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Who needs mental health care? Under the guidelines of the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association virtually any person could be diagnosed as having a mental disorder. What is the difference between the person who appears to be successfully dealing with their life, the person who requires individual or family counseling, and the person who requires more intensive interventions such as medication or hospitalization? For the most part the difference is a matter of degree, or severity of the problem.
One method of measuring a person’s need for mental health care is the “Global Assessment of Functioning” outlined by the American Psychiatric Association in the DSM. This assessment tool rates the person’s capacity to function in three areas of their life; family, social and work or school. A person who is having severe problems coping in two or three of these areas needs help; likewise a person who is only having problems in one of these areas, but the problems are so debilitating that the person is totally nonfunctional in that area also needs help. A person who is only having mild to moderate problems in one or two of these areas can usually copy without outside intervention. A good rule of thumb to use in considering mental health care is how comfortable the individual is with their situation. If the individual is satisfied with the way their life is going, then intervention is most likely not needed.
For those who feel that events or the stress in their lives have gotten out of control and beyond what they can handle, help is available. In seeking help, one must decide how much and what type of intervention is needed; the type of help sought should be tailored to the individual’s needs. When looking for mental health care it is best to seek help at the lowest, or least intrusive, level possible. Generally the help available can be divided into three categories. Lay assistance is the lowest level, then paraprofessional assistance, and professional assistance is the most intrusive.
Lay assistance utilizes the individual’s own support network of friends and family to meet their needs. Often the help available through talking with a trusted family member or friend is sufficient to help the person deal with everyday stressors and minor problems, and assist them in making decisions to improve their situation. The greatest benefits of this level of help is that the helper is familiar with the individual and often with the situation that is causing concern. The person offering help is usually of the same value and cultural system and is in the best position to understand the individual and their problem. Most importantly, there is already a relationship between the individual and the helper and some level of trust already exists.
Sometimes, however, due to the nature or severity of the problem, others involved in the problem, or a lack of personal supportive relationships, the individual finds themselves in need of more help than they can find at the lay level. Helpers in the paraprofessional category have some training and more experience in providing counseling that the lay person. The paraprofessional category includes ministers, teachers, coaches, school principals, human resource personnel (many companies now hire counselors to provide first-level care and referrals for employees needing mental health care). These individuals often have training in interviewing, basic counseling and providing referrals if further help is needed. Again the benefit is that the individual already has some relationship with the person providing care. The paraprofessional will be familiar with the person and already have information about their background. A paraprofessional that feels the nature or severity of the problem is beyond their scope of expertise will make a referral for professional intervention.
Professional intervention is usually the most expensive and intrusive form of mental health care. This category includes Psychiatrists, Psychologists, Licensed Social Workers, and Professional Counselors. At times the expertise and experience of a professional is required due to the severity of the problem. Professionals may use a combination of testing, individual or group therapy and medication to help the individual cope. It must be pointed out that while it is best to start at the lowest possible level when seeking mental health care, problems that are critical enough to be life threatening or severe enough to disrupt the person’s ability to function in any arena are serious and require immediate intervention by a professional. If in doubt as to the need for professional intervention don’t take chances. Make an appointment with a professional to discuss the situation and treatments options.
If it is determined that professional mental health care is needed, it is important that informed decisions are made in obtaining that care. There are a number of things to consider. Community Mental Health Centers offer the least expensive care available. Private practice caregivers can be much more expensive but often offer a higher level of experience and are usually more responsive in regards to scheduling and availability. In most areas emergency response treatment is rendered by the Community Mental Health Center whether or not the individual sees a private practitioner.
Licensing requirements for mental health workers have been established and are government regulated in most areas, but those requirements can vary greatly depending on the governing agency. The individual has a right to know the type of training and education that the caregiver has completed, and what their credential and licensing status is (many areas allow trainees or students to practice under the supervision of a licensed professional). If a mental health professional is reluctant to discuss or disclose their credentials seek a different caregiver immediately. Make sure that the difference between a Licensed Social Worker, Professional Counselor and Psychologist is understood (Psychiatric intervention is usually limited to medication and hospitalization), and that the individual is comfortable with the person providing care.
The client has the right to a second opinion and the right to seek treatment from the professional of their choice. When seeking help at most Community Mental Health Centers and larger private practice clinics the individual is usually scheduled for an intake interview to discuss the problem and possible interventions. Based upon that interview and availability of counselors, the individual is assigned to a professional for care. The client should be aware that they have the right to request a different counselor if they are not satisfied with the caregiver they are assigned to.
Once a professional is engaged and treatment begins it is usually best to respect the expertise of the professional and follow and treatment recommendations they may have. Considering that, the individual must never forget that it is their life that will be affected by the treatment and they must remain an active participant in planning and executing that treatment. If for some reason an individual cannot or will not follow the recommendations of the caregiver, the issue should be discussed openly and alternative treatments agreed upon.
The final issue to consider, is length of treatment. Professional caregivers should provide the individual with a treatment plan outlining the type of treatment proposed and the projected length of time treatment will take. This should be done within the first few visits. While this plan can be modified as needed, it is a contract between the individual and the professional, stating clearly what the responsibilities and expectations of both the individual and the professional are. The saying that “you get what you plan for” is especially true of mental health treatment. The success of treatment depends upon the quality and thoroughness of the treatment plan. Vague plans result in indifferent achievements.
Be smart, do the research, and take care in seeking mental health care. By doing this treatment can be a positive experience that is accomplished efficiently and effectively.
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