Wednesday, September 18, 2019

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  • David,

    We have never met, but I want you to know what a tremendously positive and important role you played in my life after I was traumatized by an involuntary commitment a number of years ago. Finding MFI, reading your words and listening to your radio shows online gave me the comfort of knowing I was not alone in my experience. You spoke for me and gave voice to my feelings when I was too humiliated and ashamed to speak up for myself.

    Thank you.

  • Building on Stanley’s points:

    It’s important to point out that the financial savings from Open Dialogue, if they exist in the form of reduced hospitalization and medication costs, would accrue to state and federal medicare/medicaid budgets as well as to private health insurers. These savings would directly threaten pharmaceutical company revenues and would probably be a net loss for psychiatrists, as their billable time in the Open Dialogue model appears to be reduced (and their centrality to the team certainly reduces prestige and control over treatment regimens). So to get Open Dialogue approaches accepted in the U.S., one would first need to demonstrate that they can be effective here; that they produce significant cost savings compared to primarily pharmacological approaches; and then one would need to rally government and private insurers against pharmaceutical and medical interests in the inevitable lobbying battles that would ensue.

  • Ken,

    I always enjoy your insightful and honest posts, both on MIA and your own website.

    One point that could be added to your list of considerations is simply the great uncertainty about the long-term effects of drugs. Any given person simply doesn’t know if the substances they took in the past (plan to take in the future) made (or will make) their suffering worse. Those of us who have already taken the drugs will never have a definitive answer to these questions.

    My advice to your veteran friend: hang in there, but look elsewhere for relief. Drugs are a crapshoot you can lose.