin with admiring your desire for a wife, children, a home and meaningful work. These are admirable things and admirable is the man that desires them. My hope is you will admire yourself as I admire you.
Godspeed!
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