Mental Treatment and Therapy Guide, Page 1

Your questions about mental health treatment and therapy might be answered by this quick guide intended as a companion document for the “Guide to Mental Health Services: Decade of the Brain, NMHIC”.

Warning Signals

Many people are not sure how to judge when professional help for mental problems may be needed. There are some behaviors that may be signs of trouble:

  1. Is the person acting differently than usual? Could this change be linked to something that has happened recently? Any event, such as the death of a close relative, loss of a job, marital break-up, or even something positive — like a job promotion — can trigger a troublesome emotional reaction.
  2. Does the person complain of episodes of extreme, almost uncontrollable, anxiety or “nervousness”? One sign of an emotional problem is “free floating” anxiety that is unrelated to a normal concern, such as a child’s illness or a backlog of bills.
  3. Does the person become aggressive, rude, and abusive over minor incidents or talk about groups or individuals “out to get me”? If such remarks are made in all seriousness, and if violent behavior occurs, it is likely that help is needed and should be sought.

Any of these symptoms, if they persist or become severe, may suggest a need for professional help. Fortunately, early identification and treatment of the problems causing this behavior often can make these symptoms disappear.

What to Do in Emergency Situations

If a person becomes violent, gets completely out of control, or tries to commit suicide, there are several things you can do:

  1. In a dangerous or violent crisis, call the police. Often the police are the best equipped, most available resource, especially when violence has occurred or when there is a strong possibility that the person may do physical injury to self or others. Once the emergency situation has been brought under control, if the troubled individual is already in treatment, call his or her therapist.
  2. In a nonviolent crisis, contacting other resources may be the best choice. For example, if an individual hasn’t eaten for a substantial period of time and has become weak and dehydrated, call his or her physician or therapist. If the person doesn’t have one, get him or her to a hospital emergency room where there are doctors on duty — even if you have to call an ambulance to get there. Look in the Yellow Pages under “Ambulance,” or call the fire department or rescue squad. Look under the list of emergency numbers in the front of your phone book or call the operator if you can’t find a number in a hurry.

Emergency room doctors will treat injuries resulting from violence, a suicide attempt, or a drug or alcohol overdose. They may also be able to provide temporary help for an emotional problem, even if they are not mental health specialists. In addition, they will be able to tell you where and how to get further help.

If the person in crisis is a member of a church, synagogue, or temple, you may choose to call the minister, priest, or rabbi. Many members of the clergy are trained to deal with emergencies, or they can refer you to other sources of help.

You may choose to call a mental health or crisis hotline, drug hotline, suicide prevention center, “free clinic,” or Alcoholics Anonymous chapter, if your area has such services. Their telephones are often staffed around the clock. Look for a number in the list of emergency or community service numbers in the front of your phone book, or you can find a listing in the white-pages section of the Yellow Pages under “Suicide,” “Mental Health” or “Alcoholics Anonymous,” or ask the operator for help.

Another option would be to call the nearest mental health center. If it is not listed that way in the phone book, look under “Hospital,” “Mental Health,” or “Physicians” in the Yellow Pages. Mental health centers generally provide a wide range of services. Included in these are:

  1. 24-hour emergency service — day or night service available at hospitals or other mental health clinics.
  2. Outpatient care — a person goes into the center’s clinic for treatment that has been set up on a regular appointment basis.
  3. Inpatient service — a person stays at the hospital where care is provided.
  4. Partial hospitalization — a person might spend occasional days, nights, or weekends at the center, living at home and going to work as much as possible.
  5. Consultation, education, and prevention services — assist schools, community organizations, institutions, and businesses in dealing with mentally ill persons and in developing programs that help in the understanding and prevention of emotional disorders.

Treatment Methods

The goals of treatment are to reduce symptoms of emotional disorders; improve personal and social functioning; develop and strengthen coping skills; and promote behaviors that make a person’s life better. Biomedical therapy, psychotherapy, and behavioral therapy are basic approaches to treatment that may help a person overcome problems. There are many specific types of therapies that may be used alone or in various combinations.

Biomedical Therapies

Treatment with medications has benefited many patients with emotional, behavioral, and mental disorders and is often combined with other therapy. The medication that a psychiatrist or other physician prescribes depends on the nature of the illness being treated as well as on an assessment of the patient’s general medical condition. During the past 35 years, many psychotherapeutic medications have been developed and have made dramatic changes in the treatment of mental disorders. Today there are specific medications to alleviate the symptoms of such mental disorders as schizophrenia, bipolar disorder, major depression, anxiety, panic disorder, and obsessive-compulsive disorder.

Electroconvulsive Treatment

(ECT) is another biomedical treatment that can help some patients. It is generally reserved for patients with severe mental illnesses who are unresponsive to or unable to tolerate medications or other treatments. While ECT is most commonly indicated in the treatment of major depression, often with psychosis (delusions or hallucinations), it is also used in selected cases of schizophrenia. Severe reduction in food and fluid intake with little physical movement (catatonia), or overwhelming suicidal ideation, where urgency of response is important, are reasons for considering ECT as treatment of choice. Modern methods of administering ECT employ low “doses” of electric shock to the brain along with general anesthesia and muscle relaxants to minimize the risk and unpleasantness to patients.

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