(As Memorial Day approaches, pause for a moment of memory, not only for our soldiers who have died in war, but those related to our area of concern that have died all over the world from human rights violations).
Now that it may be apparent that human rights should cover not only the extremes but the everyday, and that human rights are relevant for managed care, what now? There may be some hope on the horizon. After fizzling out in the 1970s, before for-profit managed care, integrated care of psychiatry with medicine is gaining traction again. Putting more psychiatrists and other mental health clinicians in primary care settings, as well as vice versa, is being tested out in many new models, which hopefully will turn out to be more financially viable and sustainable. This would likely reduce stigma.
For another, by putting managed car and psychiatry into the larger framework of international human rights, broader even than medical ethics, we have another lens to assess managed care. Given the emotional weight of human rights, and given its focus on torture and other more extreme deprivation, if we can apply human rights to what seems like more mundane human rights violations in the USA, we may have a chance.
I might even go so far as to now suggest that mental healthcare may be one of the most essential, if not THE essential, human rights, for mental disorders often compromises what we can accomplish as human beings, as well as effecting our core identities. Certainly, it inhibits “life, liberty, and the pursuit of happiness”, among the “unalienable rights” in our own Declaration of Independence. For those with mental disorders, or whatever that may be called, to achieve more independence from the constraints of their illness, or more control in how to successful adapt to the changes, adequate and appropriate mental healthcare and help of any kind should be self-evident.
Speaking of the Declaration of Independence, we must then close with a political recommendation. What can take us to the next level of human rights and managed care” I would suggest that it could be something like a not-for-profit, managed single payer system, like Canada’s, but with some more not-for-profit management for quality and cost-effectiveness, all monitored by a consumer council.
As to the answer to the initial poll, perhaps it is now obvious: managed care BOTH hinders and benefits human rights. Like most powerful forces we have in the world, such as atomic energy, how this force is used is up to all of us.
Sad in Psychiatry: Affectionately called a "gadfly," and known as "da man in psychiatric ethics," Steven Moffic writes about what makes him sad about modern day psychiatry, and how to "treat" that condition so that we will become glad about what psychiatrists can do to help.