This does bring up the other inherent issue: state licensing boards are in theory guided by the ethical code of whatever.
This is the kicker. Doesn’t matter what the APA or anyone says if your state doesn’t feel like going along with their requirements. (I don’t think any providers in Oklahoma are investigated for anything barring a rape with physical evidence).
This is where the whole relationship of everything comes into play:
In a situation like that the role of the APA is to put pressure on the state acting poorly. If the APA fails in this role it is the role of professionals within the state and across the country to put pressure on the APA to act. Obviously this does not occur
How does one organize to put pressure on the APA then….
I don’t understand how the troubled teen industry is allowed to exist. I don’t know if there needs to be some kind of regulation on licensing requirements or what.
The federal government doesn’t regulate; there’s so many ways for them to avoid state regulation. You’d think - the TTI typically traumatizes survivors in a way that leaves them opposed to all forms of mental health care - this needs to be a priority for investigation and research.
There also needs to be a serious push on protections and oversight of inpatient facilities. Especially with the way that the current administration is likely to use institutionalization as a tool for political purposes. I’m familiar with how inpatient facilities work in two states, and have both seen the long term damage and experienced it myself. Patient safety is a serious concern, especially considering that the most vulnerable cannot advocate for themselves.
It is probably how I’m going to get disappeared, so it is a very pressing concern.
Well practitioners who are members of the APA/ACA/etc have the most sway. Writing opeds, participation in meetings, submission to calls to action, becoming more involved in the organization. Like any political action really you have similar challenges: how do you organize members? Except here it’s a bit different; a great deal of membership is in agreement that conversion therapy is abhorrent. But like governmental political action leadership is often hesitant to make serious moves
The troubled teen industry is a different issue. The worst examples of these facilities often operate outside of regulation. The thing is there are regulatory concerns for certain facilities but then there are loopholes around this. If I open an inpatient residential facility I have regulatory guidelines to follow. If I open a “camp” for troubled teens the regulations are much more relaxed, basically nonexistent.
Inpatient facilities that operate properly are a different story. These are fairly heavily regulated in most states but the regulations can vary wildly. However even in states where regulations are more strict it is often cash starved on the side of regulatory oversight. Ie the bodies that exist to ensure regulatory compliance have little money. This is addition to the programs themselves being poorly funded (and often the funding being unfairly distributed)
The solution to mental health treatment is such a multifaceted problem. People don’t want this; they want a simple line. Increased funding would help, but it wouldn’t solve it. In many cases it would simply be absorbed into private equity and administrative salaries. Increased regulation would help but if you just do this it won’t do much because the programs cannot cope without the funding, training, and increased staffing. Additionally regulatory bodies would need the teeth to actually enforce. And this doesn’t even touch upon the health insurance component that is necessary to be reformed heavily so people can access these (absurdly expensive) services without being bankrupted
That last point is key. These services are absurdly expensive. Inpatient on the low end can be 10k per month and as much as 60k a month. People don’t want to pay for this and politicians know this is a class of people that can easily be erased for massive healthcare savings (at the benefit of funneling them into private prisons instead, which is absolutely disgusting, but politicians are scum)
Say one wanted a career change to mental health policy and advocacy - what kind of terminal degree would be taken seriously in these conversations? Or what are the avenues for laymen to be listened to?
I’ve experienced horrendous shit, advocated for people experiencing horrendous shit, seen shit…. My state does not give a flying fuck.
I just do not understand why so much mental health policy and practice seems counter to helping people.
Policy and advocacy? Maybe masters of public health
That said as someone who’s worked as a licensed counselor for over a decade one of my pet peeves is when someone gets an MPH and all of a sudden is an authority because they spent two years learning about “the issues”. It’s kind of like the MBA who comes into a company and is like “oh it’s pretty cool what you’re doing but I know everything because I learned that making more money is great!”
That said it does give you some cred. Ultimately the biggest thing is networking, like all things in life. Get to know people and play the game of “hey remember me from x! I’m doing x now and we’d love to x” it sucks but if you truly want to enact change you need people to know you and be on your side more than any letters
Pedigree and experience helps though. Just don’t get too bogged down in it. I’ve known people with my licensure (masters of counseling, lpc), that do work here. Plenty of psychologists, MDs and DOs, CRNPs, etc. they have the benefit of drawing on experience, which can be powerful.
I recently did some advocacy work and it involved writing an op-ed about my experience working in the residential inpatient system we are talking about here, for example. I have spoken to policy makers about what works and what doesn’t in this vein. I will admit it is unbelievably frustrating to speak to a politician who practices being super polite and nice to everyone. They hear you out and talk in empty platitudes, shake your hand, then vote for the insurance companies that you find out paid them $8,000 via open secrets. It’s disheartening but you keep trying, I guess
This is the kicker. Doesn’t matter what the APA or anyone says if your state doesn’t feel like going along with their requirements. (I don’t think any providers in Oklahoma are investigated for anything barring a rape with physical evidence).
