The Shortcomings of Health Care Part 2

The former director of the National Institute of Mental Health (NIMH), Thomas Insel, writes in his book, “Healing,” that although during his directorship countless medical breakthroughs led to reductions in death rates from heart problems and infections, the nation’s mental health crisis ballooned out of control. Today, suicide kills three times as many people as homicide, and this figure is only growing. The reason for this, Insel asserts, is that there is a “gap between what we know and what we do.” Specifically, the healthcare system is designed to help people only when they get sick; it does not prevent them from getting sick in the first place. In other words, the system ought to provide social services, rehabilitation, and job opportunities, and treat patients holistically: that is, treating them socially as well as biologically. In the current system, patients spend their time in one of three places – the homeless shelter, the emergency room, or prison. The first results in tragedies such as the death of Michelle Go, the second drains our resources, and the third perpetuates negative stereotypes and causes unnecessary and unjust suffering. Insel estimates that the current system costs us $1 Trillion a year (a lot!). Mental healthcare that does exist is often expensive or of low quality.

There is only one word to describe how the system is now: lazy. That’s one drawback of the rapid advancement of modern technologies and science – people often don’t understand how limited it really is, and assume that medicine can fix all our problems. I, myself, am guilty of this fallacy. It’s the same with climate change: it seems so far away until it happens right in front of you. While it’s true that neuroscience is a rapidly developing field, it is important to understand that the brain is an immensely complex and enigmatic organism, such that we’re probably not even close to understanding a tiny fraction of its inner workings. But we do, more or less, know how to help people with mental illnesses, and at that task we are failing horrendously. In Insel’s words, “We know what works, we’re just not doing it.” Well, it’s time for policymakers to start doing it.

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