This is where the whole relationship of everything comes into play:
In a situation like that the role of the APA is to put pressure on the state acting poorly. If the APA fails in this role it is the role of professionals within the state and across the country to put pressure on the APA to act. Obviously this does not occur
How does one organize to put pressure on the APA then….
I don’t understand how the troubled teen industry is allowed to exist. I don’t know if there needs to be some kind of regulation on licensing requirements or what.
The federal government doesn’t regulate; there’s so many ways for them to avoid state regulation. You’d think - the TTI typically traumatizes survivors in a way that leaves them opposed to all forms of mental health care - this needs to be a priority for investigation and research.
There also needs to be a serious push on protections and oversight of inpatient facilities. Especially with the way that the current administration is likely to use institutionalization as a tool for political purposes. I’m familiar with how inpatient facilities work in two states, and have both seen the long term damage and experienced it myself. Patient safety is a serious concern, especially considering that the most vulnerable cannot advocate for themselves.
It is probably how I’m going to get disappeared, so it is a very pressing concern.
Well practitioners who are members of the APA/ACA/etc have the most sway. Writing opeds, participation in meetings, submission to calls to action, becoming more involved in the organization. Like any political action really you have similar challenges: how do you organize members? Except here it’s a bit different; a great deal of membership is in agreement that conversion therapy is abhorrent. But like governmental political action leadership is often hesitant to make serious moves
The troubled teen industry is a different issue. The worst examples of these facilities often operate outside of regulation. The thing is there are regulatory concerns for certain facilities but then there are loopholes around this. If I open an inpatient residential facility I have regulatory guidelines to follow. If I open a “camp” for troubled teens the regulations are much more relaxed, basically nonexistent.
Inpatient facilities that operate properly are a different story. These are fairly heavily regulated in most states but the regulations can vary wildly. However even in states where regulations are more strict it is often cash starved on the side of regulatory oversight. Ie the bodies that exist to ensure regulatory compliance have little money. This is addition to the programs themselves being poorly funded (and often the funding being unfairly distributed)
The solution to mental health treatment is such a multifaceted problem. People don’t want this; they want a simple line. Increased funding would help, but it wouldn’t solve it. In many cases it would simply be absorbed into private equity and administrative salaries. Increased regulation would help but if you just do this it won’t do much because the programs cannot cope without the funding, training, and increased staffing. Additionally regulatory bodies would need the teeth to actually enforce. And this doesn’t even touch upon the health insurance component that is necessary to be reformed heavily so people can access these (absurdly expensive) services without being bankrupted
That last point is key. These services are absurdly expensive. Inpatient on the low end can be 10k per month and as much as 60k a month. People don’t want to pay for this and politicians know this is a class of people that can easily be erased for massive healthcare savings (at the benefit of funneling them into private prisons instead, which is absolutely disgusting, but politicians are scum)
Say one wanted a career change to mental health policy and advocacy - what kind of terminal degree would be taken seriously in these conversations? Or what are the avenues for laymen to be listened to?
I’ve experienced horrendous shit, advocated for people experiencing horrendous shit, seen shit…. My state does not give a flying fuck.
I just do not understand why so much mental health policy and practice seems counter to helping people.
Policy and advocacy? Maybe masters of public health
That said as someone who’s worked as a licensed counselor for over a decade one of my pet peeves is when someone gets an MPH and all of a sudden is an authority because they spent two years learning about “the issues”. It’s kind of like the MBA who comes into a company and is like “oh it’s pretty cool what you’re doing but I know everything because I learned that making more money is great!”
That said it does give you some cred. Ultimately the biggest thing is networking, like all things in life. Get to know people and play the game of “hey remember me from x! I’m doing x now and we’d love to x” it sucks but if you truly want to enact change you need people to know you and be on your side more than any letters
Pedigree and experience helps though. Just don’t get too bogged down in it. I’ve known people with my licensure (masters of counseling, lpc), that do work here. Plenty of psychologists, MDs and DOs, CRNPs, etc. they have the benefit of drawing on experience, which can be powerful.
I recently did some advocacy work and it involved writing an op-ed about my experience working in the residential inpatient system we are talking about here, for example. I have spoken to policy makers about what works and what doesn’t in this vein. I will admit it is unbelievably frustrating to speak to a politician who practices being super polite and nice to everyone. They hear you out and talk in empty platitudes, shake your hand, then vote for the insurance companies that you find out paid them $8,000 via open secrets. It’s disheartening but you keep trying, I guess